Rasmussen-Barr Eva, Grooten Wilhelmus J A, Hallqvist Johan, Holm Lena W, Skillgate Eva
Department of Neurobiology, Care Sciences and Society, Division of Physio-therapy, Karolinska Institutet, SE-112 28 Stockholm, Sweden.
J Rehabil Med. 2017 Jul 7;49(7):591-597. doi: 10.2340/16501977-2249.
The aim of this study was to determine whether job strain, i.e. a combination of job demands and decision latitude (job control), and sleep disturbances among persons with occasional low-back pain are prognostic factors for developing troublesome low-back pain; and to determine whether sleep disturbances modify the potential association between job strain and troublesome low-back pain. A population-based cohort from the Stockholm Public Health Cohort surveys in 2006 and 2010 (= 25,167) included individuals with occasional low-back pain at baseline 2006 (= 6,413). Through logistic regression analyses, potential prognostic effects of job strain and sleep disturbances were studied. Stratified analyses were performed to assess modification of sleep disturbances on the potential association between job strain and troublesome low-back pain. Those exposed to job strain; active job (odds ratio (OR) 1.3, 95% confidence interval (95% CI) 1.1-1.6), or high strain (OR 1.5, 95% CI 0.9-2.4) and those exposed to severe sleep disturbances (OR 3.0, 95% CI 2.3-4.0), but not those exposed to passive jobs (OR 1.1, 95% CI 0.9-1.4) had higher odds of developing troublesome low-back pain. Sleep disturbances did not modify the association between job strain and troublesome low-back pain. These findings indicate that active job, high job strain and sleep disturbances are prognostic factors for troublesome low-back pain. The odds of developing troublesome low-back pain due to job strain were not modified by sleep disturbance.
本研究的目的是确定工作压力，即工作要求与决策自由度（工作控制）的结合，以及偶尔出现下背痛的人群中的睡眠障碍是否是发展为顽固性下背痛的预后因素；并确定睡眠障碍是否会改变工作压力与顽固性下背痛之间的潜在关联。来自2006年和2010年斯德哥尔摩公共卫生队列调查的基于人群的队列（=25167人）包括在2006年基线时偶尔出现下背痛的个体（=6413人）。通过逻辑回归分析，研究了工作压力和睡眠障碍的潜在预后影响。进行分层分析以评估睡眠障碍对工作压力与顽固性下背痛之间潜在关联的修正作用。那些暴露于工作压力下的人；主动工作（优势比（OR）1.3，95%置信区间（95%CI）1.1-1.6），或高压力（OR 1.5，95%CI 0.9-2.4）以及那些暴露于严重睡眠障碍下的人（OR 3.0，95%CI 2.3-4.0），但不是那些暴露于被动工作下的人（OR 1.1，95%CI 0.9-1.4）发展为顽固性下背痛的几率更高。睡眠障碍并未改变工作压力与顽固性下背痛之间的关联。这些发现表明，主动工作、高工作压力和睡眠障碍是顽固性下背痛的预后因素。因工作压力而发展为顽固性下背痛的几率并未因睡眠障碍而改变。
