Локомотивный синдром: от парадигм до клинической реальности - Журнал Терапевтический архив №5 Вопросы ревматологии 2021
Локомотивный синдром: от парадигм до клинической реальности
Путилина М.В., Теплова Н.В., Лила А.М., Загородний Н.В. Локомотивный синдром: от парадигм до клинической реальности. Терапевтический архив. 2021; 93 (5): 613–621.
DOI: 10.26442/00403660.2021.05.200798
DOI: 10.26442/00403660.2021.05.200798
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Аннотация
Локомотивный синдром (ЛС) – это неудовлетворительное состояние пациентов старше 60 лет, которым требуется или может потребоваться посторонняя помощь в ближайшем будущем из-за функционального ухудшения опорно-двигательного аппарата, включающего патологию костной ткани, суставов, мышц и нервной ткани. В реальной клинической практике чаще приходится сталкиваться со следующими проявлениями ЛС: остеоартритом, саркопенией, нарушениями равновесия, хронической скелетно-мышечная болью. На сегодняшний день есть четкое понимание того, что терапия ЛС должна быть долговременной, включать комплексную поддержку мышечной ткани, тренировку баланса, обязательную когнитивно-поведенческую терапию. Максимальная безопасность длительной медикаментозной терапии может быть обеспечена использованием жизненно необходимых микронутриентов, к которым относятся высокоочищенные формы хондроитина сульфата и глюкозамина сульфата, имеющие широкий круг противовоспалительных и регенеративных эффектов.
Ключевые слова: локомотивный синдром, саркопения, остеоартрит, нарушения равновесия, хондроитина сульфат, глюкозамина сульфат
Keywords: locomotive syndrome, senile asthenia, sarcopenia, osteoarthritis, falls, imbalance, chondroitin sulfate, glucosamine sulfate
Ключевые слова: локомотивный синдром, саркопения, остеоартрит, нарушения равновесия, хондроитина сульфат, глюкозамина сульфат
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Keywords: locomotive syndrome, senile asthenia, sarcopenia, osteoarthritis, falls, imbalance, chondroitin sulfate, glucosamine sulfate
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3. Putilina MV. Risk factors, features of clinical course and treatment approaches in aged patients with cerebral stroke. Korsakov Journal of Neurology and Psychiatry. 2011;111(5):90-5 (in Russian)
4. Lee Y, Kim J, Chon D, et al. The effects of frailty and cognitive impairment on 3-year mortality in older adults. Maturitas. 2018;107:50-5. DOI:10.1016/j.maturitas.2017.10.006
5. Macfarlane GJ, Barnish MS, Jones GT. Persons with chronic widespread pain experience excess mortality: longitudinal results from UK Biobank and meta-analysis. Ann Rheum Dis. 2017;76(11):1815-22. DOI:10.1136/annrheumdis-2017-211476
6. Domenichiello AF, Ramsden CE. The silent epidemic of chronic pain in older adults. Prog Neuropsychopharmacol Biol Psychiatry. 2019;93:284-90. DOI:10.1016/j.pnpbp.2019.04.006
7. Matsumoto H, Hagino H, Wada T, Kobayashi E. Locomotive syndrome presents a risk for falls and fractures in the elderly Japanese population. Osteoporos Sarcopenia. 2016;2(3):156-63. DOI:10.1016/j.afos.2016.06.001
8. Tanimura C, Matsumoto H, Tokushima Y, et al. Self‐care agency, lifestyle, and physical condition predict future frailty in community‐dwelling older people. Nurs Health Sci. 2018;20:31-8. DOI:10.1111/nhs.12376
9. Castell MV, Van der Pas S, Otero A, et al. Osteoarthritis and frailty in elderly individuals across six European countries: results from the European Project on OSteoArthritis (EPOSA). BMC Musculoskelet Disord. 2015;16:359. DOI:10.1186/s12891-015-0807-8
10. Brown JC, Harhay MO, Harhay MN. The Prognostic Importance of Frailty in Cancer Survivors. J Am Geriatr Soc. 2015;63(12):2538-43. DOI:10.1111/jgs.13819
11. Ishak NA, Zahari Z, Justine M. Kinesiophobia, Pain, Muscle Functions, and Functional Performances among Older Persons with Low Back Pain. Pain Res Treat. 2017;2017:3489617. DOI:10.1155/2017/3489617
12. Putilina MV. Comorbidity in elderly patients. Korsakov Journal of Neurology and Psychiatry. 2016;116(5):106-11 (in Russian) DOI:10.17116/jnevro201611651106-111
13. Yamada K, Kubota Y, Tabuchi T. A prospective study of knee pain, low back pain, and risk of dementia: the JAGES project. Sci Rep. 2019;9(1):10690. DOI:10.1038/s41598-019-47005-x
14. Veronese N, Stubbs В, Solmi М, et al. Association between lower limb osteoarthritis and incidence of depressive symptoms: data from the osteoarthritis initiative. Age Ageing. 2017;46(3):470-6. DOI:10.1093/ageing/afw216
15. Zunszain PA, Hepgul N, Pariante CM. Inflammation and depression. Curr Top Behav Neurosci. 2013;14:135-51. DOI:10.1007/7854_2012_211
16. Putilina MV. Modern ideas about the therapy of anxiety-depressive disorders in chronic cerebral ischemia. RMZh. 2011;9(19):569-73 (in Russian)
17. Zambon S, Siviero P, Denkinger M, et al. Role of Osteoarthritis, Comorbidity, and Pain in Determining Functional Limitations in Older Populations: European Project on Osteoarthritis. Arthritis Care Res (Hoboken). 2016;68:801-10. DOI:10.1002/acr.22755
18. Naumov AV, Khovasova NO, Demenok DV, et al. Age-related musculoskeletal diseases as a leading risk factor for falls. Lechebnoye delo. 2019;1:28-39. Available at: https://cyberleninka.ru/article/n/vozrastzavisimye-kostno-myshechnye-zabolevaniya-kak-veduschiy-fakt.... Accessed: 12.01.2021 (in Russian)
19. Putilina MV. Osteoarthritis in the practice of a neurologist: “old-new opportunities”. Neurology and rheumatology. Consilium Medicum. 2016;1:66-9 (in Russian)
20. Alexandre TS, Duarte YA, Santos JL, Lebrão ML. Prevalence and associated factors of sarcopenia, dynapenia, and sarcodynapenia in community-dwelling elderly in São Paulo – SABE Study. Revista Brasileira de Epidemiologia. 2019;21(Suppl. 2):e180009. DOI:10.1590/1980-549720180009.supl.2
21. Safonova YuA. Sarcopenia risk factor for falls and fractures. The Clinician. 2019;13(3-4):22-28 (in Russian) DOI:10.17650/1818-8338-2019-13-3-4-22-28
22. Ethgen O, Beaudart C, Buckinx F, et al. The Future Prevalence of Sarcopenia in Europe: A Claim for Public Health Action. Calcif Tissue Int. 2017;100(3):229-34. DOI:10.1007/s00223-016-0220-9
23. Yang M, Hu X, Wang H, et al. Sarcopenia predicts readmission and mortality in elderly patients in acute care wards: a prospective study.
J Cachexia Sarcopenia Muscle. 2016;8(2):251-8. DOI:10.1002/jcsm.12163
24. Cruz-Jentoft AJ, Bahat G, Bauer J, et al.; Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31. DOI:10.1093/ageing/afy169 (Erratum in: Age Ageing. 2019;48(4):601).
25. Livshits G, Kalinkovich A. Inflammaging as a common ground for the development and maintenance of sarcopenia, obesity, cardiomyopathy and dysbiosis. Ageing Res Rev. 2019;56:100980. DOI:10.1016/j.arr.2019.100980
26. Perkisas S, Baudry S, Bauer J, et al. Application of ultrasound for muscle assessment in sarcopenia: towards standardized measurements. Eur Geriatr Med. 2018;9:739-57. DOI:10.1007/s41999-018-0104-9
27. Leveille SG, Bean J, Bandeen-Roche K, et al. Musculoskeletal pain and risk for falls in older disabled women living in the community. J Am Geriatr Soc. 2002;50(4):671-8. DOI:10.1046/j.1532-5415.2002.50161.x
28. Lo-Ciganic WH, Floden L, Lee JK, et al. Analgesic use and risk of recurrent falls in participants with or at risk of knee osteoarthritis: data from the Osteoarthritis Initiative. Osteoarthritis Cartilage. 2017;25(9):1390-8. DOI:10.1016/j.joca.2017.03.017
29. Al-Aama T. Falls in the elderly: spectrum and prevention. Can Fam Physician. 2011;57(7):771-6 (Erratum in: Can Fam Physician. 2014;60(3):225).
30. Putilina MV, Baranova OA. Results of the multicenter clinical and epidemiological observational program “GLOBUS„ (determination of the prevalence of dizziness and assessment of therapy regimens at the outpatient level). Korsakov Journal of Neurology and Psychiatry. 2014;114(5):33-8 (in Russian)
31. Li Y, Liu M, Sun X, et al. Independent and synergistic effects of pain, insomnia, and depression on falls among older adults: a longitudinal study. BMC Geriatr. 2020;20(1):491. DOI:10.1186/s12877-020-01887-z
32. Putilina MV, Soldatov M. Cerebral strokes in old age. Features of the clinical picture, course, treatment. Doctor. 2006;5:29-34 (in Russian)
33. Ali A, Arif AW, Bhan C, et al. Managing Chronic Pain in the Elderly: An Overview of the Recent Therapeutic Advancements. Cureus. 2018;10(9):e3293. DOI:10.7759/cureus.3293
34. Ngamkham S, Vincent C, Finnegan L, et al. The McGill Pain Questionnaire as a multidimensional measure in people with cancer: an integrative review. Pain Manag Nurs. 2012;13(1):27-51. DOI:10.1016/j.pmn.2010.12.003
35. Lints-Martindale AC, Hadjistavropoulos T, Lix LM, Thorpe L.
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36. Nishimura T, Imai A, Fujimoto M, et al. Adverse effects of the coexistence of locomotive syndrome and sarcopenia on the walking ability and performance of activities of daily living in Japanese elderly females: a cross-sectional study. J Phys Ther Sci. 2020;32(3):227-32. DOI:10.1589/jpts.32.227
37. Klinicheskie rekomendatsii po vedeniiu patsientov so starcheskoi asteniei. “Rossiiskaia assotsiatsiia gerontologov i geriatrov”. 2018. Available at: http://uzrf.ru/userfiles/file/rokgvv/GeriatricCenter/01-1-astenia_recomend.pdf. Accessed: 12.05.2021 (in Russian)
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39. Putilina MV, Teplova NV. Medicinal safety as a priority area of domestic medicine. General Medicine. 2019;4:7-14 (in Russian) DOI:10.24411/2071-5315-2019-12152
40. Oganov RG, Simanenkov VI, Bakulin IG, et al. Comorbidities in clinical practice. Algorithms for diagnostics and treatment. Cardiovascular Therapy and Prevention. 2019;18(1):5-66 (in Russian) DOI:10.15829/1728-8800-2019-1-5-66
41. Putilina MV. Neuroprotective therapy for chronic Evaluation of topical therapy of patients with osteoarthritis of small joints of the hands with Voltaren® Emulgel® 2% (diclofenac diethylamine 2%) cerebral ischemia. Doctor. 2008;8:27-32 (in Russian)
42. Wanigatunga AA, Di J, Zipunnikov V, et al. Association of Total Daily Physical Activity and Fragmented Physical Activity With Mortality in Older Adults. JAMA Netw Open. 2019;2(10):e1912352. DOI:10.1001/jamanetworkopen.2019.12352
43. Putilina MV. Features of combined neuroprotective therapy for acute disorders of cerebral circulation. RMZh. 2009;17(4):261-6 (in Russian)
44. Verlaan S, Maier AB, Bauer JM, et al. Sufficient levels of 25-hydroxyvitamin D and protein intake required to increase muscle mass in sarcopenic older adults – The PROVIDE study. Clin Nutr. 2018;37(2):551-7. DOI:10.1016/j.clnu.2017.01.005
45. Nawai A, Leveille SG, Shmerling RH, et al. Pain severity and pharmacologic pain management among community-living older adults: the MOBILIZE Boston study. Aging Clin Exp Res. 2017;29(6):1139-47. DOI:10.1007/s40520-016-0700-9
46. Bannuru RR, Osani MC, Vaysbrot EE, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019;27(11):1578-89. DOI:10.1016/j.joca.2019.06.011
47. Gromova OA, Torshin IYu, Lila AM, et al. Molecular mechanisms of myoprotective action of chondroitin sulfate and glucosamine sulfate in sarcopenia. Neurology, Neuropsychiatry, Psychosomatics. 2019;11(1):117-24 (in Russian) DOI:10.14412/2074-2711-2019-1-117-124
48. Gromova OA, Torshin IYu, Leela AM, et al. Differential chemoreactom analysis of glucosamine sulfate and nonsteroidal anti-inflammatory drugs: promising synergistic combinations. Modern Rheumatology. 2018;12(2):36-43 (in Russian)
49. Ma H, Li X, Sun D, et al. Association of habitual glucosamine use with risk of cardiovascular disease: prospective study in UK Biobank. BMJ. 2019;365:l1628. DOI:10.1136/bmj.l1628
50. Bell GA, Kantor ED, Lampe JW, et al. Use of glucosamine and chondroitin in relation to mortality. Eur J Epidemiol. 2012;27:593-603. DOI:10.1007/s10654-012-9714-6
51. Honvo G, Bruyère O, Geerinck A, et al. Efficacy of Chondroitin Sulfate in Patients with Knee Osteoarthritis: A Comprehensive Meta-Analysis Exploring Inconsistencies in Randomized, Placebo-Controlled Trials. Adv Ther. 2019;36(5):1085-99. DOI:10.1007/s12325-019-00921-w
52. Railhac JJ, Zaim M, Saurel AS, et al. Effect of 12 months treatment with chondroitin sulfate on cartilage volume in knee osteoarthritis patients: a randomized, double-blind, placebo-controlled pilot study using MRI. Clin Rheumatol. 2012;31(9):1347-57. DOI:10.1007/s10067-012-2022-4 (Erratum in: Clin Rheumatol. 2014;33(10):1527).
53. Volpi N. Analytical aspects of pharmaceutical grade chondroitin sulfates. J Pharm Sci. 2007;96(12):3168-80. DOI:10.1002/jps.20997
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25. Livshits G, Kalinkovich A. Inflammaging as a common ground for the development and maintenance of sarcopenia, obesity, cardiomyopathy and dysbiosis. Ageing Res Rev. 2019;56:100980. DOI:10.1016/j.arr.2019.100980
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28. Lo-Ciganic WH, Floden L, Lee JK, et al. Analgesic use and risk of recurrent falls in participants with or at risk of knee osteoarthritis: data from the Osteoarthritis Initiative. Osteoarthritis Cartilage. 2017;25(9):1390-8. DOI:10.1016/j.joca.2017.03.017
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31. Li Y, Liu M, Sun X, et al. Independent and synergistic effects of pain, insomnia, and depression on falls among older adults: a longitudinal study. BMC Geriatr. 2020;20(1):491. DOI:10.1186/s12877-020-01887-z
32. Путилина М.В., Солдатов М.А. Церебральные инсульты в старческом возрасте. Особенности клинической картины, течение, лечение. Врач. 2006;5:29-34 [Putilina MV, Soldatov M. Cerebral strokes in old age. Features of the clinical picture, course, treatment. Doctor. 2006;5:29-34 (in Russian)].
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35. Lints-Martindale AC, Hadjistavropoulos T, Lix LM, Thorpe L.
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42. Wanigatunga AA, Di J, Zipunnikov V, et al. Association of Total Daily Physical Activity and Fragmented Physical Activity With Mortality in Older Adults. JAMA Netw Open. 2019;2(10):e1912352. DOI:10.1001/jamanetworkopen.2019.12352
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44. Verlaan S, Maier AB, Bauer JM, et al. Sufficient levels of 25-hydroxyvitamin D and protein intake required to increase muscle mass in sarcopenic older adults – The PROVIDE study. Clin Nutr. 2018;37(2):551-7. DOI:10.1016/j.clnu.2017.01.005
45. Nawai A, Leveille SG, Shmerling RH, et al. Pain severity and pharmacologic pain management among community-living older adults: the MOBILIZE Boston study. Aging Clin Exp Res. 2017;29(6):1139-47. DOI:10.1007/s40520-016-0700-9
46. Bannuru RR, Osani MC, Vaysbrot EE, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019;27(11):1578-89. DOI:10.1016/j.joca.2019.06.011
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49. Ma H, Li X, Sun D, et al. Association of habitual glucosamine use with risk of cardiovascular disease: prospective study in UK Biobank. BMJ. 2019;365:l1628. DOI:10.1136/bmj.l1628
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51. Honvo G, Bruyère O, Geerinck A, et al. Efficacy of Chondroitin Sulfate in Patients with Knee Osteoarthritis: A Comprehensive Meta-Analysis Exploring Inconsistencies in Randomized, Placebo-Controlled Trials. Adv Ther. 2019;36(5):1085-99. DOI:10.1007/s12325-019-00921-w
52. Railhac JJ, Zaim M, Saurel AS, et al. Effect of 12 months treatment with chondroitin sulfate on cartilage volume in knee osteoarthritis patients: a randomized, double-blind, placebo-controlled pilot study using MRI. Clin Rheumatol. 2012;31(9):1347-57. DOI:10.1007/s10067-012-2022-4 (Erratum in: Clin Rheumatol. 2014;33(10):1527).
53. Volpi N. Analytical aspects of pharmaceutical grade chondroitin sulfates. J Pharm Sci. 2007;96(12):3168-80. DOI:10.1002/jps.20997
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55. Шарапова Е.П., Кашеварова Н.Г., Таскина Е.А., и др. Исследование эффективности, переносимости и безопасности препарата Хондрогард у пациентов с остеоартрозом коленных суставов и коморбидностью. Фарматека. 2017;7:46-51 [Sharapova EP, Kashevarova NG, Taskina EA, et al. Study of the efficacy, tolerability and safety of the drug Chondrogard in patients with osteoarthritis of the knee joints and comorbidity. Farmateka. 2017;7:46-51 (in Russian)].
56. Удовика М.И. Сравнительная эффективность инъекционных
и пероральных симптоматических препаратов медленного действия в терапии первичного и посттравматического остеоартроза коленных суставов. РМЖ. 2017;7:446-50 [Udovika MI. Comparative efficacy of injectable and oral symptomatic slow-acting drugs in the treatment of primary and post-traumatic osteoarthritis of the knee joints. RMZh. 2017;7:446-450 (in Russian)].
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Авторы
М.В. Путилина*1, Н.В. Теплова1, А.М. Лила2,3, Н.В. Загородний4,5
1 ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия;
2 ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой», Москва, Россия;
3 ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, Москва, Россия;
4 Клиника эндопротезирования суставов ФГБУ «Национальный медицинский исследовательский центр травматологии и ортопедии им. Н.Н. Приорова» Минздрава России, Москва, Россия;
5 ФГАОУ ВО «Российский университет дружбы народов», Москва, Россия
*profput@mail.ru
1 Pirogov Russian National Research Medical University, Moscow, Russia;
2 Nasonova Research Institute of Rheumatology, Moscow, Russia;
3 Russian Medical Academy of Continuous Professional Education, Moscow, Russia;
4 Research Center of Traumatology and Orthopedics, Moscow, Russia;
5 People’s Friendship University of Russia, Moscow, Russia
*profput@mail.ru
1 ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия;
2 ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой», Москва, Россия;
3 ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, Москва, Россия;
4 Клиника эндопротезирования суставов ФГБУ «Национальный медицинский исследовательский центр травматологии и ортопедии им. Н.Н. Приорова» Минздрава России, Москва, Россия;
5 ФГАОУ ВО «Российский университет дружбы народов», Москва, Россия
*profput@mail.ru
________________________________________________
1 Pirogov Russian National Research Medical University, Moscow, Russia;
2 Nasonova Research Institute of Rheumatology, Moscow, Russia;
3 Russian Medical Academy of Continuous Professional Education, Moscow, Russia;
4 Research Center of Traumatology and Orthopedics, Moscow, Russia;
5 People’s Friendship University of Russia, Moscow, Russia
*profput@mail.ru
Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.