Seattle Epidemiologic Research and Information Center (ERIC), VA Puget Sound Health Care System, 1660 S. Columbian Way, S-152-E, Seattle, WA, 98108, USA.
Rehabilitation Care Services, VA Puget Sound Health Care System, 1660 S. Columbian Way, S-RCS-117, Seattle, WA, 98108, USA.
BMC Musculoskelet Disord. 2022 Apr 21;23(1):376. doi: 10.1186/s12891-022-05281-1.
Although it is generally accepted that physical activity and flares of low back pain (LBP) are related, evidence for the directionality of this association is mixed. The Flares of Low back pain with Activity Research Study (FLAReS) takes a novel approach to distinguish the short-term effects of specific physical activities on LBP flares from the cumulative effects of such activities, by conducting a longitudinal case-crossover study nested within a cohort study. The first aim is to estimate the short-term effects (≤ 24 h) of specific physical activities on LBP flares among Veterans in primary care in the Veterans Affairs healthcare system. The second aim is to estimate the cumulative effects of specific activities on LBP-related functional limitations at 1-year follow-up.
Up to 550 adults of working age (18-65 years) seen for LBP in primary care complete up to 36 "Scheduled" surveys over 1-year follow-up, and also complete unscheduled "Flare Window" surveys after the onset of new flares. Each survey asks about current flares and other factors associated with LBP. Surveys also inquire about activity exposures over the 24 h, and 2 h, prior to the time of survey completion (during non-flare periods) or prior to the time of flare onset (during flares). Other questions evaluate the number, intensity, duration, and/or other characteristics of activity exposures. Other exposures include factors related to mood, lifestyle, exercise, concurrent treatments, and injuries. Some participants wear actigraphy devices for weeks 1-4 of the study. The first aim will examine associations between 10 specific activity categories and participant-reported flares over 1-year follow-up. The second aim will examine associations between the frequency of exposure to 10 activity categories over weeks 1-4 of follow-up and long-term functional limitations at 12 months. All analyses will use a biopsychosocial framework accounting for potential confounders and effect modifiers.
FLAReS will provide empirically derived estimates of both the short-term and cumulative effects of specific physical activities for Veterans with LBP, helping to better understand the role of physical activities in those with LBP.
ClinicalTrials.gov NCT04828330 , registered April 2, 2021.
尽管人们普遍认为体力活动与腰痛（LBP）发作有关，但这种关联的方向性证据却存在差异。 Flares of Low back pain with Activity Research Study（FLAReS）采用了一种新方法，通过在队列研究中嵌套纵向病例交叉研究，将特定体力活动对腰痛发作的短期影响与这种活动的累积影响区分开来。第一个目标是估计退伍军人在退伍军人事务医疗保健系统的初级保健中特定体力活动对腰痛发作的短期影响（≤24 小时）。第二个目标是估计特定活动对 1 年随访时与 LBP 相关的功能限制的累积影响。
多达 550 名年龄在 18-65 岁之间的在职成年人在初级保健中因腰痛就诊，在 1 年的随访期间完成多达 36 次“计划”调查，并在新发作的新腰痛发作后完成非计划“发作窗口”调查。每次调查都会询问当前腰痛发作情况以及与 LBP 相关的其他因素。调查还询问了在调查完成前 24 小时内（非腰痛发作期间）或在腰痛发作前 2 小时内（腰痛发作期间）的活动暴露情况。其他问题评估了活动暴露的次数、强度、持续时间和/或其他特征。其他暴露包括与情绪、生活方式、运动、同时治疗和受伤有关的因素。一些参与者在研究的第 1-4 周佩戴活动记录仪。第一个目标将检查 10 种特定活动类别与参与者在 1 年随访期间报告的腰痛发作之间的关联。第二个目标将检查在随访的第 1-4 周内每周接触 10 种活动类别与 12 个月时长期功能限制之间的关联。所有分析都将使用生物心理社会框架，考虑潜在的混杂因素和效应修饰剂。
FLAReS 将为患有 LBP 的退伍军人提供体力活动的短期和累积影响的经验估计，有助于更好地了解体力活动在 LBP 患者中的作用。
ClinicalTrials.gov NCT04828330，于 2021 年 4 月 2 日注册。
