严重腰痛患者在腰椎融合手术前身体活动水平较低：一项横断面研究。
Patients with severe low back pain exhibit a low level of physical activity before lumbar fusion surgery: a cross-sectional study.
作者信息
Lotzke Hanna, Jakobsson Max, Gutke Annelie, Hagströmer Maria, Brisby Helena, Hägg Olle, Smeets Rob, Lundberg Mari
机构信息
Institute of the Clinical Sciences, Department of Orthopaedics at Sahlgrenska Academy, University of Gothenburg, R-huset 7th Floor, SU/Mölndal, Göteborgsvägen 31, 431 80 Mölndal, Gothenburg, Sweden.
Spine Center Göteborg, Gruvgatan 8, 421 30, Västra Frölunda, Sweden.
出版信息
BMC Musculoskelet Disord. 2018 Oct 11;19(1):365. doi: 10.1186/s12891-018-2274-5.
BACKGROUND
People with severe low back pain are at higher risk of poor health. Patients scheduled for lumbar fusion surgery are assumed to have low levels of physical activity, but few data exist. The aim of the study was firstly to investigate preoperative levels of objectively measured physical activity in patients with severe low back pain waiting for lumbar fusion surgery, and secondly to investigate whether factors in the fear-avoidance model were associated with these levels.
METHODS
We included 118 patients waiting for lumbar fusion surgery (63 women and 55 men; mean age 46 years). Physical activity expressed as steps per day and total time spent in at least moderate-intensity physical activity was assessed with ActiGraph GT3X+ accelerometers. The data were compared to the WHO recommendations on physical activity for health. Whether factors in the fear-avoidance model were associated with physical activity was evaluated by two different multiple linear regression models.
RESULTS
Ninety-six patients (83%) did not reach the WHO recommendations on physical activity for health, and 19 (16%) patients took fewer than 5000 steps per day, which indicates a sedentary lifestyle. On a group level, higher scores for fear of movement and disability were associated with lower numbers of steps per day.
CONCLUSION
A high proportion of the patients did not reach the WHO recommendations on physical activity and are therefore at risk of poor health due to insufficient physical activity. We also found a negative association between both fear of movement and disability, and the number of steps per day. Action needs to be taken to motivate patients to be more physically active before surgery, to improve health postoperatively. There is a need for interventions aimed at increasing physical activity levels and reducing barriers to physical activity in the prehabilitation phase of this patient group.
TRIAL REGISTRATION
Current Controlled Trials ISCRTN 17115599 , retrospectively Registered 18 may 2015.
背景
严重腰痛患者健康状况较差的风险更高。计划进行腰椎融合手术的患者被认为身体活动水平较低，但相关数据较少。本研究的目的，一是调查等待腰椎融合手术的严重腰痛患者术前客观测量的身体活动水平，二是调查恐惧-回避模型中的因素是否与这些水平相关。
方法
我们纳入了118例等待腰椎融合手术的患者（63例女性和55例男性；平均年龄46岁）。使用ActiGraph GT3X+加速度计评估以每日步数和至少中等强度身体活动所花费的总时间表示的身体活动。将数据与世界卫生组织关于促进健康的身体活动建议进行比较。通过两个不同的多元线性回归模型评估恐惧-回避模型中的因素是否与身体活动相关。
结果
96例患者（83%）未达到世界卫生组织关于促进健康的身体活动建议，19例患者（16%）每天步数少于5000步，这表明其生活方式久坐不动。在组水平上，对运动和残疾的恐惧得分较高与每日步数较少相关。
结论
很大一部分患者未达到世界卫生组织关于身体活动的建议，因此因身体活动不足而面临健康状况不佳的风险。我们还发现对运动和残疾的恐惧与每日步数之间存在负相关。需要采取行动激励患者在手术前增加身体活动，以改善术后健康状况。有必要在该患者群体的术前康复阶段采取干预措施，以提高身体活动水平并减少身体活动的障碍。
试验注册
当前受控试验ISCRTN 17115599，于2015年5月18日追溯注册。
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