Woby Steve R, Roach Neil K, Urmston Martin, Watson Paul J
Department of Physiotherapy, North Manchester General Hospital, Delauneys Road, Crumpsall, Manchester M8 5RB, UK.
Eur J Pain. 2007 Nov;11(8):869-77. doi: 10.1016/j.ejpain.2007.01.005. Epub 2007 Mar 13.
The aim of this study was to determine the extent to which a number of distinct cognitive factors were differentially related to the levels of pain and disability reported by 183 chronic low back pain (CLBP) patients presenting for physiotherapy. After adjusting for demographics, the cognitive factors accounted for an additional 30% of the variance in pain intensity, with functional self-efficacy (beta=-0.40; P<0.001) and catastrophizing (beta=0.21; P<0.01) both uniquely contributing to the prediction of outcome. The cognitive factors also explained an additional 32% of the variance in disability after adjusting for demographics and pain intensity (total R(2)=0.61). Higher levels of functional self-efficacy (beta=-0.43; P<0.001) and lower levels of depression (beta=0.23; P<0.01) were uniquely related to lower levels of disability. Our findings clearly show that there is a strong association between cognitive factors and the levels of pain and disability reported by CLBP patients presenting for physiotherapy. Functional self-efficacy emerged as a particularly strong predictor of both pain intensity and disability. In view of our findings it would seem that targeting specific cognitive factors should be an integral facet of physiotherapy-based treatments for CLBP.
本研究的目的是确定一些不同的认知因素与183名前来接受物理治疗的慢性下腰痛（CLBP）患者报告的疼痛和残疾水平之间的差异关联程度。在对人口统计学因素进行调整后，认知因素在疼痛强度的方差中额外占30%，其中功能自我效能感（β=-0.40；P<0.001）和灾难化思维（β=0.21；P<0.01）均对结果预测有独特贡献。在对人口统计学因素和疼痛强度进行调整后，认知因素在残疾的方差中也额外解释了32%（总R²=0.61）。较高水平的功能自我效能感（β=-0.43；P<0.001）和较低水平的抑郁（β=0.23；P<0.01）与较低的残疾水平有独特关联。我们的研究结果清楚地表明，认知因素与前来接受物理治疗的CLBP患者报告的疼痛和残疾水平之间存在强烈关联。功能自我效能感是疼痛强度和残疾的一个特别强的预测指标。鉴于我们的研究结果，针对特定认知因素似乎应成为基于物理治疗的CLBP治疗的一个不可或缺的方面。
