Nielsen Jonas, Glissmann Nim Casper, O'Neill Søren, Boyle Eleanor, Hartvigsen Jan, Kawchuk Gregory N
Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Spinecenter of Southern Denmark, Lillebaelt Hospital, Middelfart, Denmark.
PeerJ. 2020 Dec 7;8:e9598. doi: 10.7717/peerj.9598. eCollection 2020.
Objectively measured reduction in lumbar posterior-to-anterior (PA) stiffness is associated with pain relief in some, but not all persons with low back pain. Unfortunately, these measurements can be time consuming to perform. In comparison, the Lumbar Spine Instability Questionnaire (LSIQ) is intended to measure spinal instability and the Lumbar Spine Disability Index (LSDI) is created for self-reporting functional disability due to increased spinal stiffness. Given the above, the aim of this study is to compare measures of the LSIQ and LSDI with objective measures of lumbar PA stiffness as measured by a mechanical device, Vertetrack (VT), in patients with persistent non-specific low back pain (nsLBP).
Twenty-nine patients with nsLBP completed the LSIQ and LSDI at baseline and after two weeks. On these same occasions, PA spinal stiffness was measured using the VT. Between measurements, patients received four sessions of spinal manipulation. The resulting data was analyzed to determine the correlation between the self-report and objective measures of stiffness at both time points. Further, the patients were categorized into responders and non-responders based on pre-established cut points depending on values from the VT and compared those to self-report measures in order to determine whether the LSIQ and the LSDI were sensitive to change.
Twenty-nine participants completed the study. Measures from the LSIQ and LSDI correlated poorly with objectively measured lumbar PA stiffness at baseline and also with the change scores. The change in objectively measured lumbar PA stiffness following spinal manipulation did not differ between those who improved, and those who did not improve according to the pre-specified cut-points. Finally, a reduction in lumbar PA stiffness following intervention was not associated with improvement in LSIQ and LSDI outcomes.
The current data indicate that the LSIQ and LSDI questionnaires do not correlate with measures obtained objectively by VT. Our results suggest that these objective and self- reported measures represent different domains and as such, cannot stand in place of one another.
客观测量发现，部分但并非所有腰痛患者的腰椎后前（PA）刚度降低与疼痛缓解相关。遗憾的是，这些测量操作可能耗时较长。相比之下，腰椎脊柱不稳问卷（LSIQ）旨在测量脊柱不稳，而腰椎脊柱功能障碍指数（LSDI）则用于自我报告因脊柱刚度增加导致的功能障碍。鉴于上述情况，本研究的目的是比较持续性非特异性腰痛（nsLBP）患者中，LSIQ和LSDI测量结果与通过机械设备Vertetrack（VT）测量的腰椎PA刚度客观测量结果。
29例nsLBP患者在基线和两周后完成了LSIQ和LSDI。在相同时间点，使用VT测量PA脊柱刚度。两次测量期间，患者接受了4次脊柱推拿治疗。对所得数据进行分析，以确定两个时间点刚度的自我报告测量结果与客观测量结果之间的相关性。此外，根据VT测量值的预先设定切点，将患者分为反应者和无反应者，并将其与自我报告测量结果进行比较，以确定LSIQ和LSDI对变化是否敏感。
29名参与者完成了研究。LSIQ和LSDI的测量结果与基线时客观测量的腰椎PA刚度以及变化分数的相关性较差。根据预先指定的切点，脊柱推拿后客观测量的腰椎PA刚度变化在改善者和未改善者之间没有差异。最后，干预后腰椎PA刚度的降低与LSIQ和LSDI结果的改善无关。
目前的数据表明，LSIQ和LSDI问卷与VT客观获得的测量结果不相关。我们的结果表明，这些客观测量和自我报告测量代表不同的领域，因此不能相互替代。
