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在接受择期腰椎手术的患者中,两年期间的运动恐惧与下腰痛残疾有关。

Fear of Movement Is Related to Low Back Disability During a Two-Year Period in Patients Who Have Undergone Elective Lumbar Spine Surgery.

机构信息

Functional Area Medical Psychology, Functional Unit Behavior Medicine, Karolinska University Hospital, Karolinska, Sweden; Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Department of Orthopaedics, Institute of the Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Spine Center Göteborg, Västra Frölunda, Sweden.

出版信息

World Neurosurg. 2020 May;137:e416-e424. doi: 10.1016/j.wneu.2020.01.218. Epub 2020 Feb 5.

Abstract

OBJECTIVE

To evaluate change in fear of movement and the relationship of fear of movement and pain intensity to low back disability and general health-related quality of life over a 2-year period.

METHODS

Consecutive patients scheduled for lumbar spine surgery were included. In addition to clinical background variables, back pain intensity, fear of movement, low back disability, and general health-related quality of life were assessed at baseline, 1 year, and 2 years after surgery. Linear mixed-effects models were used to analyze data.

RESULTS

In total, 348 patients were included in the final analyses. There was a significant reduction in fear of movement and a significant interaction between fear of movement and low back disability across assessments, showing that greater levels of fear of movement were related to greater levels of disability over the 2-year period. Similarly, greater levels of back pain intensity were related to lower levels of general health-related quality of life during this period.

CONCLUSIONS

We found that greater levels of fear of movement were related to greater levels of low back disability, following lumbar spine surgery, in a longitudinal study. This shows the need to address fear of movement in prehabilitation/rehabilitation pre- or postsurgically to improve health outcomes for patients who undergo lumbar spine surgery.

摘要

目的

评估 2 年内运动恐惧的变化,以及运动恐惧与疼痛强度与腰痛残疾和一般健康相关生活质量的关系。

方法

连续纳入计划接受腰椎手术的患者。除临床背景变量外,还在基线、术后 1 年和 2 年评估腰背疼痛强度、运动恐惧、腰痛残疾和一般健康相关生活质量。使用线性混合效应模型分析数据。

结果

共有 348 例患者纳入最终分析。在评估过程中,运动恐惧显著降低,运动恐惧与腰痛残疾之间存在显著交互作用,表明运动恐惧程度越高,在 2 年内残疾程度越高。同样,在此期间,腰背疼痛强度越高,一般健康相关生活质量越低。

结论

我们发现,在腰椎手术后的纵向研究中,运动恐惧程度越高,腰痛残疾程度越高。这表明需要在术前或术后康复期进行运动恐惧的管理,以改善接受腰椎手术的患者的健康结果。

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