Adnan Rahmat, Van Oosterwijck Jessica, Danneels Lieven, Willems Tine, Meeus Mira, Crombez Geert, Goubert Dorien
SPINE Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Belgium.
Faculty of Sports Science and Recreation, Universiti Teknologi MARA, Malaysia.
J Back Musculoskelet Rehabil. 2020;33(6):919-930. doi: 10.3233/BMR-191548.
Differences in pain processing, muscle structure and function have been reported in patients with low back pain (LBP) with different grades of pain chronicity.
The present study aims to examine differences in psychological factors, disability and subjective fatigue between subgroups of LBP based on their chronification grade.
Twenty-one healthy controls (HC) and 54 LBP patients (categorized based on the grades of chronicity into recurrent LBP (RLBP), non-continuous chronic LBP (CLBP), or continuous (CLBP)) filled out a set of self-reporting questionnaires.
The Hospital Anxiety and Depression Scale (HADS) and Multidimensional Pain Inventory (MPI) scores indicated that anxiety, pain severity, pain interference and affective distress were lower in HC and RLBP compared to non-continuous CLBP. Anxiety scores were higher in non-continuous CLBP compared to RLBP, continuous CLBP and HC. The Pain Catastrophizing Scale for Helplessness (PSCH) was higher in non-continuous CLBP compared to HC. The Survey of Pain Attitudes (SOPA) showed no differences in adaptive and maladaptive behaviors across the groups. The Pain Disability Index (PDI) measured a higher disability in both CLBP groups compared to HC. Moreover, the Rolland Morris Disability Questionnaire (RMDQ) showed higher levels of disability in continuous CLBP compared to non-continuous CLBP, RLBP and HC. The Checklist Individual Strength (CIS) revealed that patients with non-continuous CLBP were affected to a higher extent by severe fatigue compared to continuous CLBP, RLBP and HC (subjective fatigue, concentration and physical activity). For all tests, a significance level of 0.05 was used.
RLBP patients are more disabled than HC, but have a tendency towards a general positive psychological state of mind. Non-continuous CLBP patients would most likely present a negative psychological mindset, become more disabled and have prolonged fatigue complaints. Finally, the continuous CLBP patients are characterized by more negative attitudes and believes on pain, enhanced disability and interference of pain in their daily lives.
据报道，不同疼痛慢性程度的腰痛（LBP）患者在疼痛处理、肌肉结构和功能方面存在差异。
本研究旨在探讨基于慢性化程度的LBP亚组之间心理因素、残疾和主观疲劳的差异。
21名健康对照者（HC）和54名LBP患者（根据慢性程度分为复发性LBP（RLBP）、非连续性慢性LBP（CLBP）或连续性CLBP）填写了一组自我报告问卷。
医院焦虑抑郁量表（HADS）和多维疼痛量表（MPI）得分表明，与非连续性CLBP相比，HC和RLBP的焦虑、疼痛严重程度、疼痛干扰和情感困扰较低。与RLBP、连续性CLBP和HC相比，非连续性CLBP的焦虑得分更高。与HC相比，非连续性CLBP的无助疼痛灾难化量表（PSCH）更高。疼痛态度调查（SOPA）显示各组在适应性和适应不良行为方面没有差异。与HC相比，两个CLBP组的疼痛残疾指数（PDI）测量的残疾程度更高。此外，罗兰·莫里斯残疾问卷（RMDQ）显示，与非连续性CLBP、RLBP和HC相比，连续性CLBP的残疾水平更高。个人力量清单（CIS）显示，与连续性CLBP、RLBP和HC相比，非连续性CLBP患者受严重疲劳的影响程度更高（主观疲劳、注意力和身体活动）。所有测试均采用0.05的显著性水平。
RLBP患者比HC残疾程度更高，但倾向于具有总体积极的心理状态。非连续性CLBP患者很可能呈现消极的心理思维模式，残疾程度更高，疲劳抱怨持续时间更长。最后，连续性CLBP患者的特点是对疼痛有更多消极态度和信念，残疾程度增加，疼痛对其日常生活产生干扰。
