Schiphorst Preuper H R, Reneman M F, Boonstra A M, Dijkstra P U, Versteegen G J, Geertzen J H B, Brouwer S
Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Haren, Groningen, The Netherlands.
Eur Spine J. 2008 Nov;17(11):1448-56. doi: 10.1007/s00586-008-0772-0. Epub 2008 Sep 16.
Cross sectional study, performed in an outpatient university based pain rehabilitation setting. To analyze the relationship between psychological factors (psychosocial distress, depression, self efficacy, self-esteem, fear of movement, pain cognitions and coping reactions) and performance-based and self-reported disability, as measured with a Functional Capacity Evaluation (FCE) and the Roland Morris Disability Questionnaire (RMDQ), in patients with chronic low back pain (CLBP). It has been suggested that a strong relationship exists between psychological factors and disability in patients with CLBP. In former research disability was often measured by self-report and seldom performance-based. Study sample consisted of 92 patients with CLBP admitted for multidisciplinary rehabilitation. Prior to treatment, all patients completed questionnaires to measure psychological factors and self-reported disability, and performed an FCE to measure performance-based disability. Correlation coefficients between psychological variables and FCE and self-reported disability were calculated. Multivariate linear regression analyses were performed with self-reported or performance based disability measures as outcome variables, and psychological measures as predictor variables. Out of 42 relations analyzed, 5 were statistically significant. This concerned one significant correlation between kinesiophobia and a subtest of FCE, and four correlations between psychological factors and RMDQ. No correlation was significant after the Bonferroni correction was applied (P < 0.001). The strength of significant correlations ranged from r = -0.33 to r = 0.25. The multivariate analysis revealed that psychological variables measured in this study could explain 19% of the variance of self-reported disability, with kinesiophobia being the only psychological variable that contributed significantly. The suggested strong relationship between psychological factors and performance-based and self-reported disability could not be confirmed in this study. This may implicate that the relationship between psychological factors and disability in patients with CLBP is not as unambiguous as suggested.
在一所大学门诊疼痛康复机构开展的横断面研究。旨在分析慢性下腰痛（CLBP）患者的心理因素（心理社会困扰、抑郁、自我效能感、自尊、运动恐惧、疼痛认知和应对反应）与基于表现和自我报告的残疾之间的关系，残疾程度通过功能能力评估（FCE）和罗兰·莫里斯残疾问卷（RMDQ）进行测量。此前有研究表明，CLBP患者的心理因素与残疾之间存在密切关系。在以往的研究中，残疾程度通常通过自我报告来衡量，很少基于表现进行测量。研究样本包括92名因多学科康复而入院的CLBP患者。在治疗前，所有患者都完成了用于测量心理因素和自我报告残疾程度的问卷，并进行了FCE以测量基于表现的残疾程度。计算心理变量与FCE及自我报告残疾程度之间的相关系数。以自我报告或基于表现的残疾测量结果为因变量，心理测量结果为预测变量进行多元线性回归分析。在分析的42种关系中，有5种具有统计学意义。这包括运动恐惧与FCE一个子测试之间的一项显著相关性，以及心理因素与RMDQ之间的四项相关性。应用邦费罗尼校正后（P < 0.001），没有相关性具有显著性。显著相关性的强度范围为r = -0.33至r = 0.25。多元分析表明，本研究中测量的心理变量可以解释自我报告残疾程度方差的19%，运动恐惧是唯一具有显著贡献的心理变量。本研究无法证实心理因素与基于表现和自我报告的残疾之间存在所认为的密切关系。这可能意味着CLBP患者心理因素与残疾之间的关系并不像所认为的那样明确。
