Walsh Jeremy, Hall Toby
J Man Manip Ther. 2009;17(2):118-23. doi: 10.1179/106698109790824703.
It has been proposed that patients with low back-related leg pain can be classified according to pain mechanisms into four distinct subgroups: Central Sensitization (CS), Denervation (D), Peripheral Nerve Sensitization (PNS), and Musculoskeletal (M). The purpose of this study was to determine whether there were any differences in terms of disability and psychosocial factors between these four subgroups. Forty-five subjects with low back-related leg pain completed the Oswestry Disability Index, the hospital Anxiety and Depression Scale, and the Fear Avoidance Beliefs Questionnaire. Subsequently, an examiner blinded to the questionnaire results classified the subjects into one of the four subgroups, according to the findings of the self-administered Leeds Assessment of Neuropathic Signs and Symptoms questionnaire and a physical examination. It was found that the PNS subgroup had significantly greater disability compared to all other subgroups and significantly greater fear avoidance beliefs about physical activity compared to the CS and D subgroups. This highlights the importance of sub-classification but also the need to take into account disability and psychosocial factors in the management of low back-related leg pain.
有人提出，下背部相关腿痛患者可根据疼痛机制分为四个不同的亚组：中枢敏化（CS）、去神经支配（D）、周围神经敏化（PNS）和肌肉骨骼（M）。本研究的目的是确定这四个亚组在残疾和心理社会因素方面是否存在差异。45名下背部相关腿痛患者完成了奥斯威斯利残疾指数、医院焦虑抑郁量表和恐惧回避信念问卷。随后，一名对问卷结果不知情的检查人员根据自行填写的利兹神经病理性体征和症状评估问卷的结果以及体格检查，将受试者分为四个亚组之一。结果发现，与所有其他亚组相比，PNS亚组的残疾程度明显更高，与CS和D亚组相比，对体育活动的恐惧回避信念明显更强。这突出了亚分类的重要性，也强调了在管理下背部相关腿痛时考虑残疾和心理社会因素的必要性。
