Program of Physical Therapy, Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Aseer, Saudi Arabia.
Program of Physical Therapy, Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Aseer, Saudi Arabia.
J Manipulative Physiol Ther. 2023 Jun-Dec;46(5-9):294-304. doi: 10.1016/j.jmpt.2024.09.004. Epub 2024 Oct 16.
The objectives of the study were to (1) determine the association between kinesiophobia and lumbar joint position sense (JPS) in individuals with chronic low back pain (CLBP); (2) examine the relationship between kinesiophobia and postural stability in individuals with CLBP; and (3) investigate whether pain intensity mediates the relationship between kinesiophobia, lumbar JPS, and postural stability in individuals with CLBP.
In this cross-sectional study, a total of 83 individuals diagnosed with CLBP were included. The level of fear of movement was assessed using the Tampa Scale for Kinesiophobia (TSK). Lumbar JPS was measured using the active target repositioning technique, which involved evaluating JPS in 3 directions: lumbar flexion, side-bending to the left, and side-bending to the right. The repositioning accuracy of the lumbar joint was quantified in degrees using a dual digital inclinometer. Postural stability was assessed using a stabilometric force platform, which measured anterior to posterior (A-P) sway, medial to lateral (M-L) sway, and the ellipse area in mm².
The findings of this study revealed a statistically significant and moderate positive correlation between kinesiophobia and lumbar JPS in various directions, including flexion (r = 0.51, P < .001), side-bending to the left (r = 0.37, P = .001), and side-bending to the right (r = 0.34, P = .002). Similarly, a significant positive association was observed between kinesiophobia and postural stability, as indicated by the correlation coefficients: A-P sway (r = .47, P < .001), M-L sway (r = 0.58, P < .001), and ellipse area (r = 0.51, P < .001). Furthermore, the analysis revealed that pain significantly mediated the relationship between kinesiophobia and both lumbar JPS (P < .05) and postural stability (P < .05). These findings were demonstrated through mediation analysis.
This study identified a significant association between kinesiophobia, lumbar JPS, and postural stability. Additionally, we observed the presence of pain as a potential mediator in this relationship. However, it is important to note that our cross-sectional study design precludes establishing causality or determining the direct mediation effect of pain on adverse outcomes.
本研究旨在：（1）确定慢性下背痛（CLBP）患者的运动恐惧与腰椎关节位置觉（JPS）之间的关联；（2）检查 CLBP 患者的运动恐惧与姿势稳定性之间的关系；（3）调查疼痛强度是否在 CLBP 患者的运动恐惧、腰椎 JPS 和姿势稳定性之间的关系中起中介作用。
在这项横断面研究中，共纳入 83 名被诊断为 CLBP 的患者。使用 Tampa 运动恐惧量表（TSK）评估运动恐惧程度。使用主动目标重定位技术测量腰椎 JPS，该技术包括评估 3 个方向的 JPS：腰椎前屈、向左侧弯曲和向右侧弯曲。使用双数字测斜仪以度为单位量化腰椎关节的重新定位准确性。使用稳定力平台评估姿势稳定性，该平台测量前后（A-P）摆动、内外（M-L）摆动和 mm² 椭圆面积。
本研究结果显示，运动恐惧与腰椎 JPS 在各个方向上呈显著且中度正相关，包括前屈（r = 0.51，P <.001）、向左侧弯曲（r = 0.37，P =.001）和向右侧弯曲（r = 0.34，P =.002）。同样，运动恐惧与姿势稳定性之间也存在显著正相关，相关系数为：A-P 摆动（r =.47，P <.001）、M-L 摆动（r = 0.58，P <.001）和椭圆面积（r =.51，P <.001）。此外，分析表明疼痛显著介导了运动恐惧与腰椎 JPS（P <.05）和姿势稳定性（P <.05）之间的关系。这些发现通过中介分析得到证明。
本研究确定了运动恐惧、腰椎 JPS 和姿势稳定性之间存在显著关联。此外，我们观察到疼痛是这种关系中的潜在中介因素。然而，需要注意的是，我们的横断面研究设计排除了因果关系或确定疼痛对不良结果的直接中介效应。
