Caby Isabelle, Olivier Nicolas, Mendelek Faddy, Bou Kheir Rania, Vanvelcenaher Jacques, Pelayo Patrick
Pain Res Manag. 2014 Sep-Oct;19(5):e133-8. doi: 10.1155/2014/747282.
Chronic low back pain is a persistent lumbar pain of multifactorial origin. The initial pain level remains poorly used to analyze and compare responses in low back pain patients in a reconditioning program.
To assess and evaluate the responses of subjects with very painful chronic low back pain in a dynamic and intensive care program.
A total of 134 patients with chronic low back pain were included in a spine functional restoration program for five weeks. The subjects were classified into two groups by level of pain: a group experiencing severe pain (n=28) and a group experiencing mild to moderate pain (n=106). All subjects received identical support consisting primarily of physiotherapy, occupational therapy, cardiovascular and muscular reconditioning as well as psychological counselling. The physical parameters (flexibility, muscular strength) and psychological (quality of life) were measured before (T0) and after the program (T5sem).
All physical and functional performances of the subjects with severe pain were lower and the impact of back pain on quality of life for these subjects was increased. All significant differences at T0 between the two groups were no longer present at T5sem.
Muscular atrophy is more important in subjects with severe pain at T0. The intense pain would cause kinesiophobia and central inhibition in chronic low back pain. The analgesic effects of the spine functional restoration program allowed subjects to obtain similar physical, functional and psychological performances at the end of the five weeks of support.
Patients with very painful chronic low back pain respond favourably to the dynamic and intensive program. The intensity of low back pain had no effect on responses to the program. The spine functional restoration program enables patients to better manage their pain, whatever its level.
慢性下腰痛是一种多因素导致的持续性腰痛。在康复计划中，初始疼痛程度在分析和比较下腰痛患者的反应方面仍未得到充分利用。
评估在动态强化护理计划中，患有非常疼痛的慢性下腰痛患者的反应。
总共134名慢性下腰痛患者被纳入脊柱功能恢复计划，为期五周。受试者按疼痛程度分为两组：重度疼痛组（n = 28）和轻至中度疼痛组（n = 106）。所有受试者均接受相同的支持，主要包括物理治疗、职业治疗、心血管和肌肉康复以及心理咨询。在计划开始前（T0）和计划结束后（T5sem）测量身体参数（柔韧性、肌肉力量）和心理参数（生活质量）。
重度疼痛受试者的所有身体和功能表现均较低，且下腰痛对这些受试者生活质量的影响更大。两组在T0时的所有显著差异在T5sem时均不再存在。
在T0时，重度疼痛受试者的肌肉萎缩更为严重。剧烈疼痛会导致慢性下腰痛患者出现运动恐惧和中枢抑制。脊柱功能恢复计划的镇痛效果使受试者在五周的支持结束时获得了相似的身体、功能和心理表现。
患有非常疼痛的慢性下腰痛患者对动态强化计划反应良好。下腰痛的强度对该计划的反应没有影响。脊柱功能恢复计划使患者能够更好地管理疼痛，无论其疼痛程度如何。
