Sihvonen T, Huttunen M, Makkonen M, Airaksinen O
Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, Finland.
Arch Phys Med Rehabil. 1998 Oct;79(10):1210-2. doi: 10.1016/s0003-9993(98)90264-7.
To assess low back pain (LBP) intensity and subjective disability during pregnancy and compare the pain scores with lumbar motion patterns.
A prospective study of pregnant back pain sufferers and healthy controls.
Kuopio University Hospital, Kuopio, Finland.
Study group consisted of 32 pregnant women with LBP; control group consisted of 21 healthy pregnant women.
Back pain intensity was assessed by visual analog scale (VAS), and subjective disability index was measured by Oswestry Low Back Disability Questionnaire, at 20 and 36 weeks of pregnancy. Back muscle activities were recorded by surface electromyography, and movement sensors were used to detect lumbar motion.
In the study group current pain scores (VAS) at first and last trimester correlated strongly (r = .82, p < .00). Pain scores correlated with body weight at the first trimester (r = .54, p = .003) and at the last trimester (r = .67, p < .00). Significant correlation was noted between current pain intensity and back muscle activity level during forward body flexion at first trimester (r = .704, p < .00). Back muscle activity during bending measured at first trimester significantly correlated with pain intensity at last trimester (r = .703, p < .00). Back muscle activity during the first trimester of pregnancy had a negative correlation with current (r = -.57, p = .002) and later subjective disability index (r = -.42, p = .02). It correlated inversely (r = -.54, p = .003) with pain score at last trimester of pregnancy, ie, the lower the back muscle activity at the beginning of pregnancy, the more pain and disability throughout pregnancy. In the control group, three women developed LBP and disability feelings during pregnancy. They had increased muscle activity during flexion at delivery, ie, disturbed flexion relaxation.
Prepregnancy LBP predicts renewed pain during pregnancy, and dysfunction of back muscles has been established in LBP. In this study, disturbance in the relaxation of the back muscles was linearly related to current, and also to later, pain scores. In addition, back muscle activity level was inversely related to the disability index. For the first time, it has been shown prospectively that the function pattern of back extensors seems to predict, and is related to, future back pain. Simple function testing is promising and might be valuable in identifying mothers with a high risk of pregnancy-related back pain and in directing preventive intervention to high risk women by making them aware of self-treatment methods.
评估孕期腰痛（LBP）的强度和主观功能障碍，并将疼痛评分与腰椎运动模式进行比较。
对妊娠背痛患者和健康对照者进行的前瞻性研究。
芬兰库奥皮奥库奥皮奥大学医院。
研究组由32名患有LBP的孕妇组成；对照组由21名健康孕妇组成。
在妊娠20周和36周时，通过视觉模拟量表（VAS）评估背痛强度，通过Oswestry腰痛功能障碍问卷测量主观功能障碍指数。通过表面肌电图记录背部肌肉活动，并使用运动传感器检测腰椎运动。
在研究组中，孕早期和孕晚期的当前疼痛评分（VAS）高度相关（r = 0.82，p < 0.00）。疼痛评分与孕早期体重相关（r = 0.54，p = 0.003），与孕晚期体重也相关（r = 0.67，p < 0.00）。孕早期身体前屈时，当前疼痛强度与背部肌肉活动水平之间存在显著相关性（r = 0.704，p < 0.00）。孕早期测量的弯腰时背部肌肉活动与孕晚期疼痛强度显著相关（r = 0.703，p < 0.00）。妊娠早期的背部肌肉活动与当前（r = -0.57，p = 0.002）和后期主观功能障碍指数（r = -0.42，p = 0.02）呈负相关。它与妊娠晚期疼痛评分呈负相关（r = -0.54，p = 0.003），即妊娠开始时背部肌肉活动越低，整个孕期的疼痛和功能障碍就越严重。在对照组中，三名女性在孕期出现了LBP和功能障碍感。她们分娩时屈曲时肌肉活动增加，即屈曲放松障碍。
孕前LBP可预测孕期再次疼痛，且LBP患者已出现背部肌肉功能障碍。在本研究中，背部肌肉放松障碍与当前及后期疼痛评分呈线性相关。此外，背部肌肉活动水平与功能障碍指数呈负相关。首次前瞻性研究表明，背部伸肌的功能模式似乎可以预测并与未来背痛相关。简单的功能测试很有前景，可能有助于识别有妊娠相关背痛高风险的母亲，并通过让她们了解自我治疗方法，对高风险女性进行预防性干预。
