Jiang Ying, Wang Yizu, Wang Rui, Zhang Xiaogang, Wang Xueqiang
School of Rehabilitation Medicine, Binzhou Medical University, Yantai, Shandong, China.
Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Front Physiol. 2022 Nov 3;13:906461. doi: 10.3389/fphys.2022.906461. eCollection 2022.
Non-specific low back pain affects people of all ages and is a leading contributor to disease burden worldwide. Chronic low back pain (LBP) reduces working hours, increases comorbidities, and increases rehabilitation needs. The aim of this study was to evaluate whether there were differences in pain, dysfunction, and psychological factors between two groups. The supplementary demonstrated the relationship between these influencing factors and anxiety. A cross-sectional study was designed to analyze the differences in pain, disability, and psychological function in non-specific LBP patients with and without anxiety. In total, 60 subjects were divided into two groups based on self-rated anxiety scores: 30 patients with SAS score ≥50 were in the low back pain with anxiety group, and 30 for the LBP without anxiety group with SAS score <50. The pain intensity was assessed using the Visual Analog Scale; psychological function, using the Pain Anxiety Symptoms Scale, the Tampa Scale for Kinesiophobia, and the Fear Avoidance Beliefs Questionnaire; functional disability, using the Oswestry Disability Index and the Roland-Morris Disability Questionnaire; quality of life using 36-Item Short-Form Health Survey questionnaire; and the quality of sleep using Pittsburgh Sleep Quality Index, and the relationships between variables and anxiety scores were estimated using Spearman correlation analysis. A total of 60 participants were enrolled after self-rated anxiety was assessed and the full investigation was finished. The analyses showed significant differences of pain intensity ( = 0.034, disability (ODI, = 0.007; RMDQ, = 0.012) and psychological function (TSK, = 0.000; PASS, = 0.009; FABQ, = 0.000; SF-36, = 0.000; and PSQI, = 0.000) between the two groups. Spearman correlation analysis showed that the anxiety score had significant positive correlations with functional disability (ODI, = 0.004 and 95% CI = 0.112-0.573; RMDQ, = 0.003, 95% CI = 0.135-0.586) and psychological function (TSK, = 0.001, 95% CI = 0.174-0.612), excellent positive correlation with quality of sleep (PASS, = 0.025, 95% CI = 0.031-0.512), and strongly negative correlations with the quality of life (SF-36, = 0.000, 95% CI = 0.761-0.433). We recognized that anxiety in low back pain patients was mainly due to interaction with the intensity of pain, disability level, and a mass of psychological function. The future research direction could be to alleviate the anxiety on the comprehensive efficacy of patients with low back pain.
非特异性下腰痛影响所有年龄段的人群，是全球疾病负担的主要促成因素。慢性下腰痛（LBP）会减少工作时间、增加合并症并增加康复需求。本研究的目的是评估两组之间在疼痛、功能障碍和心理因素方面是否存在差异。补充内容展示了这些影响因素与焦虑之间的关系。一项横断面研究旨在分析有无焦虑的非特异性LBP患者在疼痛、残疾和心理功能方面的差异。总共60名受试者根据自评焦虑评分分为两组：30名SAS评分≥50的患者属于伴有焦虑的下腰痛组，30名SAS评分<50的患者属于无焦虑的LBP组。使用视觉模拟量表评估疼痛强度；使用疼痛焦虑症状量表、坦帕运动恐惧量表和恐惧回避信念问卷评估心理功能；使用Oswestry残疾指数和罗兰-莫里斯残疾问卷评估功能残疾；使用36项简短健康调查问卷评估生活质量；使用匹兹堡睡眠质量指数评估睡眠质量，并使用Spearman相关性分析估计变量与焦虑评分之间的关系。在完成自评焦虑评估和全面调查后，共招募了60名参与者。分析显示两组在疼痛强度（=0.034）、残疾（ODI，=0.007；RMDQ，=0.012）和心理功能（TSK，=0.000；PASS，=0.009；FABQ，=0.000；SF-36，=0.000；PSQI，=0.000）方面存在显著差异。Spearman相关性分析表明，焦虑评分与功能残疾（ODI，=0.004，95%CI=0.112-0.573；RMDQ，=0.003，95%CI=0.135-0.586）和心理功能（TSK，=0.001，95%CI=0.174-0.612）呈显著正相关，与睡眠质量呈极好的正相关（PASS，=0.025，95%CI=0.031-0.512），与生活质量呈强烈负相关（SF-36，=0.000，95%CI=0.761-0.433）。我们认识到下腰痛患者的焦虑主要是由于与疼痛强度、残疾水平以及大量心理功能的相互作用。未来的研究方向可能是减轻焦虑对下腰痛患者综合疗效的影响。
