A.J.H. Verwoerd, MD, PhD, Department of General Practice, Erasmus MC University Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands.
P.A.J. Luijsterburg, PhD, Department of General Practice, Erasmus MC University Medical Center.
Phys Ther. 2015 Sep;95(9):1217-23. doi: 10.2522/ptj.20140458. Epub 2015 Apr 30.
A higher level of kinesiophobia appears to be associated with poor recovery in patients with sciatica.
The aim of this study was to investigate whether kinesiophobia modifies the effect of physical therapy on outcomes in patients with sciatica.
This was a subgroup analysis from a randomized controlled trial.
The study was conducted in a primary care setting.
A total of 135 patients with acute sciatica participated.
Patients were randomly assigned to groups that received (1) physical therapy plus general practitioners' care (intervention group) or (2) general practitioners' care alone (control group).
Kinesiophobia at baseline was measured with the Tampa Scale for Kinesiophobia (TSK) and a single substitute question for kinesiophobia (SQK). Pain and recovery were assessed at 3- and 12-month follow-ups. Regression analysis was used to test for interaction between the level of kinesiophobia at baseline and treatment allocation. Subgroup results were calculated for patients classified with high fear of movement and for those classified with low fear of movement.
Kinesiophobia at baseline interacted with physical therapy in the analysis with leg pain intensity at 12-month follow-up. Kinesiophobia at baseline did not interact with physical therapy regarding any outcome at 3-month follow-up or recovery at 12-month follow-up. When comparing both treatment groups in the subgroup of patients with high fear of movement (n=73), the only significant result was found for leg pain intensity difference from baseline at 12-month follow-up (intervention group: X̅=-5.0, SD=2.6; control group: X̅=-3.6, SD=2.7).
The post hoc study design and relatively small sample size were limitations of the study.
In 135 patients with sciatica, evidence shows that patients with a higher level of kinesiophobia at baseline may particularly benefit from physical therapy with regard to decreasing leg pain intensity at 12-month follow-up.
运动恐惧症程度较高似乎与坐骨神经痛患者康复不良有关。
本研究旨在探讨运动恐惧症是否会改变物理治疗对坐骨神经痛患者结局的影响。
这是一项随机对照试验的亚组分析。
研究在初级保健环境中进行。
共有 135 名急性坐骨神经痛患者参与。
患者被随机分配到接受（1）物理治疗加全科医生护理（干预组）或（2）仅接受全科医生护理（对照组）的组中。
基线时的运动恐惧症采用坦帕运动恐惧症量表（TSK）和运动恐惧症替代问题（SQK）单一问题进行测量。疼痛和恢复情况在 3 个月和 12 个月随访时进行评估。回归分析用于检验基线时的运动恐惧症水平与治疗分配之间的交互作用。为高运动恐惧患者和低运动恐惧患者分别计算亚组结果。
在分析中，基线时的运动恐惧症与物理治疗在 12 个月随访时的腿部疼痛强度存在交互作用。在 3 个月随访或 12 个月随访时的恢复方面，基线时的运动恐惧症与物理治疗均无交互作用。当比较高运动恐惧患者亚组（n=73）中的两个治疗组时，仅发现 12 个月随访时的腿部疼痛强度差值具有统计学意义（干预组：X̅=-5.0，SD=2.6；对照组：X̅=-3.6，SD=2.7）。
本研究的局限性在于事后研究设计和相对较小的样本量。
在 135 名坐骨神经痛患者中，有证据表明，基线时运动恐惧症程度较高的患者在 12 个月随访时接受物理治疗可能特别有助于减轻腿部疼痛强度。
