Total physical activity and risk of chronic low back and knee pain in middle-aged and elderly Japanese people: The Murakami cohort study
Total physical activity and risk of chronic low back and knee pain in middle-aged and elderly Japanese people: The Murakami cohort study
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DOI：
10.1002/ejp.1535
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发表时间：
2020-02-25
影响因子：
3.6
通讯作者：
Nakamura, Kazutoshi
中科院分区：
文献类型：
--
作者：
Solovev, Aleksandr;Watanabe, Yumi;Nakamura, Kazutoshi
背景：体力活动的特定成分，如剧烈运动和繁重的职业工作，已知会增加慢性腰痛（CLBP）和慢性膝关节疼痛（CKP）的风险，但其他成分的影响鲜为人知。本研究旨在从公共卫生的角度评估总体力活动与CLBP和CKP风险之间的关系。方法参与者为7,565名40-74岁的个体，他们没有CLBP或CKP，并参加了为期5年的随访调查。在2011-2013年的基线调查中，使用自填式问卷获得人口统计学、体型和生活方式（包括体力活动）的信息，在随访调查中使用简明健康调查量表（SF-36）获得CLBP和CKP的信息。采用代谢当量小时/天（METs score）对职业活动中的坐、站、走和剧烈工作进行总体力活动评估，对休闲时间体力活动中的慢走、快走、轻中度运动和剧烈运动进行评估。MET评分较高的受试者发生CKP的风险显著较高（趋势p = 0.0089，第四个四分位数的OR = 1.29，95% CI：1.04-1.59 vs.第一个四分位数），但不发生CLBP。中等休闲时间METs评分与CLBP风险较低相关（OR = 0.75，95%CI：结论高水平的总体力活动可能增加CKP的风险，而中等水平的休闲时间体力活动可能降低CLBP的风险，中老年人总体力活动与CLBP和CKP之间的纵向关联缺乏显著性证据。我们进行了一项队列研究来评估这种关联，发现高水平的总体力活动会增加CKP的风险，中等水平的休闲时间体力活动会降低CLBP的风险。这表明身体活动对慢性疼痛的影响因疼痛部位而异。
Background Specific components of physical activity, such as vigorous exercise and heavy occupational work, are known to increase the risk of chronic low back pain (CLBP) and chronic knee pain (CKP), but impacts of other components are less known. This study aimed to assess the relationship between total physical activity and risk of CLBP and CKP from a public health perspective.Methods Participants were 7,565 individuals, aged 40-74 years, who did not have CLBP or CKP, and who participated in the 5-year follow-up survey. A self-administered questionnaire was used to obtain information on demographics, body size and lifestyle (including physical activity) in the baseline survey in 2011-2013, and on CLBP and CKP using Short Form 36 (SF-36) in the follow-up survey. Sitting, standing, walking and strenuous work for occupational activity were assessed for total physical activity, and walking slowly, walking quickly, light to moderate exercise and strenuous exercise were assessed for leisure-time physical activity using metabolic equivalent hours/day (METs score).Results Mean age of participants was 60.1 years (SD, 8.8). Participants with higher METs scores had a significantly higher risk of CKP (p for trend = 0.0089, OR of 4th quartile = 1.29, 95% CI: 1.04-1.59 vs. 1st quartile), but not CLBP. An intermediate leisure-time METs score was associated with a lower risk of CLBP (OR = 0.75, 95%CI: 0.61-0.92 vs. 0 METs-group).Conclusions A high level of total physical activity may increase the risk of CKP, whereas an intermediate level of leisure-time physical activity may decrease the risk of CLBP, in middle-aged and elderly individuals.Significance Evidence on the longitudinal association between total physical activity and CLBP and CKP in middle-aged and elderly people is lacking. We conducted a cohort study to assess this association, and found that high levels of total physical activity increased risk of CKP, and intermediate levels of leisure-time physical activity decreased risk of CLBP. This suggests that the effect of physical activity on chronic pain differed by pain site.