Health and Sports Medicine Department, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran.
Sport Sciences and Physical Education, Faculty of Humanities Science, University of Hormozgan, Bandar Abbas, Iran.
Sci Rep. 2023 Apr 19;13(1):6392. doi: 10.1038/s41598-023-33590-5.
Pain developers (PDs) are considered a pre-clinical low back pain (LBP) population at risk of clinical LBP development and thus exacting great social and economic costs. Therefore, it is necessary to comprehensively investigate their distinctive characteristics and the risk factors of standing-induced LBP based on which appropriate preventive measures can be planned. Scopus, Web of Science, and PubMed databases as well as Google Scholar and ProQuest were systematically searched from inception through 14 July 2022 using a combination of terms relevant to 'standing' and 'LBP'. Studies with low risk of bias in English and Persian using a methodological quality scoring system were deemed eligible for inclusion if they were laboratory studies using prolonged standing duration greater than 42 min to classify adult PDs and non-pain developers (NPDs) without a history of LBP. PDs were compared with NPDs in demographics, biomechanical, and psychological outcomes. Weighted or standardized mean differences, and Hedge's g were generated to determine the pooled effect sizes using STATA software version 17. 52 papers and theses involving 1070 participants (528 PDs and 542 NPDs) were eligible for inclusion in the systematic review 33 of which were used in meta-analyses. Significant differences between PDs and NPDs in terms of movement patterns, muscular, postural, psychological, structural, and anthropometric variables were evidenced. The following factors were found to have a statistically significant association with standing-induced LBP: lumbar fidgets (Hedge's g - 0.72, 95% CI - 1.35 to - 0.08, P = 0.03), lumbar lordosis in participants over 25 years (Hedge's g 2.75, 95% CI 1.89-3.61, P < 0.001), AHAbd test (WMD 0.7, 95% CI 0.36-1.05, P < 0.001), GMed co-activation (Hedge's g 4.24, 95% CI 3.18-5.3, P < 0.001), and Pain Catastrophizing Scale (WMD 2.85, 95% CI 0.51-5.19, P = 0.02). Altered motor control displayed in AHAbd test and higher lumbar lordosis in individuals over 25 years seem to be probable risk factors for standing-induced LBP. In order to detect standing-induced LBP risk factors, future researchers should investigate the association of the reported distinctive characteristics to the standing-induced LBP and that whether they are manipulable through various interventions.
疼痛开发者（PDs）被认为是临床低背痛（LBP）发展风险的临床前低背痛（LBP）人群，因此会产生巨大的社会和经济成本。因此，有必要综合研究其独特特征和基于此的站立诱发 LBP 的风险因素，以便可以制定适当的预防措施。从 2022 年 7 月 14 日开始，通过结合与“站立”和“LBP”相关的术语，在 Scopus、Web of Science 和 PubMed 数据库以及 Google Scholar 和 ProQuest 上进行了系统搜索。如果使用延长站立时间超过 42 分钟的实验室研究来对成人 PD 和无 LBP 病史的非疼痛开发者（NPD）进行分类，并使用方法质量评分系统评估为英语和波斯语的低偏倚风险的研究，则被认为符合纳入标准。将 PD 与 NPD 在人口统计学、生物力学和心理结果方面进行比较。使用 STATA 软件版本 17 生成加权或标准化均数差和 Hedge's g，以确定纳入系统评价的 52 篇论文和专题论文中 1070 名参与者（528 名 PD 和 542 名 NPD）的汇总效应大小。有证据表明，PD 和 NPD 在运动模式、肌肉、姿势、心理、结构和人体测量学变量方面存在显著差异。以下因素与站立诱发的 LBP 具有统计学显著关联：腰椎烦扰（Hedge's g -0.72，95%置信区间-1.35 至-0.08，P=0.03）、25 岁以上参与者的腰椎前凸（Hedge's g 2.75，95%置信区间 1.89-3.61，P<0.001）、AHAbd 测试（WMD 0.7，95%置信区间 0.36-1.05，P<0.001）、GMed 共同激活（Hedge's g 4.24，95%置信区间 3.18-5.3，P<0.001）和疼痛灾难化量表（WMD 2.85，95%置信区间 0.51-5.19，P=0.02）。AHAbd 测试中显示的运动控制改变和 25 岁以上个体的腰椎前凸较高，似乎是站立诱发 LBP 的可能危险因素。为了检测站立诱发的 LBP 风险因素，未来的研究人员应该研究报告的独特特征与站立诱发的 LBP 的关联，以及它们是否可以通过各种干预措施进行操纵。
