Miyachi Ryo, Nishimura Takaaki, Noguchi Masahiro, Goda Akio, Takeda Hiromichi, Takeshima Eisuke, Kanazawa Yuji, Imai Tadashi, Tanaka Wataru
Faculty of Health and Medical Sciences, Hokuriku University, 1-1 Taiyogaoka, Kanazawa 920-1180, Japan.
Rehabilitation Center, Kanazawa Nishi Hospital, 6-15-41 Ekinishihonmachi, Kanazawa 920-0025, Japan.
J Funct Morphol Kinesiol. 2025 Jan 14;10(1):30. doi: 10.3390/jfmk10010030.
BACKGROUND/OBJECTIVES: Chronic low back pain (CLBP) after middle age is a complex multifactorial condition, and subgrouping is recommended to determine effective treatment strategies. Multidimensional data help create new groupings to increase the effectiveness of interventions in middle-aged and older adults with CLBP. This study aimed to investigate the relationship between the factors associated with CLBP after middle age and to create and characterize a new subgroup based on these factors. METHODS: A cross-sectional observational study was conducted and included 46 women aged ≥40 years with CLBP who participated in health events. Trunk muscle mass, lumbar movement control ability, autonomic balance, lumbar tenderness threshold, lumbar proprioception, and severity of central sensitization were assessed. RESULTS: Partial correlation analysis revealed a significant negative correlation between lumbar movement control ability and autonomic balance. A significant positive correlation was observed between trunk muscle mass and the lumbar tenderness threshold. Hierarchical clustering analysis identified three subgroups. The cluster 1 participants had low trunk muscle mass, low tenderness threshold, and low severity of central sensitization. The cluster 2 participants had low trunk muscle mass and tenderness threshold and high severity of central sensitization. The cluster 3 participants had high trunk muscle mass and tenderness threshold and were sympathetically predominant. Trunk muscle mass, pressure pain threshold, severity of central sensitization, and autonomic balance were significantly different between the clusters. CONCLUSIONS: Three characteristic subgroups were identified. The results contribute to treatment and prevention strategies for middle-aged and older adults with CLBP based on the characteristics of the subgroups rather than a uniform approach.
背景/目的:中年后慢性下腰痛(CLBP)是一种复杂的多因素疾病,建议进行亚组划分以确定有效的治疗策略。多维数据有助于创建新的分组,以提高对患有CLBP的中老年人干预措施的有效性。本研究旨在调查中年后与CLBP相关因素之间的关系,并基于这些因素创建和描述一个新的亚组。 方法:进行了一项横断面观察性研究,纳入了46名年龄≥40岁且患有CLBP并参加健康活动的女性。评估了躯干肌肉质量、腰椎运动控制能力、自主神经平衡、腰椎压痛阈值、腰椎本体感觉和中枢敏化的严重程度。 结果:偏相关分析显示腰椎运动控制能力与自主神经平衡之间存在显著负相关。躯干肌肉质量与腰椎压痛阈值之间观察到显著正相关。层次聚类分析确定了三个亚组。第1组参与者的躯干肌肉质量低、压痛阈值低且中枢敏化严重程度低。第2组参与者的躯干肌肉质量和压痛阈值低且中枢敏化严重程度高。第3组参与者的躯干肌肉质量和压痛阈值高且以交感神经为主导。各亚组之间的躯干肌肉质量、压力疼痛阈值、中枢敏化严重程度和自主神经平衡存在显著差异。 结论:确定了三个特征性亚组。研究结果有助于根据亚组特征而非统一方法制定针对患有CLBP的中老年人的治疗和预防策略。
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