Mngoma Nomusa, Corbière Marc, Stevenson Joan
Nomusa Mngoma, PT, PhD: Providence Care, Kingston, Ontario.
Physiother Can. 2008 Summer;60(3):239-45. doi: 10.3138/physio.60.3.239. Epub 2008 Oct 10.
The current study investigated the pain profiles of patients with subacute non-specific low back pain attending an outpatient return-to-work rehabilitation programme. Differences in symptoms of distress (depression and anxiety) and return to work between the pain-profile groups were assessed.
Sixty-five volunteers who met the eligibility criteria and had complete follow-up data were included in the analysis. The mean age was 38.8 years (minimum 18, maximum 64); 38 (58.5%) were men. The median time since onset of low back pain was 30 days. Cluster analysis was used to categorize patients into groups according to pain severity scores (VAS).
Two distinct clusters-severe pain and moderate pain-emerged. There were significant differences in depressive and anxiety symptoms between the pain profiles. Further, return-to-work rates varied significantly between the two groups (31% in the severe pain cluster compared to 90% in the moderate pain cluster).
Although both groups showed significant improvements in depression and anxiety symptoms over time, the severe pain cluster scored higher at discharge (higher scores indicating worse outcomes). These results highlight the importance of early identification of sub-groups at risk so that rehabilitation interventions can be focused with the goal of minimizing long-term disability.
本研究调查了参加门诊重返工作岗位康复计划的亚急性非特异性下腰痛患者的疼痛特征。评估了疼痛特征组之间的痛苦症状（抑郁和焦虑）差异以及重返工作岗位的情况。
分析纳入了65名符合资格标准并拥有完整随访数据的志愿者。平均年龄为38.8岁（最小18岁，最大64岁）；38名（58.5%）为男性。自腰痛发作以来的中位时间为30天。采用聚类分析根据疼痛严重程度评分（视觉模拟评分法）将患者分为不同组。
出现了两个不同的聚类——重度疼痛和中度疼痛。疼痛特征之间的抑郁和焦虑症状存在显著差异。此外，两组之间的重返工作岗位率差异显著（重度疼痛聚类组为31%，而中度疼痛聚类组为90%）。
尽管两组随着时间推移抑郁和焦虑症状均有显著改善，但重度疼痛聚类组出院时得分更高（得分越高表明结果越差）。这些结果凸显了早期识别高危亚组的重要性，以便使康复干预措施更具针对性，目标是将长期残疾降至最低。
