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中重度残疾对慢性腰痛患者时空参数有负面影响。

Moderate disability has negative effect on spatiotemporal parameters in patients with chronic low back pain.

机构信息

Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Samanpazarı, Ankara, 06100, Turkey.

Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Samanpazarı, Ankara, 06100, Turkey.

出版信息

Gait Posture. 2020 Jun;79:251-255. doi: 10.1016/j.gaitpost.2020.05.015. Epub 2020 May 16.

Abstract

BACKGROUND

It is known that the patients with chronic low back pain (CLBP) has different spatiotemporal characteristics than healthy controls such as average speed, cadence, step and stride length parameters. CLBP is a heterogeneous phenomenon in terms of causing various level of disability.

RESEARCH QUESTION

Does disability levels make a difference on spatiotemporal characteristics of patients with CLBP?

METHODS

66 patients with CLBP and 32 healthy controls between the ages of 25 and 65 years participated to study. The patients who had neurological, orthopedic, cardiovascular, metastatic history excluded from study. Resting, activity and night pain and functional disability were evaluated with Visual Analog Scale (VAS), Oswestry Disability Index (ODI) respectively. The patients were divided into two groups according to their disability level: moderate and severe. Gait analyses were performed with Optogait treadmill-based photocell system (Version 1.6.4.0, Microgate, Bolzano, Italy). After two trials were done, the spatiotemporal characteristics recorded for one minute while patients walked their preferred speed on the treadmill. One-way ANOVA was used to compare these parameters among the perceived disability level (moderate, severe) and healthy controls.The level of significance was accepted as 0.05.

RESULTS

Step length, stride length, and preferred walking speed were the parameters that differentiate the gait between healthy controls and patients with CLBP (p < 0.05). According to post-hoc analyses, moderate CLBP was identified as the group most different from the healthy controls (p < 0.05).

SIGNIFICANCE

Results of this study describe how compensating mechanism were seen in CLBP subgroups. As opposed to expectations, an increase in disability would not create higher difference in spatiotemporal characteristics between healthy controls and patients with severe disability. We propose that patients with severe and moderate disability had different ways to normalize their gait.

摘要

背景

患有慢性下腰痛(CLBP)的患者与健康对照组相比,具有不同的时空特征,例如平均速度、步频、步幅和步长参数。CLBP 在导致各种程度的残疾方面是一种异质现象。

研究问题

残疾程度是否会对 CLBP 患者的时空特征产生影响?

方法

本研究纳入了 66 名 CLBP 患者和 32 名年龄在 25 至 65 岁之间的健康对照组。患有神经、骨科、心血管、转移病史的患者被排除在研究之外。使用视觉模拟量表(VAS)和 Oswestry 残疾指数(ODI)分别评估静息、活动和夜间疼痛以及功能障碍。根据残疾程度将患者分为中度和重度两组。使用 Optogait 跑步机式光电系统(版本 1.6.4.0,Microgate,博尔扎诺,意大利)进行步态分析。在完成两次试验后,患者在跑步机上以自己喜欢的速度行走一分钟,记录时空特征。使用单因素方差分析比较感知残疾水平(中度、重度)和健康对照组之间的这些参数。以 0.05 为显著性水平。

结果

步长、步幅和首选行走速度是区分健康对照组和 CLBP 患者步态的参数(p<0.05)。根据事后分析,中度 CLBP 被确定为与健康对照组最不同的组(p<0.05)。

意义

本研究结果描述了代偿机制如何在 CLBP 亚组中显现。与预期相反,残疾程度的增加不会在健康对照组和重度残疾患者之间的时空特征产生更高的差异。我们提出,重度和中度残疾患者有不同的方法来使他们的步态正常化。

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