Chiropractic Knowledge Hub, Odense, Denmark
Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
BMJ Open. 2022 May 11;12(5):e060084. doi: 10.1136/bmjopen-2021-060084.
To investigate associations between beliefs about low back pain (LBP) at baseline and pain intensity and disability at 2-week, 13-week and 52-week follow-up.
Observational cohort study.
Primary care private chiropractic clinics in Denmark.
A total of 2734 adults consulting a chiropractor for a new episode of LBP, with follow-up data available from 71%, 61% and 52% of the participants at 2, 13 and 52 weeks, respectively.
Beliefs about LBP were measured by the Back Belief Questionnaire (BBQ) before consulting the chiropractor. Pain (Numerical Rating Scale 0-10) and disability (the Roland-Morris Disability Questionnaire) were measured at baseline and after 2, 13 and 52 weeks. Associations were explored using longitudinal linear mixed models estimating interactions between BBQ and time, and by estimating associations between single items of BBQ and 13-week outcomes.
More positive beliefs about LBP were weakly associated with a reduction in pain at 2 weeks (β interaction BBQ#Time=-0.02 (95% CI -0.04 to -0.001)), at 13 weeks (-0.03 (95% CI -0.05 to -0.01)) and at 52 weeks of follow-up (-0.03 (95% CI -0.05 to -0.01); p=0.003). For disability, the association was uncertain (p=0.7). The item 'Back trouble means periods of pain for the rest of one's life' had the strongest association with both reduction in pain (-0.29, 95% CI -0.4 to -0.19, p<0.001) and disability (-2.42, 95% CI -3.52 to -1.33, p<0.001) at 13-week follow-up.
Positive beliefs regarding LBP, measured by the BBQ, were associated with a reduction in pain intensity at both short-term and long-term follow-up. However, the association was weak, and the clinical relevance is therefore questionable. No clear association was demonstrated between beliefs and disability. This study did not show promise that back beliefs as measured by the BBQ were helpful for predicting or explaining the course of LBP in this setting.
研究基线时对腰痛（LBP）的信念与 2 周、13 周和 52 周随访时疼痛强度和残疾的相关性。
观察性队列研究。
丹麦私人整脊诊所。
共 2734 名成年人因新出现的 LBP 咨询整脊医生，分别有 71%、61%和 52%的参与者在 2、13 和 52 周时可获得随访数据。
在咨询整脊医生之前，通过腰痛信念问卷（Back Belief Questionnaire，BBQ）测量对 LBP 的信念。在基线和 2、13 和 52 周时测量疼痛（数字评分量表 0-10）和残疾（Roland-Morris 残疾问卷）。使用纵向线性混合模型估计 BBQ 与时间之间的交互作用，并估计 BBQ 单项与 13 周结局之间的相关性，以探索相关性。
对 LBP 的信念越积极，2 周时疼痛减轻的程度越弱（BBQ#Time 交互作用=-0.02（95%CI-0.04 至-0.001）），13 周时疼痛减轻的程度越弱（-0.03（95%CI-0.05 至-0.01）），52 周时疼痛减轻的程度越弱（-0.03（95%CI-0.05 至-0.01）；p=0.003）。对于残疾，相关性不确定（p=0.7）。“背部问题意味着余生都会有疼痛期”这一项目与疼痛减轻（-0.29，95%CI-0.4 至-0.19，p<0.001）和残疾（-2.42，95%CI-3.52 至-1.33，p<0.001）都有最强的相关性。
通过 BBQ 测量的 LBP 信念与短期和长期随访时的疼痛强度降低相关。然而，这种相关性很弱，因此其临床意义值得怀疑。信念与残疾之间没有明显的关联。本研究并未表明，在这种情况下，通过 BBQ 测量的背部信念有助于预测或解释 LBP 的病程。
