Laboratory of Pain Research, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland; Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland.
Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.
J Pain. 2024 Aug;25(8):104530. doi: 10.1016/j.jpain.2024.104530. Epub 2024 Apr 8.
Research suggests that pain negatively affects body image, and body image may also influence reported pain levels. This review aims to summarize the literature on differences in body image distortion between individuals with pain compared to pain-free individuals. The review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 statement and an a priori preregistered protocol. The literature was searched using 5 electronic databases. Studies assessing body image with the Fremantle Awareness Questionnaire (FAQ) in individuals with and without pain were eligible for inclusion. Screening and selection of eligible studies were performed by independent reviewers. Methodological quality was assessed with the Joanna Briggs Institute critical appraisal tool. Meta-analyses, meta-correlations, and metamean analyses were performed using random-effect models. The primary outcome was the FAQ score; secondary outcomes were reported pain variables. Data from individuals with pain (n = 2277) and without pain (n = 615) were summarized. Significant body image distortions were found in individuals with pain compared to individuals without pain. Compared to pain-free individuals, the pain group rated significantly higher in the FAQ when experiencing back pain (standardized mean differences=1.33, 95% confidence interval=.88-1.77) or other body parts (standardized mean differences=1.25, 95% confidence interval=.51-1.99). The results of meta-correlation analyses confirmed the positive relationship between body image distortion and pain intensity (r = .31), pain at rest (r = .31), or pain during movement (r = .36), but not for pain duration. A difference in mean FAQ results was observed between individuals with pain in different areas (knee and back). PERSPECTIVE: This review confirms differences in body image distortion between pain and pain-free individuals. Pain intensity was correlated with altered body perception, but not pain duration. A moderate correlation was observed between body image distortion and reported pain variables. Body image was more impaired by knee pain than back pain. REGISTERED PROTOCOL AT PROSPERO: CRD42022309937; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022309937.
研究表明，疼痛会对身体形象产生负面影响，而身体形象也可能影响报告的疼痛程度。本综述旨在总结疼痛人群与无痛人群之间身体形象扭曲差异的文献。该综述按照系统评价和荟萃分析 2020 声明以及事先注册的方案进行。使用 5 个电子数据库进行文献检索。纳入评估有痛和无痛个体身体形象的 Fremantle 意识问卷（FAQ）的研究。由独立评审员进行筛选和合格研究的选择。使用 Joanna Briggs 研究所的批判性评价工具评估方法学质量。使用随机效应模型进行荟萃分析、荟萃相关和荟萃均数分析。主要结局是 FAQ 评分；次要结局是报告的疼痛变量。总结了有疼痛个体（n=2277）和无痛个体（n=615）的数据。与无痛个体相比，疼痛个体的身体形象明显扭曲。与无痛个体相比，疼痛组在经历背痛（标准化均数差=1.33，95%置信区间=0.88-1.77）或其他身体部位疼痛（标准化均数差=1.25，95%置信区间=0.51-1.99）时，FAQ 评分显著更高。荟萃相关分析的结果证实了身体形象扭曲与疼痛强度（r=0.31）、休息时疼痛（r=0.31）或运动时疼痛（r=0.36）之间的正相关关系，但与疼痛持续时间无关。在不同部位（膝盖和背部）疼痛的个体之间观察到 FAQ 结果的平均差异。观点：本综述证实了疼痛和无痛个体之间身体形象扭曲的差异。疼痛强度与改变的身体感知相关，但与疼痛持续时间无关。身体形象扭曲与报告的疼痛变量之间存在中度相关性。与背痛相比，膝痛对身体形象的损害更大。PROSPERO 注册协议：CRD42022309937；https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022309937。
