Melloh Markus, Aebli Nikolaus, Elfering Achim, Röder Christoph, Zweig Thomas, Barz Thomas, Herbison Peter, Hendrick Paul, Bajracharya Suraj, Stout Kirsten, Theis Jean-Claude
Department of Work and Organizational Psychology, Institute for Psychology, University of Berne, Muesmattstrasse 45, 3000 Berne 9, Switzerland.
BMC Musculoskelet Disord. 2008 Dec 19;9:167. doi: 10.1186/1471-2474-9-167.
Low back pain (LBP) is by far the most prevalent and costly musculoskeletal problem in our society today. Following the recommendations of the Multinational Musculoskeletal Inception Cohort Study (MMICS) Statement, our study aims to define outcome assessment tools for patients with acute LBP and the time point at which chronic LBP becomes manifest and to identify patient characteristics which increase the risk of chronicity.
Patients with acute LBP will be recruited from clinics of general practitioners (GPs) in New Zealand (NZ) and Switzerland (CH). They will be assessed by postal survey at baseline and at 3, 6, 12 weeks and 6 months follow-up. Primary outcome will be disability as measured by the Oswestry Disability Index (ODI); key secondary endpoints will be general health as measured by the acute SF-12 and pain as measured on the Visual Analogue Scale (VAS). A subgroup analysis of different assessment instruments and baseline characteristics will be performed using multiple linear regression models. This study aims to examine: 1. Which biomedical, psychological, social, and occupational outcome assessment tools are identifiers for the transition from acute to chronic LBP and at which time point this transition becomes manifest. 2. Which psychosocial and occupational baseline characteristics like work status and period of work absenteeism influence the course from acute to chronic LBP. 3. Differences in outcome assessment tools and baseline characteristics of patients in NZ compared with CH.
This study will develop a screening tool for patients with acute LBP to be used in GP clinics to access the risk of developing chronic LBP. In addition, biomedical, psychological, social, and occupational patient characteristics which influence the course from acute to chronic LBP will be identified. Furthermore, an appropriate time point for follow-ups will be given to detect this transition. The generalizability of our findings will be enhanced by the international perspective of this study.
[Clinical Trial Registration Number, ACTRN12608000520336].
目前，腰痛是当今社会中最为普遍且成本高昂的肌肉骨骼问题。遵循多国民肌肉骨骼起始队列研究（MMICS）声明的建议，我们的研究旨在确定急性腰痛患者的结局评估工具以及慢性腰痛显现的时间点，并识别增加慢性化风险的患者特征。
将从新西兰（NZ）和瑞士（CH）的全科医生（GP）诊所招募急性腰痛患者。他们将在基线以及随访的3周、6周、12周和6个月时通过邮寄调查问卷进行评估。主要结局将采用奥斯威斯利残疾指数（ODI）测量的残疾情况；关键次要终点将采用急性简明健康调查量表（SF - 12）测量的总体健康状况以及视觉模拟量表（VAS）测量的疼痛程度。将使用多元线性回归模型对不同评估工具和基线特征进行亚组分析。本研究旨在探讨：1. 哪些生物医学、心理、社会和职业结局评估工具可作为急性腰痛向慢性腰痛转变的标识，以及该转变在哪个时间点显现。2. 哪些心理社会和职业基线特征，如工作状态和缺勤时间，会影响从急性腰痛到慢性腰痛的病程。3. 与瑞士患者相比，新西兰患者在结局评估工具和基线特征方面的差异。
本研究将开发一种用于全科医生诊所的急性腰痛患者筛查工具，以评估发生慢性腰痛的风险。此外，还将识别影响从急性腰痛到慢性腰痛病程的生物医学、心理、社会和职业患者特征。此外，将给出一个合适的随访时间点以检测这种转变。本研究的国际视角将增强我们研究结果的普遍性。
[临床试验注册号，ACTRN12608000520336]
