Department of Orthopaedics and Rehabilitation, Interdisciplinary Center for Musculoskeletal Training and Research, University of Florida, Gainesville, USA.
Am J Phys Med Rehabil. 2013 May;92(5):439-45. doi: 10.1097/PHM.0b013e318287633c.
This study determined whether kinesiophobia levels were different among older adults with chronic low back pain (LBP) and varying body mass index and whether kinesiophobia predicted perceived disability or walking endurance.
This study was a secondary analysis from a larger interventional study. Older adults with obesity with LBP (N = 55; 60-85 yrs) were participants in this study. Data were stratified on the basis of body mass index: overweight (25-29.9 kg/m), obese (30-34.9 kg/m), and severely obese (35 kg/m). The participants completed a battery of surveys (the modified Tampa Scale of Kinesiophobia [TSK-11], the Fear-Avoidance Beliefs Questionnaire, the Pain Catastrophizing Scale, and the perceived disability measures of the Oswestry Disability Index and the Roland Morris Disability Questionnaire). Walking endurance time was captured using a symptom-limited graded walking treadmill test. The peak LBP ratings were captured during the walk test.
Walking endurance times did not differ by body mass index group, but the peak LBP ratings were higher in the moderately and severely obese groups compared with the overweight group (3.0 and 3.1 vs. 2.1 points; P < 0.05). There was no difference in the kinesiophobia scores (the TSK-11, the Pain Catastrophizing Scale, and the Fear-Avoidance Beliefs Questionnaire work and activity subscores) or the perceived disability scores (the Oswestry Disability Index and the Roland Morris Disability Questionnaire). However, adjusted regression analyses revealed that the TSK-11 scores contributed 10%-21% of the variance of the models pain with walking and perceived disability caused by back pain. Kinesiophobia was not a significant contributor to the variance of the regression model for walking endurance.
In the older population with obesity with LBP, the TSK-11 might be a quick and simple measure to identify patients at risk for poor self-perception of functional ability. The TSK and the Oswestry Disability Index may be quick useful measures to assess initial perceptions before rehabilitation. Kinesiophobia may be a good therapeutic target to address to help affected older adults with obesity fully engage in therapies for LBP.
本研究旨在确定慢性下背痛(LBP)伴不同体重指数的老年患者的恐动症水平是否存在差异,以及恐动症是否预测感知残疾或步行耐力。
这是一项大型干预性研究的二次分析。本研究的参与者为肥胖伴 LBP 的老年人(N=55;60-85 岁)。根据体重指数进行数据分层:超重(25-29.9 kg/m)、肥胖(30-34.9 kg/m)和重度肥胖(35 kg/m)。参与者完成了一系列调查(改良坦帕运动恐惧调查表[TSK-11]、恐惧回避信念问卷、疼痛灾难化量表以及 Oswestry 残疾指数和 Roland Morris 残疾问卷的感知残疾测量)。使用症状限制分级步行跑步机测试来测量步行耐力时间。在步行测试过程中测量最大 LBP 评分。
步行耐力时间不因体重指数组而异,但中重度肥胖组的最大 LBP 评分高于超重组(3.0 和 3.1 分比 2.1 分;P<0.05)。在恐动症评分(TSK-11、疼痛灾难化量表和恐惧回避信念问卷工作和活动子量表)或感知残疾评分(Oswestry 残疾指数和 Roland Morris 残疾问卷)方面,各组间均无差异。然而,调整后的回归分析显示,TSK-11 评分可解释模型中与步行相关的疼痛和由腰痛引起的感知残疾的 10%-21%的变异性。恐动症不是步行耐力回归模型变异性的显著贡献因素。
在肥胖伴 LBP 的老年人群中,TSK-11 可能是一种快速简单的测量方法,可用于识别功能能力自我感知不良的患者。TSK 和 Oswestry 残疾指数可能是康复前评估初始感知的有用快速测量方法。恐动症可能是一个很好的治疗靶点,可帮助肥胖的受影响老年人充分参与 LBP 的治疗。