Takala E P, Viikari-Juntura E
Department of Physiology, Musculoskeletal Research Unit, Finnish Institute of Occupational Health, Helsinki.
Spine (Phila Pa 1976). 2000 Aug 15;25(16):2126-32. doi: 10.1097/00007632-200008150-00018.
A cohort of 307 nonsymptomatic workers and another cohort of 123 workers with previous episodes of low back pain were followed up for 2 years. The outcomes were measured by symptoms, medical consultations, and sick leaves due to low back disorders.
To study the predictive value of a set of tests measuring the physical performance of the back in a working population. The hypothesis was that subjects with poor functional capacity are liable to back disorders.
Reduced functional performance has been associated with back pain. There are few data to show whether reduced functional capacity is a cause or a consequence of pain.
Mobility of the trunk in forward and side bending, maximal isokinetic trunk extension, flexion and lifting strength, and static endurance of back extension were measured. Standing balance and foot reaction time were recorded with a force plate. Clinical tests for the provocation of back or leg pain were performed. Gender, workload, age, and anthropometrics were managed as potential confounders in the analysis.
Marked overlapping was seen in the measures of the subjects with different outcomes. Among the nonsymptomatic subjects, low performance in tests of mobility and standing balance was associated with future back disorders. Among workers with previous episodes of back pain, low isokinetic extension strength, poor standing balance, and positive clinical signs predicted future pain.
Some associations were found between the functional tests and future low back pain. The wide variation in the results questions the value of the tests in health examinations (e.g., in screening or surveillance of low back disorders).
对307名无症状工人和另一组123名曾有过腰痛发作的工人进行了为期2年的随访。通过症状、医疗咨询以及因腰背部疾病导致的病假情况来衡量结果。
研究一套测量工作人群背部身体机能测试的预测价值。假设是功能能力差的受试者易患背部疾病。
功能表现下降与背痛有关。很少有数据表明功能能力下降是疼痛的原因还是结果。
测量躯干前屈和侧屈的活动度、最大等速躯干伸展、屈曲和提升力量以及背部伸展的静态耐力。使用测力板记录站立平衡和足部反应时间。进行诱发背部或腿部疼痛的临床测试。在分析中，将性别、工作量、年龄和人体测量学作为潜在的混杂因素进行处理。
在不同结果的受试者测量中发现了明显的重叠。在无症状受试者中，活动度和站立平衡测试表现不佳与未来的背部疾病有关。在曾有过腰痛发作的工人中，等速伸展力量低、站立平衡差和临床体征阳性可预测未来的疼痛。
在功能测试和未来的腰痛之间发现了一些关联。结果的广泛差异质疑了这些测试在健康检查（如筛查或监测腰背部疾病）中的价值。
