Comparing Movement Patterns and Physical Function Between Chronic Low Back Pain Patients With Nociplastic and Nociceptive Pain Categories

IF 3.9 3区医学 Q1 ORTHOPEDICS

JOR Spine Pub Date : 2026-03-01 DOI:10.1002/jsp2.70166

Erin Archibeck, Nicholas Harris, Patricia Zheng, Aaron Scheffler, Wolf Mehling, Conor O'Neill, Jeffrey Lotz, Grace O'Connell, Jeannie F. Bailey, REACH Investigators

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Abstract

Background

Individuals with chronic low back pain (LBP) often present with significant physical dysfunction. The underlying cause is difficult to diagnose due to the heterogeneous nature of LBP categories.

Methods

Two hundred and fifty-six patients were assessed as having either nociceptive (NC) or nociplastic (NP) chronic low back pain using validated surveys, including the PainDETECT Questionnaire and a chronic overlapping pain condition screener. Additional covariates of anxiety, depression, and fear avoidance were evaluated using standard surveys. Physical function was judged objectively using a sit-to-stand test (STS; quantified using marker-less motion capture calculated kinematic scores and movement metrics) and subjectively (PROMIS-physical function survey). Demographics (age, sex, BMI), psychological factors, and biomechanical outcomes were compared across pain categories using nonparametric statistics and regression modeling.

Results

Compared to the NC group, the NP group was significantly older (NP: 61.0 ± 21.0, NC: 53.5 ± 29.3, p = 0.03) and reported higher levels of anxiety (NP: 51.2 ± 17.4, NC: 48.0 ± 13.4, p = 0.002) and depression (NP: 49.0 ± 14.7, NC: 41.0 ± 10.8, p = 0.009). NP also had worse perceived physical function (PROMIS-PF) (NP: 39.3 ± 6.9, NC: 42.1 ± 7.3, p < 0.001) and slower STS times (NP: 12.5 ± 6.1 s, NC: 12.0 ± 5.8, p = 0.03). Despite these differences, the NP group exhibited biomechanical function closer to the healthy control average motion trajectory (K-score; NP: 77.6 ± 8.1, NC: 75.6 ± 8.1, p = 0.03) during the STS task. Regression models evaluating the association between biomechanical variables and pain categories, while adjusting for age, sex, and BMI, identified significant differences between pain categories only for PROMIS-physical function.

Conclusion

While individuals with nociplastic pain reported lower perceived physical function and exhibited differences in demographic and psychological factors, pain categories were not significant predictors of objective biomechanical measures after adjusting for age, sex, and BMI. However, pain category was a significant predictor of PROMIS-PF, suggesting that it is more closely associated with perceived functional limitations than with quantitative biomechanical performance.

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慢性腰痛致伤性和致伤性疼痛患者运动模式和身体功能的比较。

背景：慢性腰痛（LBP）患者通常表现为明显的身体功能障碍。由于腰痛类型的异质性，其根本原因难以诊断。方法：256例患者被评估为伤害性（NC）或伤害性（NP）慢性腰痛，使用有效的调查，包括PainDETECT问卷和慢性重叠疼痛状况筛查。使用标准调查评估焦虑、抑郁和恐惧回避的其他协变量。身体功能通过坐立测试（STS）进行客观判断；通过无标记运动捕捉计算的运动学评分和运动指标进行量化)和主观判断（promise -身体功能调查）。使用非参数统计和回归模型比较不同疼痛类别的人口统计学（年龄、性别、BMI）、心理因素和生物力学结果。结果：NP组与NC组相比，NP组明显衰老（NP: 61.0±21.0,NC: 53.5±29.3,p = 0.03），焦虑（NP: 51.2±17.4,NC: 48.0±13.4,p = 0.002）和抑郁（NP: 49.0±14.7,NC: 41.0±10.8,p = 0.009）水平较高。NP组的生理功能知觉（promise - pf）也较差（NP: 39.3±6.9,NC: 42.1±7.3,p p = 0.03）。尽管存在这些差异，NP组在STS任务中的生物力学功能更接近健康对照组的平均运动轨迹（K-score; NP: 77.6±8.1,NC: 75.6±8.1,p = 0.03）。回归模型评估了生物力学变量与疼痛类别之间的关联，同时调整了年龄、性别和BMI，发现疼痛类别之间仅在promise -physical function方面存在显著差异。结论：尽管患有伤害性疼痛的个体报告了较低的感知身体功能，并且在人口统计学和心理因素方面存在差异，但在调整年龄、性别和BMI后，疼痛类别并不是客观生物力学测量的显著预测因子。然而，疼痛类别是promise - pf的重要预测因子，这表明它与感知功能限制的关系比与定量生物力学表现的关系更密切。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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