Yarznbowicz Richard, Tao Minjing, Owens Alexa, Wlodarski Matt, Dolutan Jonathan
Center for Orthopedic and Sports Physical Therapy, Tallahassee, FL, USA.
Department of Statistics, Florida State University, Tallahassee, FL, USA.
J Man Manip Ther. 2018 Feb;26(1):18-24. doi: 10.1080/10669817.2017.1343538. Epub 2017 Jun 25.
Pain Pattern Classification (PPC) and Directional Preference (DP) have shown merit as reliable and predictable clinical solutions to help reduce the burden posed by low back pain (LBP). We conducted a prospective, observational cohort study to verify the association between PPC, DP, and clinical outcomes. We hypothesized that (1) patients who demonstrated DP Centralization (CEN) would have lower pain intensity and disability at follow-up than patients who demonstrated Non-DP Non-CEN, and (2) the prevalence of DP at first examination would be lowest for patients with chronic LBP and are greater than 65 years old. First examination and follow-up data were completed by 639 patients. Clinical outcome measures, including pain intensity and disability, were collected at first examination and follow-up. Baseline comparisons were made between groups with first examination data only and groups with first examination data and follow-up data. A Pearson's chi-squared test was used to determine differences in prevalence rates for the categorical variables, and two-sample -tests were used for the continuous variables. A Turkey's range test was used to determine differences in follow-up pain intensity and disability for LBP dual-classifications. Multiple regression was used to investigate DP prevalence considering risk adjusted factors. Overall prevalence of DP was 84.5% and prevalence was lowest for patients with sub-acute symptoms. No significant difference existed for the prevalence of DP for patients based on age. Patients classified as DP CEN had, on average, 1.99 pain intensity units less than patients classified as Non-DP Non-CEN at follow-up. Patients classified as DP CEN had, on average, 3.43 RMDQ units less than patients classified as Non-DP Non-CEN at follow-up.These findings support previous reports, verifying the association between LBP dual-classification schemes and clinical outcomes.
疼痛模式分类（PPC）和方向偏好（DP）已显示出作为可靠且可预测的临床解决方案的优势，有助于减轻腰痛（LBP）带来的负担。我们进行了一项前瞻性观察队列研究，以验证PPC、DP与临床结局之间的关联。我们假设：（1）表现出DP集中化（CEN）的患者在随访时的疼痛强度和残疾程度低于表现出非DP非CEN的患者；（2）对于慢性LBP且年龄大于65岁的患者，首次检查时DP的患病率最低。639例患者完成了首次检查和随访数据。在首次检查和随访时收集了包括疼痛强度和残疾程度在内的临床结局指标。仅对有首次检查数据的组与有首次检查数据和随访数据的组进行基线比较。使用Pearson卡方检验确定分类变量患病率的差异，使用两样本t检验确定连续变量的差异。使用Turkey范围检验确定LBP双重分类的随访疼痛强度和残疾程度的差异。使用多元回归研究考虑风险调整因素的DP患病率。DP的总体患病率为84.5%，亚急性症状患者的患病率最低。基于年龄的患者DP患病率无显著差异。在随访时，分类为DP CEN的患者平均疼痛强度单位比分类为非DP非CEN的患者少1.99个单位。在随访时，分类为DP CEN的患者平均RMDQ单位比分类为非DP非CEN的患者少3.43个单位。这些发现支持了先前的报告，验证了LBP双重分类方案与临床结局之间的关联。
