Le 14/10/2021 de 09:00 à 11:00

Retour Session


La consommation chronique d’opioïdes est associée à une perception plus élevée du handicap et plus basse des capacités fonctionnelles à l’entrée en réadaptation professionnelle musculo squelettique stationnaire : à propos de 3761 patients.

michel konzelmann (sion, Suisse), philippe vuistiner (Sion, Suisse), Cyrille Burrus (sion, Suisse), bertrand Léger (Sion, Suisse), François Luthi (sion, Suisse)

Objective : Opioid use for chronic pain is a public health problem worldwide. Aim of this study: investigate whether chronic opioid use was associated with poorer perception of disability and functional ability in a population of patients hospitalized for vocational musculoskeletal rehabilitation.

Material / Patients and Methods : Retrospective study, prospective data of patients hospitalized over six years. Classification into three groups at entry: no analgesics (NA), non-opioid analgesics (NOA), opioids (O). Questionnaires assessing disability: upper limb (DASH), lower limb (IKDC for knee, FAAM for ankle-foot), spine (Oswestry, NDI) and functional abilities: HFS (upper limb) and SFS (lower limb, spine). ANOVA analysis and multivariate analysis after adjustment (age, gender, severity, location, pain).

Results : 3761 patients, trauma lower limb: 43%, upper limb: 43%, spine: 14%. NA= 40%, NOA= 40%, O=20%.
For disability and functional abilities, all the questionnaires were associated with the medication consumption with an increasing gradient between the three groups (ANOVA). It shows that the more analgesics and in particular opioids are taken, the higher the perception of disability (high DASH/Oswestry/NDI, low FAAM/ IKDC) and the lower the self-assessment of functional abilities (low HFS and SFS). Multivariate analysis after adjustment confirms these differences: for example O/NA: + 6 point (DASH), + 9 point (NDI).

Discussion - Conclusion : To our knowledge, our study is the first to investigate the relationship between opioid use and perceived disability and functional ability with specific questionnaires. Other personal and environmental factors associated with opioid use may probably play a role to explain this result and must be explored during the rehabilitative stay.

Keywords : pain-opioids-vocational rehabilitation-injuries-musculoskeletal

Disclosure of interest : aucun