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[慢性下腰痛老年患者的恐惧回避信念与身体功能]

[Fear Avoidance Beliefs and physical function in elderly individuals with chronic low back pain].

作者信息

Basler H-D, Quint S, Wolf U

机构信息

Institut für Medizinische Psychologie, Philipps-Universität Marburg.

出版信息

Schmerz. 2006 Jun;20(3):189-90, 192-4, 196-7. doi: 10.1007/s00482-005-0418-7.

Abstract

Fear Avoidance Beliefs and physical function in elderly individuals with chronic low back pain This analysis assessed how fear avoidance beliefs (FABs) affected subjective and objective functional parameters as well as pain in elderly individuals. The study comprised 152 elderly patients with low back pain, which was attributed to spondylosis in almost half of the cases. Their average age was 70.1 years (SD=4.3, range 65-84). All of the patients participated in a physiotherapeutic program including data acquisition before treatment (t1), immediately after its completion (t2), and 6 months later (t3). FABs were assessed by a five-item scale with satisfying psychometric properties. The primary outcome criterion was function, which was evaluated as a subjective measure using the Hannover functional disability scale and as an objective measure based on the anteflexion determined by ultrasound topometry. Secondary outcome criteria were pain parameters. At the time o the first measurement (t1), the patients were classified into three groups with strong, intermediate, or weak FABs. Analyses of variance reveal an improvement of subjective functional capacity in every FAB group between t1 and t2. At t3, there is a decline of these values only in the group of the high fear avoiders. High fear avoiders also show lower values in the objective measure at all three measurement points. No influence of the FABs on the pain parameters could be determined. It would be expected that the efficacy of physiotherapy could be improved if the patients' FABs are taken into consideration when planning the treatment regimen.

摘要

慢性下腰痛老年患者的恐惧回避信念与身体功能 本分析评估了恐惧回避信念(FABs)如何影响老年个体的主观和客观功能参数以及疼痛。该研究纳入了152名老年下腰痛患者,其中近一半病例归因于脊柱关节病。他们的平均年龄为70.1岁(标准差=4.3,范围65-84岁)。所有患者都参与了一个物理治疗项目,包括在治疗前(t1)、治疗结束后立即(t2)以及6个月后(t3)进行数据采集。FABs通过一个具有良好心理测量特性的五项量表进行评估。主要结局标准是功能,通过汉诺威功能障碍量表作为主观测量指标,并基于超声测角法测定的前屈作为客观测量指标进行评估。次要结局标准是疼痛参数。在首次测量时(t1),患者被分为FABs强、中、弱三组。方差分析显示,在t1和t2之间,每个FAB组的主观功能能力都有所改善。在t3时,只有高恐惧回避者组的这些值有所下降。高恐惧回避者在所有三个测量点的客观测量中也显示出较低的值。未确定FABs对疼痛参数有影响。如果在制定治疗方案时考虑患者的FABs,预计物理治疗的效果会得到改善。

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