University of Health Science, Faculty of Gülhane Physiotherapy and Rehabilitation, Ankara, Turkey.
Hacettepe University, Medical School, Ankara, Turkey.
J Orthop Sci. 2024 Jul;29(4):958-963. doi: 10.1016/j.jos.2023.07.006. Epub 2023 Jul 26.
Pregnancy-related low back pain is a multifactorial problem and its assosiation with pain intensity and biopsycosocial factors can not be fully explained. This study aimed to determine the psychosocial as well as biological/physical risk factors associated with self-reported low back pain (LBP) intensity during different trimesters of pregnancy.
This cross-sectional study comprised 107 pregnant women. An introductory information form for physical and medical characteristics, Visual Analog Scale (VAS) for low back pain intensity and Oswestry Disability Index (ODI) for degree of loss of functionality, Short Form-36 (SF-36) for quality of life and Pregnancy Physical Activity Questionnaire (PPAQ) for physical activity were applied. Abdominal muscle thicknesses and diastasis recti were measured by ultrasonography. Univariate regression was used to analyse associations between each plausible independent variable and low back pain intensity.
Mean LBP intensity during 1st, 2nd ve 3rd trimesters were 26.8 ± 20.9, 27.3 ± 19.8, 21.6 ± 20.1 mm, respectively. ODI scores were associated with LBP intensity, explaining 11%, 13% and 26% of LBP severity during the 1st, 2nd ve 3rd trimesters, respectively. Other biological/physical variables like age, body mass index, muscle thickness and diastasis recti were not associated with pain intensity. SF-36 emotional role limitation (coef = -0.03, R2 = 0.20, p = 0.01) in the 3rd trimester and SF-36 pain score in the 1st (coef = -0.04, R2 = 0.12, p = 0.02) and 3rd (coef = -0.05, R2 = 0.26, p = 0.004) trimesters and PPAQ-sedentary was associated during the 2nd trimester (coef = 0.17, R2 = 0.17, p = 0.02) with pain intensity.
ODI scores were associated with LBP intensity in all three trimesters, with SF-36 pain domain in the 1st and 3rd trimesters, with SF-36 emotional role limitation only in the 3rd trimester and with sedentary activity level only in the 2nd trimester. İncreased pain intensity was surprisingly associated with a small number of biopsychosocial factors in all the trimesters. There is need for further large-sample studies.
与妊娠相关的下腰痛是一个多因素的问题，其与疼痛强度和生物心理社会因素的关联尚不能完全解释。本研究旨在确定与不同孕期自我报告的下腰痛（LBP）强度相关的心理社会以及生物/物理危险因素。
这是一项横断面研究，共纳入 107 名孕妇。应用了一般资料问卷、视觉模拟评分（VAS）评估腰痛强度、Oswestry 功能障碍指数（ODI）评估功能丧失程度、SF-36 生活质量问卷评估生活质量、妊娠体力活动问卷（PPAQ）评估体力活动。采用超声测量腹直肌厚度和腹直肌分离。采用单变量回归分析探讨各潜在自变量与腰痛强度之间的关系。
1 期、2 期和 3 期的平均腰痛强度分别为 26.8±20.9、27.3±19.8、21.6±20.1mm。ODI 评分与腰痛强度相关，分别解释了 1 期、2 期和 3 期腰痛严重程度的 11%、13%和 26%。其他生物学/物理变量如年龄、体重指数、肌肉厚度和腹直肌分离与疼痛强度无关。3 期的 SF-36 情绪角色限制（系数=-0.03，R2=0.20，p=0.01）和 1 期的 SF-36 疼痛评分（系数=-0.04，R2=0.12，p=0.02）和 3 期的 SF-36 疼痛评分（系数=-0.05，R2=0.26，p=0.004）以及 2 期的 PPAQ-久坐行为（系数=0.17，R2=0.17，p=0.02）与疼痛强度相关。
ODI 评分与所有三个孕期的腰痛强度相关，SF-36 疼痛领域与 1 期和 3 期相关，SF-36 情绪角色限制仅与 3 期相关，而久坐行为仅与 2 期相关。令人惊讶的是，在所有孕期，疼痛强度的增加与少数生物心理社会因素相关。需要进一步开展大样本研究。
