Aidinoff Elena, Ayalon Sharona Yosef, Michaeli Dianne, Gelernter Ilana, Catz Amiram, Bluvshtein Vadim
Department of Spinal Rehabilitation, Loewenstein Rehabilitation Medical Center, Ra'anana, Israel.
Department of Rehabilitation and the Statistical Laboratory, Tel Aviv University, Tel Aviv, Israel.
Rambam Maimonides Med J. 2024 Oct 28;15(4):e0016. doi: 10.5041/RMMJ.10530.
Chronic low back pain disability (CLBPD) is a syndrome that includes pain, disability, emotional impairments, and social problems. The study was conducted to examine the effect of an inpatient rehabilitation program on the performance of everyday life tasks (daily activities), and report on pain in CLBPD patients with primary activities of daily living (ADL) deficits.
In a retrospective cohort study, demographic and clinical data were retrieved from records of inpatients admitted consecutively to the program. Scores of the Spinal Pain Independence Measure (SPIM) and of changes in reported pain levels were used to assess improvement in the performance of daily activities and pain reduction. T-tests were used to assess the significance of score changes. Spearman's correlations and analysis of variance were used to assess relationships of SPIM gain and affecting factors.
Ninety-nine patients were included. Daily task performance improved in 71 patients (71.7%). The SPIM score increased from 48.7 (SD 16.3) at admission to the rehabilitation program to 57.8 (SD 12.5) at discharge (P<0.001). The SPIM score at admission negatively affected SPIM gain (P<0.001). The SPIM gain was significant for admission SPIM scores of 50 or lower (P<0.05), but differences in SPIM scores were not as noticeable for patients with admission SPIM scores above 50. Relief in pain was reported in 59 patients (59.6%) and was not associated with function.
The multidisciplinary rehabilitation program, which improved function and provided limited pain relief in inpatients with CLBPD primary ADL deficits, can be effective for the most severe CLBPD cases.
慢性下腰痛残疾（CLBPD）是一种包括疼痛、残疾、情感障碍和社会问题的综合征。本研究旨在探讨住院康复计划对日常生活任务（日常活动）表现的影响，并报告有基本日常生活活动（ADL）缺陷的CLBPD患者的疼痛情况。
在一项回顾性队列研究中，从该计划连续收治的住院患者记录中检索人口统计学和临床数据。使用脊柱疼痛独立测量（SPIM）评分和报告的疼痛水平变化来评估日常活动表现的改善和疼痛减轻情况。采用t检验评估评分变化的显著性。使用Spearman相关性分析和方差分析来评估SPIM得分增加与影响因素之间的关系。
纳入99例患者。71例患者（71.7%）的日常任务表现有所改善。SPIM评分从康复计划入院时的48.7（标准差16.3）提高到出院时的57.8（标准差12.5）（P<0.001）。入院时的SPIM评分对SPIM得分增加有负面影响（P<0.001）。入院SPIM评分为50或更低时，SPIM得分增加显著（P<0.05），但入院SPIM评分高于50的患者，其SPIM评分差异不明显。59例患者（59.6%）报告疼痛减轻，且与功能无关。
多学科康复计划改善了CLBPD原发性ADL缺陷住院患者的功能，并提供了有限的疼痛缓解，对最严重的CLBPD病例可能有效。
