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慢性下腰痛患者的躯干侧方判断:下腰痛病史、任务复杂性及临床相关因素的影响

Trunk Laterality Judgement in Chronic Low Back Pain: Influence of Low Back Pain History, Task Complexity, and Clinical Correlates.

作者信息

Matheve Thomas, Janssens Lotte, Timmermans Annick, Goossens Nina, Danneels Lieven, Meirezonne Hannes, Brandt Michiel, De Baets Liesbet

机构信息

Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Ghent University, 9000 Gent, Belgium.

REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Wetenschapspark 7, 3590 Diepenbeek, Belgium.

出版信息

J Clin Med. 2025 Jul 28;14(15):5328. doi: 10.3390/jcm14155328.


DOI:10.3390/jcm14155328
PMID:40806950
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12347674/
Abstract

: Left/right discrimination (LRD) training is increasingly being used in the treatment of chronic low back pain (CLBP). However, it is unclear whether trunk LRD-performance is impaired in CLBP patients and whether clinical parameters are related to LRD-performance. Therefore, this cross-sectional study aimed to examine (1) whether LRD-performance differs between CLBP patients and pain-free individuals; (2) whether these differences depend on the low back pain (LBP) history in pain-free individuals; (3) if clinical factors are related to LRD-performance; (4) whether LRD-task difficulty influences these results. : Participants included 150 pain-free persons (107 with no LBP-history; 43 with past LBP) and 150 patients with CLBP. All participants performed the LRD-task in a simple and complex condition. Outcomes were reaction time and accuracy. : CLBP patients were significantly slower (Cohen's d = 0.47 to 0.50, < 0.001) and less accurate (Cohen's d = 0.30 to 0.55, < 0.001) than pain-free individuals without LBP-history, but not compared to those with past LBP (Cohen's d reaction time = 0.07 to 0.15, = 0.55; Cohen's d accuracy = 0.03 to 0.28, -value = 0.28). All participant groups were slower and less accurate in the complex condition, but between-groups differences were independent of task difficulty. Linear mixed models showed that older age and lower education were independently associated with less accuracy. When controlling for demographics, pain intensity, disability, fear of movement, pain-related worry and pain duration were not related to LRD-performance in patients with CLBP. : Patients with CLBP showed impaired trunk LRD-performance compared to pain-free persons without LBP history, but not compared to those with past LBP. When controlling for demographics, clinical parameters were not related to LRD-performance in patients with CLBP. Our findings indicate that LRD-performance may remain impaired after recovering from LBP.

摘要

左右辨别(LRD)训练越来越多地被用于慢性下腰痛(CLBP)的治疗。然而,尚不清楚CLBP患者的躯干LRD表现是否受损,以及临床参数是否与LRD表现相关。因此,这项横断面研究旨在检验:(1)CLBP患者与无疼痛个体之间的LRD表现是否存在差异;(2)这些差异是否取决于无疼痛个体的下腰痛(LBP)病史;(3)临床因素是否与LRD表现相关;(4)LRD任务难度是否会影响这些结果。参与者包括150名无疼痛者(107名无LBP病史;43名有既往LBP)和150名CLBP患者。所有参与者在简单和复杂条件下执行LRD任务。结果指标为反应时间和准确性。与无LBP病史的无疼痛个体相比,CLBP患者的反应明显更慢(Cohen's d = 0.47至0.50,P < 0.001)且准确性更低(Cohen's d = 0.30至0.55,P < 0.001),但与有既往LBP的个体相比则不然(Cohen's d反应时间 = 0.07至0.15,P = 0.55;Cohen's d准确性 = 0.03至0.28,P值 = 0.28)。所有参与者组在复杂条件下的反应都更慢且准确性更低,但组间差异与任务难度无关。线性混合模型显示,年龄较大和教育程度较低与准确性较低独立相关。在控制人口统计学因素后,疼痛强度、残疾、运动恐惧、疼痛相关担忧和疼痛持续时间与CLBP患者的LRD表现无关。与无LBP病史的无疼痛个体相比,CLBP患者的躯干LRD表现受损,但与有既往LBP的个体相比则不然。在控制人口统计学因素后,临床参数与CLBP患者的LRD表现无关。我们的研究结果表明,从LBP恢复后,LRD表现可能仍然受损。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9e9/12347674/19cedc87cd85/jcm-14-05328-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9e9/12347674/209cda426974/jcm-14-05328-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9e9/12347674/33334596dfdb/jcm-14-05328-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9e9/12347674/b420301628f2/jcm-14-05328-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9e9/12347674/19cedc87cd85/jcm-14-05328-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9e9/12347674/209cda426974/jcm-14-05328-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9e9/12347674/33334596dfdb/jcm-14-05328-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9e9/12347674/b420301628f2/jcm-14-05328-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9e9/12347674/19cedc87cd85/jcm-14-05328-g004.jpg

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本文引用的文献

[1]
Impact of chronic low back pain on implicit motor imagery assessed by a new laterality judgment task.

J Pain. 2025-1

[2]
Task-Specific Perceived Harmfulness Predicts Protective Movement Behaviour in Chronic Low Back Pain.

J Clin Med. 2024-8-25

[3]
Unraveling the Left-Right Judgment Task in Chronic Low Back Pain: Insights Through Behavioral, Electrophysiological, Motor Imagery, and Bodily Disruption Perspectives.

J Pain. 2024-7

[4]
Association between educational level and self-reported musculoskeletal pain and physical functioning in Danes 60-70 years old from 2010 to 2017: a longitudinal analysis of trends over time on data from the Danish Health and Morbidity Survey.

BMJ Open. 2023-11-1

[5]
The Role of Back Muscle Dysfunctions in Chronic Low Back Pain: State-of-the-Art and Clinical Implications.

J Clin Med. 2023-8-24

[6]
Is movement variability altered in people with chronic non-specific low back pain? A systematic review.

PLoS One. 2023

[7]
Understanding Discrepancies in a Person's Fear of Movement and Avoidance Behavior: A Guide for Musculoskeletal Rehabilitation Clinicians Who Support People With Chronic Musculoskeletal Pain.

J Orthop Sports Phys Ther. 2023-5

[8]
Task-specific fear rather than general kinesiophobia assessment is associated with kinematic differences in chronic low back pain during lumbar flexion: a preliminary investigation.

Pain Rep. 2022-8-5

[9]
Effect of Graded Sensorimotor Retraining on Pain Intensity in Patients With Chronic Low Back Pain: A Randomized Clinical Trial.

JAMA. 2022-8-2

[10]
Cortical function and sensorimotor plasticity are prognostic factors associated with future low back pain after an acute episode: the Understanding persistent Pain Where it ResiDes prospective cohort study.

Pain. 2023-1-1

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