Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
KU Leuven - University of Leuven, Health Psychology Research Group, Leuven, Belgium.
Eur Spine J. 2022 Jul;31(7):1802-1820. doi: 10.1007/s00586-022-07261-4. Epub 2022 May 18.
PURPOSE: Low back pain (LBP) individuals with high levels of fear of pain might display changes in motor behavior, which leads to disability. This study aimed to systematically review the influence of pain-related threat beliefs or disability on trunk kinematic or postural control in LBP. METHOD: Eight electronic databases were searched from January 1990 to July 1, 2020. Meta-analysis using random-effect model was performed for 18 studies on the association between pain-related threat beliefs or disability and lumbar range of motion. Pearson r correlations were used as the effect size. RESULT: Negative correlations were observed between lumbar range of motion (ROM) and pain-related threat beliefs (r = - 0.31, p < 0.01, 95% CI: - 0.39, - 0.24) and disability (r = - 0.24, p < 0.01, 95% CI: - 0.40, - 0.21). Nonsignificant correlations were reported between pain-related threat beliefs and center of pressure parameters during static standing in 75% of the studies. In 33% of the studies, moderate negative correlations between disability and postural control were observed. CONCLUSION: Motor behaviors are influenced by several factors, and therefore, the relatively weak associations observed between reduced lumbar ROM with higher pain-related threat beliefs and perceived disability, and postural control with disability are to be expected. This could aid clinicians in the assessment and planning rehabilitation interventions. LEVEL OF EVIDENCE I: Diagnostic: individual cross-sectional studies with the consistently applied reference standard and blinding.
目的:患有高水平疼痛恐惧的下腰痛(LBP)患者可能会表现出运动行为的改变,从而导致残疾。本研究旨在系统地回顾疼痛相关威胁信念或残疾对 LBP 躯干运动学或姿势控制的影响。
方法:从 1990 年 1 月至 2020 年 7 月 1 日,检索了 8 个电子数据库。对 18 项关于疼痛相关威胁信念或残疾与腰椎活动范围之间关系的研究进行了随机效应模型的荟萃分析。Pearson r 相关系数被用作效应量。
结果:腰椎活动范围(ROM)与疼痛相关威胁信念(r=-0.31,p<0.01,95%CI:-0.39,-0.24)和残疾(r=-0.24,p<0.01,95%CI:-0.40,-0.21)之间存在负相关。在 75%的静态站立研究中,疼痛相关威胁信念与压力中心参数之间的相关性无统计学意义。在 33%的研究中,观察到残疾与姿势控制之间存在中度负相关。
结论:运动行为受到多种因素的影响,因此,观察到腰椎 ROM 降低与较高的疼痛相关威胁信念和感知残疾之间以及残疾与姿势控制之间的关联相对较弱是可以预期的。这可以帮助临床医生进行评估和计划康复干预。
证据水平 I:诊断:具有一致应用参考标准和盲法的个体横断面研究。
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