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对一小群患有非特异性慢性下腰痛的青少年的疼痛、残疾、身体和心理特征进行详细描述。

A detailed characterisation of pain, disability, physical and psychological features of a small group of adolescents with non-specific chronic low back pain.

作者信息

Astfalck Roslyn G, O'Sullivan Peter B, Straker Leon M, Smith Anne J

机构信息

Curtin University of Technology, Perth, Western Australia, Australia.

出版信息

Man Ther. 2010 Jun;15(3):240-7. doi: 10.1016/j.math.2009.12.007. Epub 2010 Jan 29.

Abstract

The objective of the study was to provide a detailed biopsychosocial evaluation of adolescent NSCLBP compared to those without LBP. NSCLBP was described by pain level, duration, levels of disability and kinesiophobia, aggravating factors and functional movements. Each pain subject was sub-classified using the O'Sullivan system. Groups were compared on physical activity levels, sitting posture, trunk extensor and thigh muscle endurance, psychosocial behaviour, depression, family functioning and exposure to stressful life events. Adolescents with NSCLBP reported moderate levels of pain (4.4/10 +/- 1.9), disability (17.9 +/- 10.1%) and fear avoidance beliefs (36.1/68 +/- 7.1). Differences between control and pain groups were only found for back muscle (p = 0.033) and squat endurance times (p = 0.032) and stressful life events (p = 0.030). Differences in sitting posture between pain and no pain groups were only found when pain subjects were sub-classified (lumbar angle p = 0.001). In conclusion, adolescents with NSCLBP reported moderate pain and disability with deficits in trunk and squat endurance. That they remained physically active is at odds with the activity avoidance and subsequent deconditioning model proposed for adults with NSCLBP. Differences between control and pain groups on history of stressful life events suggest this may contribute to adolescent NSCLBP. Differences with sitting posture are only seen when patients were sub-classified.

摘要

本研究的目的是对患有非特异性慢性下腰痛(NSCLBP)的青少年与无下腰痛的青少年进行详细的生物心理社会评估。通过疼痛程度、持续时间、残疾水平、运动恐惧、加重因素和功能运动来描述非特异性慢性下腰痛。每个疼痛受试者使用奥沙利文系统进行亚分类。比较两组在身体活动水平、坐姿、躯干伸肌和大腿肌肉耐力、心理社会行为、抑郁、家庭功能以及暴露于应激性生活事件方面的差异。患有非特异性慢性下腰痛的青少年报告的疼痛程度为中度(4.4/10±1.9),残疾程度为(17.9±10.1%),恐惧回避信念为(36.1/68±7.1)。仅在背部肌肉(p = 0.033)、深蹲耐力时间(p = 0.032)和应激性生活事件(p = 0.030)方面发现了对照组与疼痛组之间的差异。仅在对疼痛受试者进行亚分类时,才发现疼痛组与无疼痛组在坐姿上存在差异(腰椎角度p = 0.001)。总之,患有非特异性慢性下腰痛的青少年报告有中度疼痛和残疾,躯干和深蹲耐力存在缺陷。他们保持身体活跃的情况与为患有非特异性慢性下腰痛的成年人提出的活动回避及随后的失健模型不一致。对照组与疼痛组在应激性生活事件史方面的差异表明,这可能是青少年非特异性慢性下腰痛的一个原因。仅在对患者进行亚分类时,才会出现坐姿方面的差异。

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