Crombez G, Vervaet L, Baeyens F, Lysens R, Eelen P
Centrum voor Leerpsychologie en Gedragstherapie, Leuven, Belgium.
Behav Res Ther. 1996 Nov-Dec;34(11-12):919-25. doi: 10.1016/s0005-7967(96)00049-6.
The present study investigated whether pain expectancies cause pain in chronic low back patients. Back patients (N = 29) were requested to perform four exercise bouts (two with each leg), each consisting of flexing and extending the knee three times at maximal force (Cybex 350 System). During each exercise bout the baseline pain, the expected pain and experienced pain were recorded. Patients also reported their experienced fear of further injury to the back. Furthermore, the peak force of both knee flexors and extensors was assessed. Although patients did expect a back pain increase during the first exercise bout with each leg, no evidence was found for the thesis that pain expectancies generate increases in subjective pain experiences. Instead, the reported pain expectancy was readily corrected during the next exercise bout, whereas the experienced pain remained unchanged. Furthermore, a high pain expectancy co-occurred with (1) a marginally significant fear of (re)injury, and (2) a significant lower peak torque of the knee flexors. These results are consistent with conditioning models which state that pain expectations are associated with a fear response and an urge to avoid the pain.
本研究调查了疼痛预期是否会导致慢性腰痛患者产生疼痛。让腰痛患者（N = 29）进行四轮运动（每条腿各两轮），每轮运动包括以最大力量屈伸膝盖三次（Cybex 350系统）。在每轮运动期间，记录基线疼痛、预期疼痛和实际经历的疼痛。患者还报告了他们对背部进一步受伤的实际恐惧程度。此外，评估了膝关节屈伸肌的峰值力量。尽管患者确实预期在每条腿的第一轮运动期间背痛会加剧，但未找到证据支持疼痛预期会导致主观疼痛体验增加这一论点。相反，在下一轮运动期间，报告的疼痛预期很快得到纠正，而实际经历的疼痛保持不变。此外，高疼痛预期与（1）对（再）受伤的轻微显著恐惧以及（2）膝关节屈肌的显著较低峰值扭矩同时出现。这些结果与条件作用模型一致，该模型表明疼痛预期与恐惧反应以及避免疼痛的冲动相关。
