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.
Locomotive syndrome is an unsatisfactory condition of patients over 60 years of age who need or may require outside help in the near future due to functional deterioration of the musculoskeletal system, including pathology of bone tissue, joints, muscles and nervous tissue. In real clinical practice, one often has to deal with the following manifestations of locomotive syndrome: osteoarthritis, sarcopenia, balance disorders, chronic musculoskeletal pain. Today, there is a clear understanding that drug therapy should be long-term, include comprehensive support for muscle tissue, balance training, and mandatory cognitive-behavioral therapy. Maximum safety of long-term drug therapy can be ensured by the use of vital micronutrients, which include highly purified forms of chondroitin sulfate and glucosamine sulfate, which have a wide range of anti-inflammatory and regenerative effects.
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________________________________________________
1. Ikemoto T, Arai YC. Locomotive syndrome: clinical perspectives. Clin Interv Aging. 2018;13:819-27. DOI:10.2147/CIA.S148683
2. Otchet “Mirovye demograficheskie perspektivy: peresmotrennoe izdanie 2017 goda”. Available at: https://esa.un.org/unpd/wpp/Publications/Files/WPP2017_KeyFindings.pdf. Accessed: 20.12.2018 (in Russian)
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
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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
________________________________________________
Marina V. Putilina*1, Natalia V. Teplova1, Aleksander M. Lila2,3, Nikolay V. Zagorodniy4,5
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