O'Sullivan Kieran, Verschueren Sabine, Van Hoof Wannes, Ertanir Faik, Martens Lien, Dankaerts Wim
Department of Clinical Therapies, University of Limerick, Limerick, Ireland.
Man Ther. 2013 Dec;18(6):526-32. doi: 10.1016/j.math.2013.05.005. Epub 2013 Jun 5.
Studies examining repositioning error (RE) in non-specific chronic low back pain (NSCLBP) demonstrate contradictory results, with most studies not correlating RE deficits with measures of pain, disability or fear. This study examined if RE deficits exist among a subgroup of patients with NSCLBP whose symptoms are provoked by flexion, and how such deficits relate to measures of pain, disability, fear-avoidance and kinesiophobia. 15 patients with NSCLBP were matched (age, gender, and body mass index) with 15 painfree participants. Lumbo-pelvic RE, pain, functional disability, fear-avoidance and kinesiophobia were evaluated. Participants were asked to reproduce a target position (neutral lumbo-pelvic posture) after 5 s of slump sitting. RE in each group was compared by evaluating constant error (CE), absolute error (AE) and variable error (VE). Both AE (p = 0.002) and CE (p = 0.006) were significantly larger in the NSCLBP group, unlike VE (p = 0.165) which did not differ between the groups. There were significant, moderate correlations in the NSCLBP group between AE and functional disability (r = 0.601, p = 0.018), and between CE and fear-avoidance (r = -0.577, p = 0.0024), but all other correlations were weak (r < 0.337, rs < 0.377) or non-significant (p > 0.05). The results demonstrate increased lumbo-pelvic RE in a subgroup of NSCLBP patients, with the selected subgroup undershooting the target position. Overall, RE was only weakly to moderately correlated with measures of pain, disability or fear. The deficits observed are consistent with findings of altered motor control in patients with NSCLBP. The mechanisms underlying these RE deficits, and the most effective method of addressing these deficits, require further study.
研究非特异性慢性下腰痛(NSCLBP)患者重新定位误差(RE)的结果相互矛盾,大多数研究未发现RE缺陷与疼痛、功能障碍或恐惧之间存在关联。本研究调查了NSCLBP症状由屈曲引发的患者亚组中是否存在RE缺陷,以及这些缺陷与疼痛、功能障碍、恐惧回避和运动恐惧测量指标之间的关系。15例NSCLBP患者与15名无疼痛参与者进行匹配(年龄、性别和体重指数)。对腰骨盆RE、疼痛、功能障碍、恐惧回避和运动恐惧进行评估。要求参与者在弯腰坐5秒后重现目标位置(腰骨盆中立姿势)。通过评估恒定误差(CE)、绝对误差(AE)和可变误差(VE)比较两组的RE。NSCLBP组的AE(p = 0.002)和CE(p = 0.006)显著更大,而VE在两组之间无差异(p = 0.165)。在NSCLBP组中,AE与功能障碍之间存在显著的中度相关性(r = 0.601,p = 0.018),CE与恐惧回避之间存在显著的中度相关性(r = -0.577,p = 0.0024),但所有其他相关性较弱(r < 0.337,rs < 0.377)或无显著性(p > 0.05)。结果表明,NSCLBP患者亚组的腰骨盆RE增加,所选亚组未达到目标位置。总体而言,RE与疼痛、功能障碍或恐惧测量指标仅存在弱至中度相关性。观察到的缺陷与NSCLBP患者运动控制改变的研究结果一致。这些RE缺陷的潜在机制以及解决这些缺陷的最有效方法需要进一步研究。