肌肉衰减综合征对运动治疗老年慢性腰痛患者最小临床重要差异的影响

Influence of muscle attenuation syndrome on the minimal clinically significant difference of exercise therapy in elderly patients with chronic low back pain

目的探讨肌肉衰减综合征对老年慢性腰痛(chronic low back pain,CLBP)接受运动治疗后最小临床重要差异的影响。方法选择2018年7月~2020年6月在本院就诊的163例CLBP患者作为研究对象,均给予运动疗法治疗,干预时间2个月。观察患者肌肉衰减综合征的发生率和治疗后疼痛VAS评分、功能障碍评分(Roland-Morris disability questionnaire,RMDQ)的最小临床重要差异(minimal clinically important difference,MCID)率,并观察肌肉衰减综合征对MCID的影响。结果163例中,共71例检查出肌肉衰减综合征,占43.55%。肌肉衰减综合征患者的年龄、疼痛持续时间、VAS、RMDQ均显著高于非肌肉衰减综合征患者,体质量指数显著低于非肌肉衰减综合征患者,差异均有统计学意义(P<0.05)。多因素Logistic分析显示,肌肉衰减综合征、年龄是MCID的限制性因素,文化程度是MCID的促进因素(P均<0.05)。结论肌肉衰减综合征可影响运动疗法治疗CLBP的MCID,临床应予以重视。

Objective To investigate the effect of sarcopenia on the minimum clinical difference in elderly chronic low back pain(CLBP)patients with chronic lumbago exercise.Methods From July 2018 to June 2020,163 patients with CLBP in our hospital were selected in the research.All patients were given exercise therapy for 2 months.The incidence of muscle atrophy and the minimal clinically important difference(MCID)rate of visual analog scale(VAS)and Roland Morris disability questionnaire(RMDQ)after treatment were observed,and the effect of muscle atrophy on MCID was observed.Results There were 71 cases of muscle atrophy in 163 patients(43.55%).The age,pain duration,VAS,RMDQ of patients with amyotrophy were higher than those of patients without atrophy,and body mass index was lower than that of patients without atrophy,the differences were statistically significant(P<0.05).Multivariate logistic analysis showed that muscle atrophy and age were the limiting factors of MCID,and education level was the promoting factor of MCID(all P<0.05).Conclusion Sarcopenia can affect the MCID of exercise therapy on CLBP,which should be paid attention in clinic.