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慢性下背痛患者的中枢敏化与远隔肌肉表现之间的相关性。

Correlation Between Central Sensitization and Remote Muscle Performance in Individuals With Chronic Low Back Pain.

机构信息

Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas.

Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas.

出版信息

J Manipulative Physiol Ther. 2021 Jan;44(1):14-24. doi: 10.1016/j.jmpt.2020.07.008. Epub 2020 Nov 26.

Abstract

OBJECTIVE

The purpose of this study was to examine associations between the degree of central sensitization (CS) and remote muscle performance in people with chronic low back pain (CLBP).

METHODS

The 2011 fibromyalgia (FM) criteria and severity scales (2011 FM survey) were used as a surrogate measure of CS to divide the participants into 2 groups: FM-positive CLBP and FM-negative CLBP. Measures related to central sensitization included the 2011 FM survey and pressure pain threshold of the thumbnail. Measures related to muscle performance included neck flexor muscle strength and endurance and plantar flexor muscle strength. Between-groups and correlation analyses were performed.

RESULTS

Sixty people with CLBP were enrolled (30 FM-positive, 30 FM-negative). There was no significant difference between the subgroups in age, sex, or pain duration (P > .05). The FM-positive CLBP group showed poorer neck flexor muscle endurance (P = .01) and plantar flexor muscle strength (P = .002) than the FM-negative CLBP group, whereas neck flexor muscle strength was not different between the groups (P = .175). Scores for FM and values for pressure pain thresholds of the thumbnail were associated with neck flexor muscle strength (respectively, r = -0.320, P = .013, and r = 0.467, P < .001), endurance (r = -0.242, P < .001, and r = 0.335, P = .009), and plantar flexor muscle strength (r = -0.469, P < .001, and r = 0.500, P < .001).

CONCLUSION

We found associations between the degree of CS and remote muscle strength and endurance, suggesting that poor remote muscle performance is possibly a clinical sign of CS in people with CLBP.

摘要

目的

本研究旨在探讨慢性下背痛(CLBP)患者的中枢敏化(CS)程度与远隔肌肉表现之间的关联。

方法

采用 2011 年纤维肌痛(FM)标准和严重程度量表(2011 FM 调查)作为 CS 的替代测量指标,将参与者分为 2 组:FM 阳性 CLBP 和 FM 阴性 CLBP。与 CS 相关的测量指标包括 2011 FM 调查和拇指压痛阈。与肌肉表现相关的测量指标包括颈屈肌力量和耐力以及跖屈肌力量。进行组间和相关性分析。

结果

共纳入 60 名 CLBP 患者(FM 阳性 30 例,FM 阴性 30 例)。亚组间在年龄、性别或疼痛持续时间方面无显著差异(P>.05)。FM 阳性 CLBP 组颈屈肌耐力(P=.01)和跖屈肌力量(P=.002)较 FM 阴性 CLBP 组差,而颈屈肌力量无差异(P=.175)。FM 评分和拇指压痛阈值与颈屈肌力量(分别为 r= -0.320,P=.013 和 r= 0.467,P<.001)、耐力(r= -0.242,P<.001 和 r= 0.335,P=.009)和跖屈肌力量(r= -0.469,P<.001 和 r= 0.500,P<.001)相关。

结论

我们发现 CS 程度与远隔肌肉力量和耐力之间存在关联,这表明 CLBP 患者的远隔肌肉表现不佳可能是 CS 的临床标志。

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