Presented at the 2012 AAPM Annual Meeting « Back

Measurement of Skeletal Muscle Mass by Bioelectric Impedance Analysis in Elderly Individuals with Chronic Nonmalignant Pain and in Asymptomatic Individuals and Its Relationships Among Functional Disability and Impairments in Gait and Balance

Armando S. Miciano, MD, drmiciano@me.com, Nevada Rehabilitation Institute, Las Vegas, Nevada

Objectives were to evaluate the skeletal muscle mass (SMM) of elderly individuals with chronic non-malignant pain (CNMP) and of asymptomatic elderly adults (AEA) by using Bioelectric Impedance Analysis (BIA) and analyze the relationships between SMM, pain-related impairment (PRI), and physical performance. A retrospective study was done on community-dwelling elderly individuals and identified 26 of 100 CNMP subjects and 23 AEA. The BIA measured SMM, calculated using a BIA prediction equation. PRI was quantified using the Pain Disability Questionnaire (PDQ), a formal assessment of pain disability from the AMA Guides to Evaluation of Permanent Impairment, 6th Edition. Functional limitations were assessed with Physical Performance Tests: 6-Minute Walk Test (6MWT) & Berg Balance Scale (BBS). Mean (range) SMM was 20.94 kg. (11-40 kg.) in CNMP and 24.58 kg. (12-39 kg.) in AEA. Mean PDQ score was 59 of 150 (mild PRI). Work performance percentage calculated from 6MWT values averaged 63.14% (48-74%) in CNMP and 64.42% (54-82%) in AEA. BBS score averaged 42 of 56 (12-56) in CNMP and 49 of 56 (36-55) in AEA. Elderly individuals with CNMP tend to have lower SMM, which tend to be affected by PRI, and poorer balance, but they have a similar work performance capacity as in AEA. Objective physical function in CNMP was poorer with increasing PRI. Older adults with a pain co-morbidity should focus on increasing strength and balance in order to decrease functional limitations. Further study on the correlation of the SMM, BBS, and work performance in elderly individuals with CNMP is suggested.

Funding: Nevada Rehabilitation Institute