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特定型慢性低背痛(以中枢敏化为主)患者中极端特质敏感型和人格类型的流行率:一项国际观察性研究的二次分析。

Prevalence of Extreme Trait Sensory Profiles and Personality Types in Nonspecific Chronic Low Back Pain with Predominant Central Sensitization: Secondary Analysis of an International Observational Study.

机构信息

Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom; Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium: Pain in Motion international research collaboration, Brussels, Belgium.

Pain in Motion Research Group (www.paininmotion.be); Department of Human Physiology and Physiotherapy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium.

出版信息

Pain Physician. 2019 May;22(3):E181-E190.

Abstract

BACKGROUND

Individuals with nonspecific chronic low back pain (NSCLBP) and central sensitization (CS) exhibit sensory hypersensitivity that may be related to pre-existing trait characteristics. Sensory profiles and trait anxiety-related characteristics have sensory sensitivity in common with CS.

OBJECTIVES

The objectives of this study were 1) to observe the prevalence of 4 personality types and extreme scores of 4 trait sensory profiles in people with NSCLBP and predominant CS; and 2) to compare these between 2 subgroups based on high and low self-reported CS symptoms.

STUDY DESIGN

An international cross-sectional observational study was undertaken.

SETTING

Adults (n = 165; mean age = 45 ± 12 standard deviation) were recruited from physiotherapy clinics across 3 countries and 2 continents.

METHODS

The inclusion criteria were: NSCLBP, aged 18-64 years, with clinically identified predominant CS pain, without specific pathology. The outcome measures were: Central Sensitization Inventory (CSI), Adolescent/Adult Sensory Profile, State/Trait Anxiety Inventory, and Marlowe Crowne Social Desirability Scale. Descriptive and comparative statistics were used.

RESULTS

CSI scores ranged from 19-79 (mean = 50). There was a high prevalence of extreme 1) trait sensory hyper- and, unexpectedly, hyposensitivity profile scores (P < 0.001) and Defensive High Anxious personality type (P < 0.01) in the high-CSI (CSI>= 40; 78%) subgroup, and 2) trait sensory hyposensitivity profile scores (P < 0.01) and Repressor personality type (P < 0.01) in the low-CSI subgroup (CSI < 40; 22%).

LIMITATIONS

Self-report measures only were used; limited demographics.

CONCLUSIONS

To our knowledge, these results are the first to demonstrate extreme trait sensory profiles and personality types in people with NSCLBP and predominant CS. A subgroup who reports low levels of CS symptoms may have a hyposensitive sensory profile and Repressor personality type. Further study is required to investigate the extent to which these trait characteristics may predict CS symptoms in people with NSCLBP.

KEY WORDS

Central sensitization, nonspecific chronic low back pain, prevalence of extreme trait characteristics, sensory profiles, trait anxiety-related personality types.

摘要

背景

患有非特异性慢性下腰痛(NSCLBP)和中枢敏化(CS)的个体表现出感觉过敏,这可能与预先存在的特质特征有关。感觉特征和特质焦虑相关特征与 CS 具有共同的感觉敏感性。

目的

本研究的目的是 1)观察具有主要 CS 疼痛的 NSCLBP 患者中 4 种人格类型和 4 种特质感觉特征的极端分数的患病率;2)根据自我报告的 CS 症状的高低,将这些分数在 2 个亚组之间进行比较。

研究设计

这是一项国际横断面观察性研究。

设置

来自 3 个国家和 2 个大陆的物理治疗诊所招募了 165 名成年人(平均年龄=45±12 标准差)。

方法

纳入标准为:NSCLBP,年龄 18-64 岁,临床诊断为主要 CS 疼痛,无特定病理。结果测量指标包括:中枢敏化量表(CSI)、青少年/成人感觉特征量表、状态/特质焦虑量表和马洛-克劳恩社会期望量表。使用描述性和比较性统计。

结果

CSI 评分范围为 19-79(平均=50)。在高 CSI(CSI>=40;78%)亚组中,1)特质感觉超敏和出乎意料的低敏特征评分(P<0.001)和防御性高焦虑人格类型(P<0.01),以及 2)特质感觉低敏特征评分(P<0.01)和压抑人格类型(P<0.01)的发生率较高。而在低 CSI 亚组(CSI<40;22%)中,这些发生率较低。

局限性

仅使用自我报告的测量方法;人口统计学数据有限。

结论

据我们所知,这些结果是首次在具有主要 CS 症状的 NSCLBP 患者中发现极端特质感觉特征和人格类型。报告 CS 症状水平较低的亚组可能具有低敏感觉特征和压抑人格类型。需要进一步研究以调查这些特质特征在 NSCLBP 患者的 CS 症状中的预测程度。

关键词

中枢敏化、非特异性慢性下腰痛、极端特质特征患病率、感觉特征、特质焦虑相关人格类型。

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