Massé-Alarie Hugo, Angarita-Fonseca Adriana, Lacasse Anaïs, Pagé M Gabrielle, Tétreault Pascal, Fortin Maryse, Léonard Guillaume, Stone Laura S, Roy Jean-Sébastien
Department of Rehabilitation, Faculty of Medicine, Université Laval & Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Canada.
Department of Health Sciences, Université du Québec en Abitibi-Témiscamingue (UQAT), Rouyn-Noranda, Canada.
Pain Rep. 2022 Mar 22;7(2):e997. doi: 10.1097/PR9.0000000000000997. eCollection 2022 Mar-Apr.
Numerous definitions of acute low back pain (aLBP) exist. The use of different definitions results in variability in reported prevalence or incidence, conflicting data regarding factors associated with the transition to chronic LBP (cLBP), and hampers comparability among studies.
Here, we compare the impact of 3 aLBP definitions on the number of aLBP cases and participants' characteristics and explore the distribution of participants across definitions.
A sample of 1264 participants from the Quebec Low Back Pain Study was included. Three definitions of aLBP were used: (1) not meeting the National Institutes of Health (NIH) cLBP definition ("nonchronic"), (2) pain beginning <3 months ago ("acute"), and (3) pain beginning <3 months with a preceding LBP-free period ("new episode").
There were 847, 842, and 489 aLBP cases meeting the criteria for the 3 definitions, respectively. Participants included in the "nonchronic" had lower pain interference, greater physical function scores, and fewer participants reporting >5 years of pain than in the other definitions. Half the participants meeting the "acute" definition and one-third of participants meeting the "new episode" definition were also classified as cLBP based on the NIH definition.
Our results highlight the importance of the definition used for aLBP. Different definitions influence the sample size and clinical profiles (group's characteristics). We recommended that cohort studies examining the transition from aLBP to cLBP ensure that the definitions selected are mutually exclusive (ie, participants included [aLBP] differ from the expected outcome [cLBP]).
急性下腰痛（aLBP）存在众多定义。使用不同的定义会导致报告的患病率或发病率存在差异，关于向慢性下腰痛（cLBP）转变相关因素的数据相互矛盾，并且妨碍了研究之间的可比性。
在此，我们比较3种aLBP定义对aLBP病例数量和参与者特征的影响，并探讨参与者在不同定义中的分布情况。
纳入了来自魁北克下腰痛研究的1264名参与者样本。使用了3种aLBP定义：（1）不符合美国国立卫生研究院（NIH）的cLBP定义（“非慢性”），（2）疼痛始于<3个月前（“急性”），以及（3）疼痛始于<3个月且之前有一段无下腰痛的时期（“新发作”）。
分别有847、842和489例aLBP病例符合这3种定义的标准。与其他定义相比，纳入“非慢性”定义的参与者疼痛干扰较低，身体功能得分较高，且报告疼痛>5年的参与者较少。根据NIH定义，符合“急性”定义的参与者中有一半以及符合“新发作”定义的参与者中有三分之一也被归类为cLBP。
我们的结果突出了aLBP定义的重要性。不同的定义会影响样本量和临床概况（组的特征）。我们建议研究从aLBP向cLBP转变的队列研究确保所选定义相互排斥（即纳入的参与者[aLBP]与预期结果[cLBP]不同）。
