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采用腰椎刚度、压痛阈值和热痛阈值之间的相关性对持续性腰痛进行横断面分析。

A cross-sectional analysis of persistent low back pain, using correlations between lumbar stiffness, pressure pain threshold, and heat pain threshold.

机构信息

Spine Center of Southern Denmark, University Hospital of Southern Denmark, Oestrehougvej 55, 5500, Middelfart, Denmark.

Department of Regional Health Research, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.

出版信息

Chiropr Man Therap. 2021 Sep 3;29(1):34. doi: 10.1186/s12998-021-00391-4.


DOI:10.1186/s12998-021-00391-4
PMID:34479585
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8414715/
Abstract

INTRODUCTION: Little is known about the underlying biomechanical cause of low back pain (LBP). Recently, technological advances have made it possible to quantify biomechanical and neurophysiological measurements, potentially relevant factors in understanding LBP etiology. However, few studies have explored the relation between these factors. This study aims to quantify the correlation between biomechanical and neurophysiological outcomes in non-specific LBP and examine whether these correlations differ when considered regionally vs. segmentally. METHODS: This is a secondary cross-sectional analysis of 132 participants with persistent non-specific LBP. Biomechanical data included spinal stiffness (global stiffness) measured by a rolling indenter. Neurophysiological data included pain sensitivity (pressure pain threshold and heat pain threshold) measured by a pressure algometer and a thermode. Correlations were tested using Pearson's product-moment correlation or Spearman's rank correlation as appropriate. The association between these outcomes and the segmental level was tested using ANOVA with post-hoc Tukey corrected comparisons. RESULTS: A moderate positive correlation was found between spinal stiffness and pressure pain threshold, i.e., high degrees of stiffness were associated with high pressure pain thresholds. The correlation between spinal stiffness and heat pain threshold was poor and not statistically significant. Aside from a statistically significant minor association between the lower and the upper lumbar segments and stiffness, no other segmental relation was shown. CONCLUSIONS: The moderate correlation between spinal stiffness and mechanical pain sensitivity was the opposite of expected, meaning higher degrees of stiffness was associated with higher pressure pain thresholds. No clinically relevant segmental association existed.

摘要

简介:目前对于导致下腰痛(LBP)的潜在生物力学原因知之甚少。最近,技术的进步使得量化生物力学和神经生理学测量成为可能,这些因素可能与理解 LBP 病因有关。然而,很少有研究探讨这些因素之间的关系。本研究旨在量化非特异性 LBP 患者的生物力学和神经生理学结果之间的相关性,并检验这些相关性在区域性和节段性上是否存在差异。 方法:这是一项对 132 名持续存在非特异性 LBP 患者的二次横断面分析。生物力学数据包括由滚动压头测量的脊柱刚度(整体刚度)。神经生理学数据包括由压力测痛计和热测痛计测量的疼痛敏感性(压痛阈值和热痛阈值)。使用 Pearson 积差相关或 Spearman 等级相关(视情况而定)检验相关性。使用方差分析和事后 Tukey 校正比较检验这些结果与节段水平之间的关系。 结果:发现脊柱刚度与压痛阈值之间存在中度正相关,即高刚度与高压痛阈值相关。脊柱刚度与热痛阈值之间的相关性较差,且无统计学意义。除了下腰椎和上腰椎节段与刚度之间存在统计学上显著的次要关联外,没有显示出其他节段性关联。 结论:脊柱刚度与机械性疼痛敏感性之间的中度相关性与预期相反,即较高的刚度与较高的压痛阈值相关。不存在具有临床意义的节段性关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfc7/8414715/cd65eac43b74/12998_2021_391_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfc7/8414715/4c5ec0e317bd/12998_2021_391_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfc7/8414715/02091a85c2bb/12998_2021_391_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfc7/8414715/cd65eac43b74/12998_2021_391_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfc7/8414715/4c5ec0e317bd/12998_2021_391_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfc7/8414715/02091a85c2bb/12998_2021_391_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfc7/8414715/cd65eac43b74/12998_2021_391_Fig3_HTML.jpg

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引用本文的文献

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The combined effect of transcutaneous electrical nerve stimulation and transcutaneous auricular vagus nerve stimulation on pressure and heat pain thresholds in pain-free subjects: a randomized cross-over trial.

Trials. 2024-7-31

[2]
Effects of transcutaneous electrical nerve stimulation on pain, function, and descending inhibition in people with non-specific chronic low-back pain: a study protocol for a randomized crossover trial.

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[4]
Current Concept of Quantitative Sensory Testing and Pressure Pain Threshold in Neck/Shoulder and Low Back Pain.

Healthcare (Basel). 2022-8-7

[5]
Pressure pain thresholds in a real-world chiropractic setting: topography, changes after treatment, and clinical relevance?

Chiropr Man Therap. 2022-5-12

[6]
Segmental Chiropractic Spinal Manipulation Does not Reduce Pain Amplification and the Associated Pain-Related Brain Activity in a Capsaicin-Heat Pain Model.

Front Pain Res (Lausanne). 2021-11-1

本文引用的文献

[1]
Posterior to anterior spinal stiffness measured in a sample of 127 secondary care low back pain patients.

Clin Biomech (Bristol). 2021-7

[2]
The effect on clinical outcomes when targeting spinal manipulation at stiffness or pain sensitivity: a randomized trial.

Sci Rep. 2020-9-3

[3]
The bench-top accuracy of the VerteTrack spinal stiffness assessment device.

Chiropr Man Therap. 2020-8-18

[4]
Shoulder stiffness after rotator cuff repair: the fate of stiff shoulders up to 9 years after rotator cuff repair.

J Shoulder Elbow Surg. 2020-2-19

[5]
Superficial temperature and pain tolerance in patients with chronic low back pain.

J Bodyw Mov Ther. 2019-7

[6]
Reliability of a new loaded rolling wheel system for measuring spinal stiffness in asymptomatic participants.

BMC Musculoskelet Disord. 2019-4-24

[7]
Clinicians' Ability to Detect a Palpable Difference in Spinal Stiffness Compared With a Mechanical Device.

J Manipulative Physiol Ther. 2019-2

[8]
Topographic mapping of pain sensitivity of the lower back - a comparison of healthy controls and patients with chronic non-specific low back pain.

Scand J Pain. 2019-1-28

[9]
From acute to persistent low back pain: a longitudinal investigation of somatosensory changes using quantitative sensory testing-an exploratory study.

Pain Rep. 2018-3-5

[10]
The regional effect of spinal manipulation on the pressure pain threshold in asymptomatic subjects: a systematic literature review.

Chiropr Man Therap. 2018-4-19

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