Puschmann Anne-Katrin, Lin Chiao-I, Wippert Pia-Maria
Sociology of Medicine and Psychobiology, Department of Physical Activity and Health, University of Potsdam, Potsdam, Germany.
Faculty of Health Sciences Brandenburg [University of Potsdam, the Brandenburg Medical School Theodor Fontane and the Brandenburg University of Technology Cottbus - Senftenberg], Senftenberg, Germany.
Front Sports Act Living. 2021 Jul 20;3:659982. doi: 10.3389/fspor.2021.659982. eCollection 2021.
Development of chronic pain after a low back pain episode is associated with increased pain sensitivity, altered pain processing mechanisms and the influence of psychosocial factors. Although there is some evidence that multimodal therapy (such as behavioral or motor control therapy) may be an important therapeutic strategy, its long-term effect on pain reduction and psychosocial load is still unclear. Prospective longitudinal designs providing information about the extent of such possible long-term effects are missing. This study aims to investigate the long-term effects of a homebased uni- and multidisciplinary motor control exercise program on low back pain intensity, disability and psychosocial variables. 14 months after completion of a multicenter study comparing uni- and multidisciplinary exercise interventions, a sample of one study center ( = 154) was assessed once more. Participants filled in questionnaires regarding their low back pain symptoms (characteristic pain intensity and related disability), stress and vital exhaustion (short version of the Maastricht Vital Exhaustion Questionnaire), anxiety and depression experiences (the Hospital and Anxiety Depression Scale), and pain-related cognitions (the Fear Avoidance Beliefs Questionnaire). Repeated measures mixed ANCOVAs were calculated to determine the long-term effects of the interventions on characteristic pain intensity and disability as well as on the psychosocial variables. Fifty four percent of the sub-sample responded to the questionnaires ( = 84). Longitudinal analyses revealed a significant long-term effect of the exercise intervention on pain disability. The multidisciplinary group missed statistical significance yet showed a medium sized long-term effect. The groups did not differ in their changes of the psychosocial variables of interest. There was evidence of long-term effects of the interventions on pain-related disability, but there was no effect on the other variables of interest. This may be partially explained by participant's low comorbidities at baseline. Results are important regarding costless homebased alternatives for back pain patients and prevention tasks. Furthermore, this study closes the gap of missing long-term effect analysis in this field.
腰痛发作后慢性疼痛的发展与疼痛敏感性增加、疼痛处理机制改变以及社会心理因素的影响有关。尽管有证据表明多模式疗法（如行为或运动控制疗法）可能是一种重要的治疗策略，但其对减轻疼痛和社会心理负担的长期效果仍不明确。缺乏能提供此类可能长期效果程度信息的前瞻性纵向研究设计。本研究旨在调查基于家庭的单学科和多学科运动控制锻炼计划对腰痛强度、功能障碍和社会心理变量的长期影响。在一项比较单学科和多学科运动干预的多中心研究完成14个月后，对其中一个研究中心的样本（n = 154）再次进行评估。参与者填写了关于腰痛症状（特征性疼痛强度和相关功能障碍）、压力和体力耗竭（马斯特里赫特体力耗竭问卷简版）、焦虑和抑郁经历（医院焦虑抑郁量表）以及疼痛相关认知（恐惧回避信念问卷）的问卷。计算重复测量混合协方差分析以确定干预对特征性疼痛强度、功能障碍以及社会心理变量的长期影响。子样本中有54%（n = 84）对问卷做出了回应。纵向分析显示运动干预对疼痛功能障碍有显著的长期影响。多学科组未达到统计学显著性，但显示出中等程度的长期影响。两组在感兴趣的社会心理变量变化方面没有差异。有证据表明干预对与疼痛相关的功能障碍有长期影响，但对其他感兴趣的变量没有影响。这可能部分归因于参与者基线时合并症较少。研究结果对于腰痛患者的免费家庭替代方案和预防工作具有重要意义。此外，本研究填补了该领域长期效果分析缺失的空白。
