Johnston Venerina, Jimmieson Nerina L, Jull Gwendolen, Souvlis Tina
Physiotherapy Division, School of Health and Rehabilitation Sciences, Level 7, Therapies Building 84A, The University of Queensland, St Lucia, QLD, Australia.
Eur J Pain. 2009 Oct;13(9):985-91. doi: 10.1016/j.ejpain.2008.11.014. Epub 2008 Dec 25.
This study investigated the relative contribution of individual, workplace, psychosocial and physiological features associated with neck pain in female office workers towards developing appropriate intervention programs. Workers without disability (Neck Disability Index (NDI) score < or = 8, n=33); workers with neck pain and disability (NDI > or = 9/100, n=52) and 22 controls (women who did not work and without neck pain) participated in this study. Two logistic regression models were constructed to test the association between various measures in (1) workers with and without disability, and (2) workers without disability and controls. Measures included those found to be significantly associated with higher NDI in our previous studies: psychosocial domains; individual factors; task demands; quantitative sensory measures and measures of motor function. In the final model, higher score on negative affectivity scale (OR=4.47), greater activity in the neck flexors during cranio-cervical flexion (OR=1.44), cold hyperalgesia (OR=1.27) and longer duration of symptoms (OR=1.19) remained significantly associated with neck pain in workers. Workers without disability and controls could only be differentiated by greater muscle activity in the cervical flexors and extensors during a typing task. No psychosocial domains remained in either regression model. These results suggest that impairments in the sensory and motor system should be considered in any assessment of the office worker with neck pain and may have stronger influences on the presenting symptoms than workplace and psychosocial features.
本研究调查了女性办公室职员中与颈部疼痛相关的个人、工作场所、心理社会和生理特征对制定适当干预方案的相对贡献。无残疾的工作人员(颈部残疾指数(NDI)评分≤8,n = 33);有颈部疼痛和残疾的工作人员(NDI≥9/100,n = 52)以及22名对照者(未工作且无颈部疼痛的女性)参与了本研究。构建了两个逻辑回归模型,以检验(1)有残疾和无残疾的工作人员以及(2)无残疾的工作人员与对照者之间各种测量指标的关联。测量指标包括在我们之前的研究中发现与较高NDI显著相关的指标:心理社会领域;个人因素;任务要求;定量感觉测量指标和运动功能测量指标。在最终模型中,消极情感量表得分较高(OR = 4.47)、颅颈屈曲时颈部屈肌活动增强(OR = 1.44)、冷痛觉过敏(OR = 1.27)以及症状持续时间较长(OR = 1.19)与工作人员的颈部疼痛仍显著相关。无残疾工作人员与对照者之间仅在打字任务期间颈部屈肌和伸肌的肌肉活动更强方面存在差异。两个回归模型中均未保留任何心理社会领域指标。这些结果表明,在对有颈部疼痛的办公室职员进行任何评估时,都应考虑感觉和运动系统的损伤,并且这些损伤对所呈现症状的影响可能比工作场所和心理社会特征的影响更强。