Abstract
BackgroundIn an ageing population, pain, frailty and disability frequently coexist across a wide range of musculoskeletal diagnoses, but their associations remain incompletely understood. The Investigating Musculoskeletal Health and Wellbeing (IMH&W) study aims to measure and characterise the development and progression of pain, frailty and disability, and to identify discrete subgroups and their associations. The survey will form a longitudinal context for nested research, permitting targeted recruitment of participants for qualitative, observational and interventional studies; helping to understand recruitment bias in clinical studies; and providing a source cohort for cohort randomised controlled trials.MethodsIMH&W will comprise a prospective cohort of 10,000 adults recruited through primary and secondary care, and through non-clinical settings. Data collection will be at baseline, and then through annual follow-ups for 4 years. Questionnaires will address demographic characteristics, pain severity (0–10 Numerical Rating Scale), pain distribution (reported on a body Manikin), pain quality (McGill Pain Questionnaire), central aspects of pain (CAP-Knee), frailty and disability (based on Fried criteria and the FRAIL questionnaire), and fracture risk. Baseline characteristics, progression and associations of frailty, pain and disability will be determined. Discrete subgroups and trajectories will be sought by latent class analysis. Recruitment bias will be explored by comparing participants in nested studies with the eligible IMH&W population.DiscussionIMH&W will elucidate associations and progression of pain, frailty and disability. It will enable identification of people at risk of poor musculoskeletal health and wellbeing outcomes who might be suitable for specific interventions, and facilitate generalisation and comparison of research outcomes between target populations. The study will benefit from a large sample size and will recruit from diverse regions across the UK. Purposive recruitment will enrich the cohort with people with MSK problems with high representation of elderly and unwell people.Trial registrationClinicaltrials.gov NCT03696134. Date of Registration: 04 October 2018.
Highlights
Improvements in public health and medical treatments over recent decades have contributed to increased life expectancies and increasingly ageing populations
Musculoskeletal (MSK) conditions, such as osteoarthritis and spinal pain are amenable to treatment, but often are not cured, and their prevalence increases with increasing age
Increasing MSK problems are associated with increased risk of frailty [5], which in turn is associated with more frequent falls, fractures and associated morbidities [6]
Summary
Improvements in public health and medical treatments over recent decades have contributed to increased life expectancies and increasingly ageing populations. Musculoskeletal (MSK) conditions, such as osteoarthritis and spinal pain are amenable to treatment, but often are not cured, and their prevalence increases with increasing age. MSK conditions contribute importantly to pain, frailty and disability. With associated comorbidities and multimorbidity (cardiovascular, metabolic, obesity, neurological, mental health), MSK conditions increasingly threaten personal independence and challenge healthcare budgets. Pain, frailty and disability frequently coexist across a wide range of musculoskeletal diagnoses, but their associations remain incompletely understood. The Investigating Musculoskeletal Health and Wellbeing (IMH&W) study aims to measure and characterise the development and progression of pain, frailty and disability, and to identify discrete subgroups and their associations. The survey will form a longitudinal context for nested research, permitting targeted recruitment of participants for qualitative, observational and interventional studies; helping to understand recruitment bias in clinical studies; and providing a source cohort for cohort randomised controlled trials
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