Hirsch G, Beach G, Cooke C, Menard M, Locke S
Division of Physical Medicine and Rehabilitation, University Hospital, Vancouver, British Columbia, Canada.
Spine (Phila Pa 1976). 1991 Sep;16(9):1039-43. doi: 10.1097/00007632-199109000-00004.
A prospective, blinded cohort study was performed to investigate the relationship between biomechanical variables measured during lumbar dynamometry and several psychological tests and measures of nonorganic pain behavior. Eighty-five men, aged 18-60 years, who had had low-back pain for longer than 5 weeks participated in the study. Nonorganic pain behavior was measured with the Waddell score, and lumbar function was measured with the Isostation B-200 Lumbar Dynamometer. Two brief psychological tests, the Coopersmith Self-Esteem inventory and an analog self-rating of wellness, were also administered. Relationships between biomechanical variables and psychological tests were calculated with the t-test, the Pearson r correlation, analysis of variance, and multiple step-wise logistic regression. Patients who exhibited excessive illness behavior (Waddell Scores 3-5) performed significantly worse (P less than .01) on almost all biomechanical variables. The Coopersmith Self-Esteem Score and "feelings" score had a slightly weaker but still significant correlation with motor performance. The results suggest that poor performance on biomechanical testing in this population may be a form of abnormal illness behavior and thus may not accurately reflect organic alterations of neuromusculoskeletal function.
开展了一项前瞻性、盲法队列研究，以调查腰椎测力过程中测得的生物力学变量与多项心理测试以及非器质性疼痛行为测量指标之间的关系。85名年龄在18至60岁之间、下背痛超过5周的男性参与了该研究。采用瓦德尔评分法测量非器质性疼痛行为，使用等动B - 200腰椎测力计测量腰椎功能。还进行了两项简短的心理测试，即库珀史密斯自尊量表和健康状况模拟自评。采用t检验、皮尔逊r相关性分析、方差分析和多元逐步逻辑回归分析来计算生物力学变量与心理测试之间的关系。表现出过度疾病行为（瓦德尔评分3 - 5分）的患者在几乎所有生物力学变量上的表现都显著更差（P小于0.01）。库珀史密斯自尊得分和“感觉”得分与运动表现的相关性稍弱，但仍具有显著性。结果表明，该人群在生物力学测试中的不佳表现可能是异常疾病行为的一种形式，因此可能无法准确反映神经肌肉骨骼功能的器质性改变。
