Chronic Pain Characteristics and Gait in Older Adults: The MOBILIZE Boston Study II.
Aging
Chronic pain
Cognition
Gait
Mobility limitation
Rehabilitation
Journal
Archives of physical medicine and rehabilitation
ISSN: 1532-821X
Titre abrégé: Arch Phys Med Rehabil
Pays: United States
ID NLM: 2985158R
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
27
02
2019
revised:
13
09
2019
accepted:
16
09
2019
pubmed:
22
10
2019
medline:
7
7
2020
entrez:
22
10
2019
Statut:
ppublish
Résumé
To investigate a proposed cognitively-mediated pathway whereby pain contributes to gait impairments by acting as a distractor in community-living older adults. A cross-sectional study of a population-based cohort of older adults. Urban and suburban communities in a large metropolitan area. Community-living participants (N=302) 70 years and older recruited from a previous population-based cohort. Not applicable. Gait parameters including gait speed, stride length, double support and swing characteristics, and variability were assessed under single- and dual-task conditions involving cognitive challenges (eg, counting backward). A joint pain questionnaire assessed pain distribution in the back and major joints. We examined pain-gait relationships using multivariable linear regression and bootstrapping mediation procedures. Forty-three percent of participants had pain in 2 or more musculoskeletal sites. Pain distribution was related to slower gait speed and other gait characteristics for all gait conditions. Associations persisted after adjustment for age, sex, education, body mass index, medication, and vision. Decrements in gait measures related to pain were comparable with decrements in gait related to dual-task conditions. There were no differences in dual-task cost among the pain distribution groups. Adjusted for confounders, pain-gait relationships appear mediated by selective attention. These findings suggest that chronic pain contributes to decrements in gait, including slower gait speed, and that it operates through a cognitively-mediated pathway. Further research is needed to understand the mechanisms via pain alters mobility and to develop interventions to improve mobility among older adults with chronic pain.
Identifiants
pubmed: 31634443
pii: S0003-9993(19)31306-1
doi: 10.1016/j.apmr.2019.09.010
pmc: PMC7050337
mid: NIHMS1542628
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
418-425Subventions
Organisme : NIA NIH HHS
ID : P01 AG004390
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG041525
Pays : United States
Informations de copyright
Copyright © 2019 American Congress of Rehabilitation Medicine. All rights reserved.
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