Graduate School of Health Science, Kio University, 4-2-2 Umaminaka, Koryo-cho, Kitakatsuragi-gun, Nara, 635-0832, Japan.
Department of Pain and Palliative Medicine, The University of Tokyo Hospital, Tokyo, Japan.
Eur Spine J. 2019 Jul;28(7):1572-1578. doi: 10.1007/s00586-019-06010-4. Epub 2019 May 21.
PURPOSE: We aimed to kinematically analyze lumbar bending and returning movements and clarify the relationship between fear of movement and kinematic output. METHODS: We recruited 45 participants with CLBP (i.e., > 6 months) and 20 healthy control (HC) participants with no history of CLBP. We used the numerical rating pain scale (NRS), Tampa Scale for Kinesiophobia (TSK-11), and Pain Self-Efficacy Questionnaire (PSEQ-2) as qualitative outcome measurements. CLBP participants were divided into two subgroups (high- and low-fear groups) based on the median split of the total TSK-11 score. In the kinematic recording session, a starting-cue beep signaled participants to bend forward using the lumbar region of their spine and then return to an upright posture, and we used a flexible twin-axis electrogoniometer to record the lumbar movements. The time series of lumbar movements was divided into four phases according to lumbar movement velocity, and we calculated the length (sec) of each phase. RESULTS: Phase 1 (duration prior to cue-induced movement initiation) and phase 3 (switch in the direction of lumbar movement from forward to backward) were significantly longer in the CLBP high-fear group compared with those in the CLBP low-fear group and HC group (p < 0.05). The increased lengths of these two phases were positively correlated with not only pain intensity but also TSK-11 scores (p < 0.05). CONCLUSIONS: These results represent evidence of a particular lumbar movement pattern associated with kinesiophobia. These results might help to identify psychological factors that impact lumbar movement patterns in individuals with CLBP. These slides can be retrieved under Electronic Supplementary Material.
目的:我们旨在对腰椎弯曲和恢复运动进行运动学分析,并阐明运动恐惧与运动学输出之间的关系。
方法:我们招募了 45 名有慢性下腰痛(即 > 6 个月)的参与者和 20 名没有慢性下腰痛病史的健康对照组参与者。我们使用数字评分疼痛量表(NRS)、凯斯勒运动恐惧量表(TSK-11)和疼痛自我效能问卷(PSEQ-2)作为定性结果测量。根据 TSK-11 总分的中位数将 CLBP 参与者分为两个亚组(高恐惧组和低恐惧组)。在运动学记录过程中,起始提示音提示参与者使用脊柱腰部向前弯曲,然后恢复到直立姿势,我们使用灵活的双轴测角仪记录腰椎运动。根据腰椎运动速度将腰椎运动的时间序列分为四个阶段,并计算每个阶段的长度(秒)。
结果:与 CLBP 低恐惧组和 HC 组相比,CLBP 高恐惧组的阶段 1(提示引起运动起始前的持续时间)和阶段 3(腰椎运动方向从向前变为向后的切换)明显较长(p < 0.05)。这两个阶段的长度增加与疼痛强度和 TSK-11 评分呈正相关(p < 0.05)。
结论:这些结果代表了与运动恐惧相关的特定腰椎运动模式的证据。这些结果可能有助于确定影响 CLBP 个体腰椎运动模式的心理因素。这些幻灯片可在电子补充材料中检索。
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