PM&R最新文献

{"title":"Fear of falling is associated with physical functioning, activity performance, and participation in individuals with multiple sclerosis.","authors":"Libak Abou, Jeeyeon Kim, Chloe McCloskey, Cory Wernimont, Anna L Kratz","doi":"10.1002/pmrj.70131","DOIUrl":"10.1002/pmrj.70131","url":null,"abstract":"<p><strong>Background: </strong>Fear of falling (FoF) is a common concern in individuals with multiple sclerosis (MS). Understanding whether and how FoF affects activities and participation is crucial for developing effective rehabilitation programs in individuals with MS.</p><p><strong>Objective: </strong>To examine the relationship between measures of FoF (degree of FoF and avoidance behavior due to FoF) and measures of activities and participation in ambulatory individuals with MS. We also aim to investigate whether avoidance behavior due to FoF is relevant beyond the effect of degree of FoF.</p><p><strong>Design: </strong>Cross-sectional survey-based design.</p><p><strong>Setting: </strong>Community.</p><p><strong>Participants: </strong>A convenience sample of 531 community-dwelling ambulatory individuals with MS.</p><p><strong>Interventions: </strong>N/A.</p><p><strong>Main outcome measures: </strong>Activities measures included Patient-Reported Outcomes Measurement Information System (PROMIS) physical functioning and self-efficacy to manage activities of daily living (ADLs). Measures of participation included PROMIS ability to participate in social roles and activities (SRAs) and Community Participation Indicators-Control subscale.</p><p><strong>Results: </strong>After controlling for age, gender, duration of MS, disability level, history of previous falls, and MS subtype, hierarchical linear regression analyses indicated participants with moderate and high FoF showed lower physical functioning and ability to participate in SRAs (B = -4.75 to -10.81, p < .01) compared to those with low FoF. Participants with high FoF also had reduced self-efficacy in managing ADLs (B = -6.29, p < .01) and less control over community participation (B = 6.77, p < .05) compared to those with low FoF. Avoidance behavior due to FoF was associated with lower self-efficacy to manage ADLs (Β = -1.59, p < .01), ability to participate in SRAs (Β = -2.62, p < .01), and control over community participation (Β = 3.34, p < .01).</p><p><strong>Conclusions: </strong>FoF is a significant predictor of activities performance and participation in individuals with MS. Our findings highlight the importance of assessing avoidance behavior due to FoF to inform rehabilitation approaches aimed at improving the participation and community integration of individuals with MS.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"1194-1203"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13686106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cadence and tibial acceleration in runners with and without patellofemoral pain.","authors":"José Roberto de Souza Júnior, Glauber Marques Paraizo Barbosa, Leonardo Luiz Barretti Secchi, Maikon Gleibyson Rodrigues Dos Santos, Thiago Vilela Lemos, João Paulo Chieregato Matheus","doi":"10.1002/pmrj.70124","DOIUrl":"10.1002/pmrj.70124","url":null,"abstract":"<p><strong>Background: </strong>Patellofemoral pain (PFP) is one of the main injuries in runners and the most common site of injury during ultramarathon races. The association between running biomechanics and PFP has been investigated over the years and conflicting to moderate evidence were found for kinematic and kinetic aspects. Differences in cadence and tibial acceleration should be investigated, as they are accessible variables used in gait retraining.</p><p><strong>Objective: </strong>To compare the cadence and peak vertical tibial acceleration between runners with PFP and pain-free controls.</p><p><strong>Methods: </strong>Cross-sectional study with 53 recreational rearfoot strike runners (PFP n = 27; Controls n = 26). All participants ran at 10 km/h on a motorized treadmill (Movement XL 1600) for 1 minute with the Tgforce accelerometer (v2.0.0.10) fixed to the anteromedial region of the right tibia above the medial malleolus. Cadence (steps/min) and vertical acceleration of the tibia (g) were measured. A significance level of α = 0.05 was adopted.</p><p><strong>Results: </strong>Values of 164.22 (8.08) steps/min and 6.88 (2.01) g were found for participants with PFP, whereas 171.53 (9.89) steps/min and 6.62 (1.55) g were found for the pain-free controls. A significant difference was found for cadence (p = .007; d = 0.80) but not for vertical tibial acceleration (p > .05; d = 0.21).</p><p><strong>Conclusion: </strong>Participants with PFP had lower cadence values when compared to healthy runners. However, differences in tibial vertical acceleration were not found. Future studies should evaluate other aspects that can discriminate between healthy runners and those with PFP.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"1204-1210"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social drivers of health and physical medicine and rehabilitation.","authors":"Cleo Stafford, Arpit Arora, Edmond Benedetti, Priya Chandan, Prateek Grover, Serena Satcher, Scott Laker, Devon McFedries, Melanie Dolak","doi":"10.1002/pmrj.70229","DOIUrl":"10.1002/pmrj.70229","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"1217-1224"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The characterization of dysphagia in COVID-19 rehabilitation patients: An inpatient rehabilitation cohort study.","authors":"Benjamin K Petrie, Christopher W Lewis, Sean Dreyer, Prakash Jayabalan","doi":"10.1002/pmrj.70113","DOIUrl":"10.1002/pmrj.70113","url":null,"abstract":"<p><strong>Background: </strong>Severe COVID-19 infection requiring hospitalization is associated with oropharyngeal dysphagia, yet trajectories in the inpatient rehabilitation facility (IRF) setting remain undercharacterized.</p><p><strong>Objective: </strong>To investigate the prevalence, risk factors, recovery likelihood, and evolution of dietary requirements of patients with dysphagia due to severe COVID-19 infection admitted to IRF.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Three free-standing urban IRFs.</p><p><strong>Patients: </strong>Two hundred forty eight patients with acute symptomatic COVID-19 admitted to IRF between April 2020 and February 2021. Dysphagia was defined by abnormalities on videofluoroscopic swallow study, Functional Oral Intake Scale, or Mann Assessment of Swallowing Ability. Patients with neurologic disease, nil per os status on IRF admission, or indeterminate dysphagia status were excluded.</p><p><strong>Interventions: </strong>Multidisciplinary IRF dysphagia treatment, per standard of care.</p><p><strong>Main outcome measures: </strong>Dysphagia prevalence and resolution, dietary consistencies, and Functional Independence Measure scores.</p><p><strong>Results: </strong>Of the included patients, 46.0% had dysphagia on admission (n = 114), most commonly oropharyngeal (89.7%), followed by oral (8.6%) and pharyngeal (1.7%). Dysphagia resolved during an average 3-week IRF stay in 43.5% of cases. Higher Functional Independence Measure comprehension scores were associated with lower likelihood of dysphagia (p = .002) and higher likelihood of resolution (p = .021). Discharge to home was common in both those with persistent and resolved dysphagia (86.5% vs. 88.6%). Additionally, 92.1% (n = 105) of patients with dysphagia on admission were discharged on a normal or International Dysphagia Diet Standardisation Initiative Level 6/0 diet.</p><p><strong>Conclusions: </strong>In this large study of dysphagia in patients with COVID-19 requiring IRF, a strong, novel association between cognitive function and both dysphagia incidence and recovery was observed in patients without discrete neurologic injury. Although persistent dysphagia was common at discharge, most patients transitioned to a normal or near-normal diet.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"1145-1153"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13686111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with low anaerobic threshold and its impact on sleep quality and health-related quality of life in individuals with long COVID.","authors":"Chia-Huei Lin, Chia-Ying Lai, Chih-Ya Chang, Ta-Chung Chao, Chieh-Yi Song, Cheng-Chiang Chang, Wen-Yuan Chang, Chien-Yao Huang, Jyun-Wei Jhuang, Shang-Lin Chiang","doi":"10.1002/pmrj.70133","DOIUrl":"10.1002/pmrj.70133","url":null,"abstract":"<p><strong>Introduction: </strong>Anaerobic threshold (AT), a crucial indicator of submaximal exercise capacity and cardiorespiratory function, has been reported to be impaired in individuals with long COVID. However, the predictors of reduced AT during exercise in this population and its impacts on patient-reported outcomes, including sleep quality and health-related quality of life (HRQL), remain unknown. This study aims to identify factors associated with low AT and examine its relationship with patient-reported outcomes.</p><p><strong>Objective: </strong>To investigate the predictors of low AT and compare patient-reported outcomes (sleep quality and HRQL) between individuals with normal and low AT among those with long COVID.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Post-COVID integrated outpatient clinic at a medical center in northern Taiwan.</p><p><strong>Patients (or participants): </strong>Eligible patients aged 20-80 years with long COVID were recruited.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measure(s): </strong>AT, peak oxygen consumption (peak VO₂), and patient-reported outcomes, including sleep quality and HRQL, assessed using the Taiwanese version of the World Health Organization Quality of Life-BREF and Pittsburgh Sleep Quality Index.</p><p><strong>Results: </strong>Factors associated with low AT included younger age (odds ratio [OR] = 0.904, 95% confidence interval [CI]: 0.867-0.942, p < .001) and lower peak VO₂ (OR = 0.737, 95% CI: 0.659-0.842, p < .001). Participants with low AT exhibited impaired patient-reported outcomes including poorer sleep quality (p = .008), and lower HRQL scores across all domains, as compared to those with normal AT. After adjustment for significant covariates, only the psychological domain of HRQL remained statistically significant (adjusted p = .035).</p><p><strong>Conclusions: </strong>Low AT in individuals with long COVID was associated with younger age and lower peak VO₂. Its independent impact on sleep quality and HRQL appears limited, suggesting that patient-reported outcomes may be influenced by multiple interacting factors and warrant further investigation.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"1154-1163"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of median nerve conduction parameters from the index and middle fingers in carpal tunnel syndrome: Toward a standardized electrophysiological evaluation protocol.","authors":"Maryam Cheraghali, Ensieh Taftian, Farzad Fatehi, Ali Asghar Okhovat, Nasim Shahbazi, Hamid Reza Fateh","doi":"10.1002/pmrj.70101","DOIUrl":"10.1002/pmrj.70101","url":null,"abstract":"<p><strong>Background: </strong>Variability exists regarding which is the best digit for diagnosing and classifying the severity of carpal tunnel syndrome (CTS) with electrodiagnostic studies.</p><p><strong>Objective: </strong>To compare nerve conduction parameters-peak sensory latency, amplitude, and conduction velocity-of the median nerve between the index and middle fingers in patients with mild to moderate CTS and to assess the diagnostic value of interdigit latency differences.</p><p><strong>Design: </strong>Diagnostic study with the gold standard of electrodiagnosis.</p><p><strong>Setting: </strong>Department of physical medicine and rehabilitation at a tertiary hospital affiliated with a university of medical sciences.</p><p><strong>Participants: </strong>Participants were adult patients with a clinical diagnosis of primary idiopathic mild (n = 53) or moderate (n = 53) CTS, along with a control group (n = 53) with no electrodiagnostic evidence of CTS.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measure: </strong>Antidromic sensory nerve conduction studies were performed on the index and middle fingers, and the parameters were compared among the study groups. Linear regression and supervised machine learning models, adjusted for age and body mass index, were used to evaluate diagnostic performance.</p><p><strong>Results: </strong>Peak sensory latencies increased with the severity of CTS for both the index and middle fingers (both p <.001). The difference in interdigit latency also increased significantly with syndrome severity (p < .001). Post hoc tests revealed significant differences in interdigit latencies for all pairwise comparisons among the study groups (all p < .001). Multivariable models adjusted for age and body mass index achieved the highest diagnostic accuracy for middle finger latency (area under the receiver operating characteristic curve = 0.973, p < .001). The interdigit latency difference model demonstrated the highest sensitivity (90%) for moderate CTS.</p><p><strong>Conclusions: </strong>Middle finger peak latency outperformed index finger recordings and interdigit latency comparisons in diagnosing CTS. Adding middle finger peak latency and interdigit latency difference to standard electrodiagnostic protocols improves early detection and classification of the syndrome.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"1176-1183"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of 5% dextrose prolotherapy compared with saline injections for chondromalacia patella: A randomized controlled trial.","authors":"Yunus Burak Bayır, Özlem Köroğlu, Yasin Demir","doi":"10.1002/pmrj.70119","DOIUrl":"10.1002/pmrj.70119","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the efficacy of 5% dextrose prolotherapy applied to patients with chondromalacia patella.</p><p><strong>Design: </strong>This 2-arm, double-blinded, prospective, randomized controlled interventional study in a single center included 54 patients with knee pain ongoing for at least 3 months. The patients were randomly assigned to a dextrose prolotherapy group (DPG) or a saline group (SG). Periarticular 5% dextrose prolotherapy or saline injections were applied to these groups, respectively, at 0, 3, and 6 weeks. The outcome measures were Visual Analog Scale (VAS), Patellofemoral Pain Severity Scale (PPSS), Kujala Patellofemoral Scoring System (KPSS), and the Short Form-36 (SF-36) at baseline and at the end of the 3rd, 6th, and 24th weeks.</p><p><strong>Results: </strong>A total of 54 patients were included, with 27 in each group. After the withdrawal of 2, evaluation was made of 52 patients. Compared to baseline values, the VAS, PPSS scores, and number of tender points significantly decreased (p < .001 for all), and the KPSS and SF-36 scores increased at the end of weeks 3, 6, and 24 in both groups (p = .003 for the SF-36 mental health subscale and p < .001 in all other evaluations). At 24 weeks, in the DPG compared to SG, VAS was 1.67 points lower (95% CI: -2.57 to -7.80; p < .001), PPSS was 15.4 points lower (95% CI: -23.6 to -7.18; p < .001), KPSS was 9.3 points higher (95% CI: 5.3-13.2; p < .001), the number of tender points was 0.79 points lower (95% CI: -1.4 to -0.12; p < .021), and the physical function SF-36 subscale was 7.8 points higher (95% CI: 3.6-12.7; p < .001).</p><p><strong>Conclusion: </strong>In patients with chondromalacia patella, 5% dextrose prolotherapy reduced pain and improved symptoms, functional status, and quality of life more effectively than saline injections. Therefore, 5% dextrose prolotherapy can be recommended as an effective treatment option.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"1133-1144"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spanish Translated Abstracts.","authors":"","doi":"10.1002/pmrj.70258","DOIUrl":"https://doi.org/10.1002/pmrj.70258","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":"18 10","pages":"1242-1251"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149239407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limbs lost, lives changed: The unprecedented limb amputation crisis in Gaza.","authors":"Suzanne Abou-Diab, Sana Al Ani, Laura Hobart-Porter","doi":"10.1002/pmrj.70215","DOIUrl":"https://doi.org/10.1002/pmrj.70215","url":null,"abstract":"<p><p>Historically in armed conflicts, traumatic amputations result in long-term impacts on individuals, healthcare systems, and society. Though amputations are not new, the ongoing conflict in Gaza has resulted in an unusually high number of amputations. The scale of conflict-related amputations in Gaza, accompanied by systemic barriers to acute and rehabilitative care, necessitates feasible rehabilitation-focused responses relevant to physiatrists and global health stakeholders. The World Health Organization documentation reflects between 3105 and 4050 amputations between January 10 and May 16, 2024. Ongoing data are limited due to infrastructure damage, but available estimates indicate a scale of limb loss that is disproportionately high compared with recent conflict settings. Gaza's population density, targeting of healthcare infrastructure and workers, and supply disruptions contribute to high levels of conflict-related limb loss. Further compounding these concerns, delays in care result in undesired outcomes with medical, economic, and social consequences. Though conflict-related amputations concern all age groups, the lifetime burden of care is particularly striking for pediatric amputees. Based on literature from high-resource settings, estimated costs are approximately $90,000 USD per limb for immediate healthcare needs and $500,000 USD for lifetime care. With 3578 estimated cases in Gaza in a period of four months, this translates to $322 million for immediate treatment costs and $1.79 billion in projected lifetime care. The scale of limb loss among all age groups in Gaza has resulted in long-term rehabilitative care needs within a severely resource-limited environment. Physiatrists' skill sets in rehabilitation-informed planning and coordination of international rehabilitation efforts uniquely position them to help. This article is structured as an international perspective synthesizing reports from humanitarian organizations, global health agencies, and published literature.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between the accumulation of unhealthy lifestyle factors and musculoskeletal pain in older adults.","authors":"Rodrigo Núñez-Cortés, Carlos Cruz-Montecinos, Andrea Tur-Boned, Luis Suso-Martí, Andrea Fuenzalida-Palma, Lars Louis Andersen, Joaquín Calatayud","doi":"10.1002/pmrj.70226","DOIUrl":"https://doi.org/10.1002/pmrj.70226","url":null,"abstract":"<p><strong>Background: </strong>Although previous studies have examined individual lifestyle behaviors in chronic musculoskeletal pain outcomes, the cumulative impact of unhealthy lifestyle behaviors remains unclear.</p><p><strong>Objective: </strong>To assess whether the accumulation of unhealthy lifestyle behaviors, as measured by the LIFESTYLE-4 score, is associated with the intensity and distribution of musculoskeletal pain in older adults.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with 100 older adults with chronic pain (83% women; mean age 69 ± 9.8 years). Lifestyle-related factors were assessed using validated instruments: physical activity (International Physical Activity Questionnaire), diet (Mediterranean diet score), sleep (Pittsburgh Sleep Quality Index), and stress (Perceived Stress Scale-4). The LIFESTYLE-4 score was constructed by assigning one point for each unfavorable factor (Pittsburgh Sleep Quality Index score >5, Perceived Stress Scale-4 score > 8, physical activity <600 metabolic equivalent of task-min/wk, Mediterranean diet score <9). Pain intensity (numerical rating scale, 0-10) and pain distribution (regional vs. widespread) were the main outcomes. The data were analyzed using one-way analysis of variance, χ² tests, and multivariate logistic regression adjusted for sociodemographic and clinical covariates.</p><p><strong>Results: </strong>Analysis of variance showed significant differences in pain intensity between LIFESTYLE-4 score categories (F = 6.40, p = .004; ηp² = 0.06). Participants with the highest score reported greater pain compared to the low (mean difference = 1.80, p = .010) and medium (mean difference = 1.49, p = .011) groups. Logistic regression showed higher odds of severe pain in the high-score group (odds ratio = 10.5, 95% confidence interval 1.08-102.3). A χ² test revealed an association between LIFESTYLE-4 and the number of painful areas (χ² ₍₄₎ = 12.7, p = .013).</p><p><strong>Conclusion: </strong>The accumulation of multiple unhealthy lifestyle behaviors was associated with greater intensity and a wider distribution of musculoskeletal pain. These findings underscore the importance of multidomain lifestyle approaches in the prevention and treatment of pain among older adults.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}