Lanhers Charlotte, Dualé Christian, Corteval Alice, Coudeyre Emmanuel, Pereira Bruno, Kerckhove Nicolas
CHU Clermont-Ferrand, Médecine Physique et Réadaptation, Clermont-Ferrand, France; Université Clermont-Auvergne, Clermont-Ferrand, France.
CHU Clermont-Ferrand, Plateforme d'Investigation Clinique (INSERM CIC1405), Clermont-Ferrand, France; INSERM UMR1107 Neuro-Dol, Clermont-Ferrand, France.
J Rehabil Med. 2025 Sep 4;57:jrm43450. doi: 10.2340/jrm.v57.43450.
To study the biopsychosocial model of chronic low back pain in the workplace and the role of sex in it.
Cross-sectional nationwide survey in a service company.
256 workers (women 64.1%) reporting chronic low back pain.
Variables on biometry, job description, physical activity, pain severity/interference, neuropathic features, and questionnaire-based cognitive and affective parameters were collected. Within each sex group, the interrelationships between variables by Multiple Correspondence Analysis were analysed, followed by cluster analysis.
In the overall sample, neuropathic features were reported by 28.9% of the patients; the cluster including the high pain disorder modalities (i.e., severity and interference) also included high pain catastrophizing and fear/avoidance towards work, as well as neuropathic features. However, in men, the modalities neighbouring high pain disorder were high anxiety and depression, and low mental quality of life, while in women, they were kinesiophobia, high fear/avoidance towards physical activity and stress at work, and low physical quality of life.
As there is now a major demand for defining chronic low back pain patients based on their biopsychosocial profile to improve care and prognosis, this study's results indicate the relevance of conducting such phenotyping at an early stage in a working environment, and that it is preferable to construct predictive models for each sex group.
研究工作场所慢性下腰痛的生物心理社会模型以及性别在其中的作用。
在一家服务公司进行的全国性横断面调查。
256名报告有慢性下腰痛的工人（女性占64.1%）。
收集了生物测量、工作描述、身体活动、疼痛严重程度/干扰、神经病理性特征以及基于问卷的认知和情感参数等变量。在每个性别组内，通过多重对应分析分析变量之间的相互关系，随后进行聚类分析。
在总体样本中，28.9%的患者报告有神经病理性特征；包括高疼痛障碍模式（即严重程度和干扰）的聚类还包括高疼痛灾难化以及对工作的恐惧/回避，以及神经病理性特征。然而，在男性中，与高疼痛障碍相邻的模式是高焦虑和抑郁以及低心理生活质量，而在女性中，它们是运动恐惧症、对身体活动和工作压力的高恐惧/回避以及低身体生活质量。
由于目前迫切需要根据慢性下腰痛患者的生物心理社会特征来定义他们，以改善护理和预后，本研究结果表明在工作环境中早期进行这种表型分析具有相关性，并且最好为每个性别组构建预测模型。
