Al-Obaidi S M, Nelson R M, Al-Awadhi S, Al-Shuwaie N
Department of Physical Therapy, Kuwait University, Faculty of Allied Health Sciences and Nursing, Sulaibikhat, Kuwait.
Spine (Phila Pa 1976). 2000 May 1;25(9):1126-31. doi: 10.1097/00007632-200005010-00014.
A correlative design using stepwise regression analysis.
To explore the variation in spinal isometric strength that can be accounted for by anticipation of pain, sensory perception of pain, functional disability belief, and the fear-avoidance belief in chronic low back pain patients.
Several biobehavioral factors contribute to the persistence of pain behavior in chronic patients. Recent studies suggest a need to explore the relation between reduced physical performance and the sensory and cognitive perception of pain.
Sixty-three patients with chronic low back pain 20 to 56 years of age participated in this study. Visual Analogs Scales, the Fear-Avoidance Belief questionnaire, and the Disability Belief questionnaire were used to measure the sensory and cognitive dimensions of pain. Spinal isometric strength was measured by the Medx lumbar extension machine.
Analysis of variance and the stepwise regression analysis demonstrated that anticipation of pain and the fear-avoidance belief about physical activity significantly predicted variation in the spinal isometric strength deficit P < 0. 001. True pain experienced during the testing and answers to the Disability Belief questionnaire were not related.
The results of this study strongly support the hypothesis that spinal physical capacity in chronicity is not explained solely by the sensory perception of pain. The anticipation of pain and the fear-avoidance belief about physical activities were the strongest predictors of the variation in physical performance.
采用逐步回归分析的相关性设计。
探讨慢性下腰痛患者中，因对疼痛的预期、疼痛的感觉认知、功能障碍信念以及恐惧回避信念而导致的脊柱等长肌力变化情况。
多种生物行为因素导致慢性病患者疼痛行为持续存在。近期研究表明，有必要探究身体机能下降与疼痛的感觉及认知之间的关系。
63名年龄在20至56岁之间的慢性下腰痛患者参与了本研究。采用视觉模拟量表、恐惧回避信念问卷和残疾信念问卷来测量疼痛的感觉和认知维度。通过Medx腰椎伸展机测量脊柱等长肌力。
方差分析和逐步回归分析表明，对疼痛的预期以及对体育活动的恐惧回避信念显著预测了脊柱等长肌力缺陷的变化（P < 0.001）。测试期间经历的真实疼痛与残疾信念问卷的答案无关。
本研究结果有力支持了以下假设：慢性病中的脊柱身体能力并非仅由疼痛的感觉认知来解释。对疼痛的预期以及对体育活动的恐惧回避信念是身体机能变化的最强预测因素。
