腰痛患者不同风险水平下的心理、残疾和体感特征：一项横断面研究。
Psychological, disability, and somatosensory characteristics across different risk levels in individuals with low back pain: A cross-sectional study.
作者信息
den Bandt Hester L, Ickmans Kelly, Buyl Ronald, Leemans Lynn, Nijs Jo, Voogt Lennard
机构信息
Research Centre for Health Care Innovations, University of Applied Sciences Rotterdam, Rotterdam, The Netherlands; Pain in Motion Research Group, Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium.
Pain in Motion Research Group, Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Physical Medicine and Physical Therapy, University Hospital Brussels, Brussels, Belgium; Movement & Nutrition for Health & Performance research group (MOVE), Department of Movement and Sport Sciences, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium.
出版信息
Braz J Phys Ther. 2025 Mar-Apr;29(2):101185. doi: 10.1016/j.bjpt.2025.101185. Epub 2025 Feb 11.
BACKGROUND
Current low back pain (LBP) treatment might be improved by tailoring treatments to subgroup characteristics. The Start Back screening Tool (SBT) and Central Sensitization Inventory (CSI) classify people with LBP into subgroups. It is currently unknown whether linear trends exist regarding somatosensory changes, psychological characteristics, and physical disability across severity levels of the SBT and CSI in patients with LBP.
OBJECTIVE
To investigate whether linear trends in psychological variables (kinesiophobia, pain catastrophizing), disability, and somatosensory characteristics exist in a sample of people with acute and chronic LBP in primary care across severity levels based on the SBT and CSI.
METHODS
Participants with LBP were recruited in primary care. Demographic, psychological, and disability data were obtained. A comprehensive Quantitative Sensory Testing (QST) protocol was followed. Linear contrast analysis was conducted.
RESULTS
Kinesiophobia and pain catastrophizing show significant positive linear trends across the subgroups based on the SBT (p < 0.001) and CSI (p < 0.001 to p = 0.01). Heat pain threshold at the lower leg (p = 0.005) and pressure pain threshold at the lumbar region and lower leg (p = 0.02 and p = 0.04, respectively) show significant negative linear trends within the SBT. Negative linear trends in sensory changes exist within CSI for all pressure pain thresholds and a positive linear trend was seen in δ conditioned pain modulation at the thumb (p = 0.03).
CONCLUSION
Kinesiophobia, pain catastrophizing, disability, and pain intensity are positively related with the severity levels based on the SBT and CSI in our participants. Results of somatosensory changes were sometimes related to the severity levels.
背景
通过根据亚组特征调整治疗方案，当前的腰痛（LBP）治疗可能会得到改善。起始背部筛查工具（SBT）和中枢敏化量表（CSI）可将腰痛患者分为不同亚组。目前尚不清楚在腰痛患者中，SBT和CSI严重程度水平上的体感变化、心理特征和身体残疾是否存在线性趋势。
目的
基于SBT和CSI，调查初级保健中急性和慢性腰痛患者样本在严重程度水平上，心理变量（运动恐惧、疼痛灾难化）、残疾和体感特征是否存在线性趋势。
方法
在初级保健中招募腰痛患者。获取人口统计学、心理和残疾数据。遵循全面的定量感觉测试（QST）方案。进行线性对比分析。
结果
基于SBT（p < 0.001）和CSI（p < 0.001至p = 0.01），运动恐惧和疼痛灾难化在各亚组中显示出显著的正线性趋势。小腿的热痛阈值（p = 0.005）以及腰部和小腿的压痛阈值（分别为p = 0.02和p = 0.04）在SBT内显示出显著的负线性趋势。在CSI中，所有压痛阈值的感觉变化均存在负线性趋势，拇指的δ条件性疼痛调制呈正线性趋势（p = 0.03）。
结论
在我们的参与者中，运动恐惧、疼痛灾难化、残疾和疼痛强度与基于SBT和CSI的严重程度水平呈正相关。体感变化结果有时与严重程度水平相关。
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