Article

For older adults with mobility problems, one focus of rehabilitation
is treating the underlying neuromuscular impairment(s) that lead to functional
decline and disability. Knowing which neuromuscular impairments contribute to
basic mobility tasks among older adults with back pain will fill an important
knowledge gap and is a critical step towards developing mechanistically based
rehabilitative interventions. OBJECTIVE: To evaluate the relationship of
neuromuscular impairments with performance of mobility tasks among older adults
with and without back pain. DESIGN: Cross-sectional analysis of baseline data
from the Boston Rehabilitative Impairment Study of the Elderly. SETTING: Primary
care-based population. PATIENTS: Participants (N = 430) were older primary care
patients who completed assessments of neuromuscular impairments and mobility
tasks. METHODS: Back pain was assessed by the use of an established comorbidity
questionnaire. Neuromuscular impairments included trunk extensor muscle
endurance, kyphosis, leg strength, leg strength asymmetry, leg speed, mean
reaction time, leg coordination, and knee and ankle range of motion. MAIN OUTCOME
MEASUREMENTS: Mobility tasks included gait speed, standing balance, chair stand,
and patient-reported functional status. Analysis of covariance was used to
generate adjusted means for neuromuscular impairments that differed significantly
by back pain status. Separate multivariable regression models evaluated the
association between neuromuscular impairments and mobility based on back pain
status after we adjusted for sociodemographic factors and physiologic
impairments. RESULTS: Participants had an average age of 77 years, 68% were
female, and 31% reported back pain. Trunk extensor muscle endurance, leg
strength, and rapid leg coordination were significantly lower among those with
back pain compared to those without (P < .01, P = .01, P = .04, respectively).
Patterns of neuromuscular impairments that were associated with mobility tasks
differed according to back pain status. CONCLUSIONS: The neuromuscular impairment
profiles associated with mobility function among older adults with back pain vary
compared with older adults without back pain.
CI - Copyright (c) 2016 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS