Pugliese Jenifer M, Sions Jaclyn Megan, Knox Patrick J, Pohlig Ryan T, Hicks Gregory E
Department of Physical Therapy, University of Delaware, Newark, DE.
Department of Epidemiology, University of Delaware, Newark, DE.
Arch Phys Med Rehabil. 2025 May 5. doi: 10.1016/j.apmr.2025.04.018.
To investigate and compare the clinical profiles of 3 previously established hip-based subgroups of older adults with chronic low back pain (LBP) using data from multiple domains.
Cross-sectional analysis of baseline cohort study data.
Clinical research laboratory.
Two hundred fifty (n=250) community dwelling older adults with chronic LBP.
Not applicable.
Clinical profiles of the previously derived subgroups were established. Pain quality and dispersion were captured with the McGill Pain Questionnaire. Self-efficacy was measured using the Low Back Activity Confidence Scale. Catastrophic thoughts about LBP were captured with the Pain Catastrophizing Scale. Trunk mobility was measured with an inclinometer. Trunk muscle function was captured through standardized muscle endurance testing and ultrasound measures of muscle activity. One-way analysis of variance was used to analyze between-group differences.
Each chronic LBP subgroup was named based on the level of hip strength and hip symptoms: weak and symptomatic, weak and nonsymptomatic, and strong and nonsymptomatic. The weak and symptomatic subgroup had distinctly worse levels of pain quality, dispersion, catastrophizing and self-efficacy, compared with the other 2 subgroups. In contrast, the strong and nonsymptomatic subgroup, as compared with the other subgroups, had greater thoracolumbar flexion, greater trunk muscle endurance and better psychological profiles.
The unique clinical profile of each subgroup underscores how important it is to consider the heterogeneous nature of chronic LBP in the geriatric population when developing treatment approaches. The clinical characterization of these subgroups across multiple rehabilitation-focused domains may optimize the development of tailored interventions for each subgroup.
利用来自多个领域的数据，调查并比较3个先前已确定的以髋关节为基础的慢性下腰痛（LBP）老年亚组的临床特征。
对基线队列研究数据进行横断面分析。
临床研究实验室。
250名社区居住的患有慢性LBP的老年人。
不适用。
确定先前得出的亚组的临床特征。使用麦吉尔疼痛问卷获取疼痛性质和扩散情况。使用下背部活动信心量表测量自我效能感。使用疼痛灾难化量表获取对LBP的灾难性想法。使用倾角仪测量躯干活动度。通过标准化肌肉耐力测试和肌肉活动的超声测量获取躯干肌肉功能。采用单因素方差分析来分析组间差异。
每个慢性LBP亚组均根据髋关节力量和髋关节症状水平命名：虚弱且有症状、虚弱且无症状、强壮且无症状。与其他2个亚组相比，虚弱且有症状的亚组在疼痛性质、扩散、灾难化和自我效能感方面的水平明显更差。相比之下，与其他亚组相比，强壮且无症状的亚组有更大的胸腰椎前屈、更强的躯干肌肉耐力和更好的心理状况。
每个亚组独特的临床特征凸显了在制定治疗方法时考虑老年人群慢性LBP异质性的重要性。这些亚组在多个以康复为重点的领域的临床特征描述可能会优化为每个亚组量身定制干预措施的制定。
