Taulaniemi Annika, Kuusinen Lotta, Tokola Kari, Kankaanpää Markku, Suni Jaana H
Health-enhancing physical activity, UKK Institute for Health Promotion Research, BOX 30, 33501 Tampere, Finland.
J Rehabil Med. 2017 Aug 31;49(8):667-676. doi: 10.2340/16501977-2261.
To investigate associations of various bio-psychosocial factors with bodily pain, physical func-tioning, and ability to work in low back pain.
Cross-sectional study.
A total of 219 female healthcare workers with recurrent non-specific low back pain.
Associations between several physical and psychosocial factors and: (i) bodily pain, (ii) physical functioning and (iii) ability to work were studied. Variables with statistically significant associations (p < 0.05) in bivariate analysis were set within a generalized linear model to analyse their relationship with each dependent variable.
In generalized linear model analysis, perceived work-induced lumbar exertion (p < 0.001), multi-site pain (p <0.001) and work-related fear-avoidance beliefs (FAB-W) (p = 0.02) best explained bodily pain. Multi-site pain (p < 0.001), lumbar exertion (p = 0.005), FAB-W (p = 0.01) and physical performance in figure-of-eight running (p = 0.01) and modified push-ups (p = 0.05) best explained physical functioning; FAB-W (p <0.001), lumbar exertion (p = 0.003), depression (p = 0.01) and recovery after work (p = 0.03) best explained work ability. In bivariate analysis lumbar exertion was associated with poor physical performance.
FAB-W and work-induced lumbar exertion were associated with levels of pain, physical functioning and ability to work. Poor physical performance capacity was associated with work-induced lumbar exertion. Interventions that aim to reduce fear-avoidance and increase fitness capacity might be beneficial.
探讨各种生物心理社会因素与身体疼痛、身体功能以及腰痛患者工作能力之间的关联。
横断面研究。
共有219名患有复发性非特异性腰痛的女性医护人员。
研究了几种身体和心理社会因素与以下方面的关联:(i)身体疼痛,(ii)身体功能,以及(iii)工作能力。在双变量分析中具有统计学显著关联(p < 0.05)的变量被纳入广义线性模型,以分析它们与每个因变量之间的关系。
在广义线性模型分析中,感知到的工作引起的腰部用力(p < 0.001)、多部位疼痛(p < 0.001)和与工作相关的恐惧回避信念(FAB-W)(p = 0.02)最能解释身体疼痛。多部位疼痛(p < 0.001)、腰部用力(p = 0.005)、FAB-W(p = 0.01)以及“8”字跑(p = 0.01)和改良俯卧撑(p = 0.05)中的身体表现最能解释身体功能;FAB-W(p < 0.001)、腰部用力(p = 0.003)、抑郁(p = 0.01)和下班后恢复情况(p = 0.03)最能解释工作能力。在双变量分析中,腰部用力与身体表现不佳有关。
FAB-W和工作引起的腰部用力与疼痛程度、身体功能和工作能力相关。身体表现能力差与工作引起的腰部用力有关。旨在减少恐惧回避并提高健康能力的干预措施可能有益。