腰痛患者的心理特征及其与基于运动的亚组的关系。
Psychological Features and Their Relationship to Movement-Based Subgroups in People Living With Low Back Pain.
作者信息
Karayannis Nicholas V, Jull Gwendolen A, Nicholas Michael K, Hodges Paul W
机构信息
National Health and Medical Research Council Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia; Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA.
National Health and Medical Research Council Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.
出版信息
Arch Phys Med Rehabil. 2018 Jan;99(1):121-128. doi: 10.1016/j.apmr.2017.08.493. Epub 2017 Oct 5.
OBJECTIVE
To determine the distribution of higher psychological risk features within movement-based subgroups for people with low back pain (LBP).
DESIGN
Cross-sectional observational study.
SETTING
Participants were recruited from physiotherapy clinics and community advertisements. Measures were collected at a university outpatient-based physiotherapy clinic.
PARTICIPANTS
People (N=102) seeking treatment for LBP.
INTERVENTIONS
Participants were subgrouped according to 3 classification schemes: Mechanical Diagnosis and Treatment (MDT), Treatment-Based Classification (TBC), and O'Sullivan Classification (OSC).
MAIN OUTCOME MEASURES
Questionnaires were used to categorize low-, medium-, and high-risk features based on depression, anxiety, and stress (Depression, Anxiety, and Stress Scale-21 Items); fear avoidance (Fear-Avoidance Beliefs Questionnaire); catastrophizing and coping (Pain-Related Self-Symptoms Scale); and self-efficacy (Pain Self-Efficacy Questionnaire). Psychological risk profiles were compared between movement-based subgroups within each scheme.
RESULTS
Scores across all questionnaires revealed that most patients had low psychological risk profiles, but there were instances of higher (range, 1%-25%) risk profiles within questionnaire components. The small proportion of individuals with higher psychological risk scores were distributed between subgroups across TBC, MDT, and OSC schemes.
CONCLUSIONS
Movement-based subgrouping alone cannot inform on individuals with higher psychological risk features.
目的
确定下腰痛（LBP）患者基于运动的亚组中较高心理风险特征的分布情况。
设计
横断面观察性研究。
设置
参与者从物理治疗诊所和社区广告中招募。测量在大学门诊物理治疗诊所进行。
参与者
寻求LBP治疗的患者（N = 102）。
干预措施
参与者根据3种分类方案进行亚组划分：机械诊断与治疗（MDT）、基于治疗的分类（TBC）和奥沙利文分类（OSC）。
主要结局指标
使用问卷根据抑郁、焦虑和压力（抑郁、焦虑和压力量表 - 21项）、恐惧回避（恐惧回避信念问卷）、灾难化和应对方式（疼痛相关自我症状量表）以及自我效能感（疼痛自我效能量表）对低、中、高风险特征进行分类。比较每种方案中基于运动的亚组之间的心理风险概况。
结果
所有问卷的得分显示，大多数患者的心理风险概况较低，但在问卷各部分中存在较高（范围为1% - 25%）风险概况的情况。心理风险得分较高的一小部分个体分布在TBC、MDT和OSC方案的亚组之间。
结论
仅基于运动的亚组划分无法识别具有较高心理风险特征的个体。
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