School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia. Arthritis and Osteoporosis Victoria, Caulfield South, Melbourne, Australia.
Institute of Bone and Joint Research, University of Sydney, Royal North Shore Hospital Department of Rheumatology, St Leonards, New South Wales, Australia.
Gerontologist. 2016 Apr;56 Suppl 2:S243-55. doi: 10.1093/geront/gnw002.
Persistent pain, impaired mobility and function, and reduced quality of life and mental well-being are the most common experiences associated with musculoskeletal conditions, of which there are more than 150 types. The prevalence and impact of musculoskeletal conditions increase with aging. A profound burden of musculoskeletal disease exists in developed and developing nations. Notably, this burden far exceeds service capacity. Population growth, aging, and sedentary lifestyles, particularly in developing countries, will create a crisis for population health that requires a multisystem response with musculoskeletal health services as a critical component. Globally, there is an emphasis on maintaining an active lifestyle to reduce the impacts of obesity, cardiovascular conditions, cancer, osteoporosis, and diabetes in older people. Painful musculoskeletal conditions, however, profoundly limit the ability of people to make these lifestyle changes. A strong relationship exists between painful musculoskeletal conditions and a reduced capacity to engage in physical activity resulting in functional decline, frailty, reduced well-being, and loss of independence. Multilevel strategies and approaches to care that adopt a whole person approach are needed to address the impact of impaired musculoskeletal health and its sequelae. Effective strategies are available to address the impact of musculoskeletal conditions; some are of low cost (e.g., primary care-based interventions) but others are expensive and, as such, are usually only feasible for developed nations. In developing nations, it is crucial that any reform or development initiatives, including research, must adhere to the principles of development effectiveness to avoid doing harm to the health systems in these settings.
持续性疼痛、活动能力和功能受损以及生活质量和精神健康状况下降,是与肌肉骨骼疾病相关的最常见问题,肌肉骨骼疾病超过 150 种。肌肉骨骼疾病的发病率和影响随着年龄的增长而增加。在发达国家和发展中国家,都存在着严重的肌肉骨骼疾病负担。值得注意的是,这种负担远远超过了服务能力。人口增长、老龄化以及久坐不动的生活方式,尤其是在发展中国家,将对人口健康造成危机,需要多系统应对,将肌肉骨骼健康服务作为一个关键组成部分。在全球范围内,人们强调保持积极的生活方式,以减少肥胖、心血管疾病、癌症、骨质疏松症和糖尿病对老年人的影响。然而,肌肉骨骼疼痛疾病严重限制了人们进行这些生活方式改变的能力。肌肉骨骼疼痛疾病与身体活动能力下降之间存在密切关系,这会导致功能下降、虚弱、幸福感降低和丧失独立性。需要采取多层次的策略和护理方法,采用整体方法来解决肌肉骨骼健康受损及其后果的影响。目前已经有有效的策略来应对肌肉骨骼疾病的影响;有些策略成本较低(例如,以初级保健为基础的干预措施),但其他策略成本较高,因此,通常仅适用于发达国家。在发展中国家,任何改革或发展举措,包括研究,都必须坚持发展有效性原则,以避免对这些环境中的卫生系统造成损害。