Subgrouping People With Acute Low Back Pain Based on Psychological, Sensory, and Motor Characteristics: A Cross-Sectional Study

IF 3.5 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-03-04 DOI:10.1002/ejp.70006

Patrick Ippersiel, Claudia Côté-Picard, Jean-Sébastien Roy, Hugo Massé-Alarie

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Abstract

Background

Clustering helps identify patient subgroups with similar biopsychosocial profiles in acute low-back pain (LBP). Motor factors are common treatment targets and are associated with disability but have not been included in acute LBP cluster development. This study aimed to identify subgroups of individuals with acute LBP based on motor, sensory and psychological characteristics and to compare these subgroups regarding clinical outcomes.

Methods

Ninety-nine participants with acute LBP were recruited, and motor (bending range of motion [ROM], flexion relaxation), pain sensitivity (pressure-pain thresholds, temporal summation of pain) and psychological factors (pain catastrophising, kinesiophobia, self-efficacy) were measured, along with pain, disability and demographics.

Results

Principal component analysis accounted for 66.03% of the variance. Four component scores were entered in a hierarchical linear clustering model, deriving 3 subgroups (‘mild features’ n = 39, ‘sensorimotor’ n = 35 and ‘psychomotor’ n = 25). Between-cluster comparisons revealed significant differences in motor, sensory and psychological variables (p < 0.05). Sensorimotor and psychomotor clusters had higher flexion–relaxation ratios (mean difference: > 0.2), greater disability (mean difference: > 7/100) and smaller ROM (mean difference: 7 cm) compared to the ‘mild’ group. The sensorimotor cluster mostly exhibited higher temporal summation of pain (mean difference: > 1.3/10) and lower pressure-pain thresholds (mean difference: > 1.2 kg/cm²) than ‘mild’ and psychomotor clusters. The psychomotor cluster showed higher kinesiophobia (mean difference: > 6/44) and pain catastrophising (mean difference: > 12/52) than ‘mild’ and sensorimotor groups.

Conclusion

Findings indicate 3 subgroups, suggesting that motor factors may add granularity to acute LBP clusters. Stratified care based on these subgroups may help refine treatment pathways for acute LBP.

Significance Statement

Including motor factors in cluster development adds a clinically relevant metric to describe people with acute LBP and generates insight into underlying mechanisms of motor adaptation. Longitudinal testing is required to see if these subgroups are differentially related to short- and long-term pain and disability.

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基于心理、感觉和运动特征对急性腰痛患者进行亚分组：一项横断面研究

背景聚类有助于识别急性腰痛（LBP）中具有相似生物心理社会特征的患者亚组。运动因素是常见的治疗目标，与残疾有关，但未包括在急性腰痛集群发展中。本研究旨在根据运动、感觉和心理特征确定急性腰痛患者亚组，并比较这些亚组的临床结果。方法招募99名急性腰痛患者，测量运动（弯曲运动范围、屈曲放松）、疼痛敏感性（压力-疼痛阈值、疼痛时间总和）和心理因素（疼痛灾难、运动恐惧症、自我效能感），以及疼痛、残疾和人口统计学特征。结果主成分分析占方差的66.03%。将四个成分得分输入到分层线性聚类模型中，得出3个亚组（“轻度特征”n = 39，“感觉运动”n = 35和“精神运动”n = 25）。聚类间比较显示运动、感觉和心理变量有显著差异（p < 0.05）。与“轻度”组相比，感觉运动组和精神运动组具有更高的屈曲-舒张比（平均差值：>； 0.2），更大的残疾（平均差值：>； 7/100）和更小的ROM（平均差值：7 cm）。与“轻度”和精神运动集群相比，感觉运动集群大多表现出更高的疼痛时间总和（平均差值：1.3/10）和更低的压力-疼痛阈值（平均差值：1.2 kg/cm2）。精神运动组比“轻度”组和感觉运动组表现出更高的运动恐惧症（平均差值：6/44）和疼痛灾难（平均差值：12/52）。结论运动因子可分为3个亚组，提示运动因子可增加急性腰痛聚集的粒度。基于这些亚组的分层护理可能有助于改善急性腰痛的治疗途径。包括运动因素在集群发展中增加了临床相关的指标来描述急性腰痛患者，并对运动适应的潜在机制有了深入的了解。需要进行纵向测试，以确定这些亚组与短期和长期疼痛和残疾之间是否存在差异。

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.