Guillaume Christe, Charles Benaim, Brigitte M. Jolles, Julien Favre
{"title":"脊柱运动行为的变化与慢性腰背痛患者残疾程度的减轻有关：一项为期一年的纵向队列研究。","authors":"Guillaume Christe, Charles Benaim, Brigitte M. Jolles, Julien Favre","doi":"10.1002/ejp.2245","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>The need to improve spinal motor behaviour in chronic low back pain (CLBP) rehabilitation remains unclear. The objective of this study was to test if changes in spinal motor behaviour were associated with changes in disability after an interdisciplinary rehabilitation program (IRP) in patients with CLBP.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Seventy-one patients with CLBP participating in an IRP were included. Spinal motor behaviour was assessed with biomechanical (lumbar angular amplitude and velocity, erector spinae muscle activity and duration of the task), cognitive-emotional (task-specific fear [PRF]) and pain-related (movement-evoked pain [MEP]) measures during a lifting task before and after the IRP. Disability was measured before and after the IRP, and at 3-month and 1-year follow-ups.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>After adjusting for confounders, changes in disability were significantly associated with MEP changes (<i>β</i> adj. = 0.49, <i>p</i> < 0.001) and PRF changes (<i>β</i> adj. = 0.36, <i>p</i> = 0.008), but not with changes in any of the biomechanical measures. MEP at the end of IRP was also associated with disability at 3 months (<i>β</i> adj. = 0.37, <i>p</i> = 0.001) and 1 year (<i>β</i> adj. = 0.42, <i>p</i> = 0.01). Biomechanical measures at the end of the IRP were not associated with disability, except for the duration of the task that was significantly associated with reduction of disability at 3 months (<i>β</i> non-adj = 0.5, <i>p</i> < 0.001).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Pain-related and cognitive-emotional measures of spinal motor behaviour were associated with reduction in disability following an IRP. Future research is needed to further investigate causal relationships between spinal motor behaviour and disability.</p>\n </section>\n \n <section>\n \n <h3> Significance statement</h3>\n \n <p>This study supports a multidimensional understanding and analysis of spinal motor behaviour, integrating the cognitive-emotional, pain-related and biomechanical domains. It also supports the consideration of spinal motor behaviour as a potentially important treatment target in chronic low back pain management. Moreover, it suggests that reducing movement-evoked pain and task-specific fear may have more influence on disability than changing lumbar amplitude, lumbar angular velocity or erector muscle activity, which may have important implications for rehabilitation.</p>\n </section>\n </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":null,"pages":null},"PeriodicalIF":3.5000,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.2245","citationCount":"0","resultStr":"{\"title\":\"Changes in spinal motor behaviour are associated with reduction in disability in chronic low back pain: A longitudinal cohort study with 1-year follow-up\",\"authors\":\"Guillaume Christe, Charles Benaim, Brigitte M. 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Disability was measured before and after the IRP, and at 3-month and 1-year follow-ups.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>After adjusting for confounders, changes in disability were significantly associated with MEP changes (<i>β</i> adj. = 0.49, <i>p</i> < 0.001) and PRF changes (<i>β</i> adj. = 0.36, <i>p</i> = 0.008), but not with changes in any of the biomechanical measures. MEP at the end of IRP was also associated with disability at 3 months (<i>β</i> adj. = 0.37, <i>p</i> = 0.001) and 1 year (<i>β</i> adj. = 0.42, <i>p</i> = 0.01). Biomechanical measures at the end of the IRP were not associated with disability, except for the duration of the task that was significantly associated with reduction of disability at 3 months (<i>β</i> non-adj = 0.5, <i>p</i> < 0.001).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Pain-related and cognitive-emotional measures of spinal motor behaviour were associated with reduction in disability following an IRP. Future research is needed to further investigate causal relationships between spinal motor behaviour and disability.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Significance statement</h3>\\n \\n <p>This study supports a multidimensional understanding and analysis of spinal motor behaviour, integrating the cognitive-emotional, pain-related and biomechanical domains. It also supports the consideration of spinal motor behaviour as a potentially important treatment target in chronic low back pain management. 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Changes in spinal motor behaviour are associated with reduction in disability in chronic low back pain: A longitudinal cohort study with 1-year follow-up
Background
The need to improve spinal motor behaviour in chronic low back pain (CLBP) rehabilitation remains unclear. The objective of this study was to test if changes in spinal motor behaviour were associated with changes in disability after an interdisciplinary rehabilitation program (IRP) in patients with CLBP.
Methods
Seventy-one patients with CLBP participating in an IRP were included. Spinal motor behaviour was assessed with biomechanical (lumbar angular amplitude and velocity, erector spinae muscle activity and duration of the task), cognitive-emotional (task-specific fear [PRF]) and pain-related (movement-evoked pain [MEP]) measures during a lifting task before and after the IRP. Disability was measured before and after the IRP, and at 3-month and 1-year follow-ups.
Results
After adjusting for confounders, changes in disability were significantly associated with MEP changes (β adj. = 0.49, p < 0.001) and PRF changes (β adj. = 0.36, p = 0.008), but not with changes in any of the biomechanical measures. MEP at the end of IRP was also associated with disability at 3 months (β adj. = 0.37, p = 0.001) and 1 year (β adj. = 0.42, p = 0.01). Biomechanical measures at the end of the IRP were not associated with disability, except for the duration of the task that was significantly associated with reduction of disability at 3 months (β non-adj = 0.5, p < 0.001).
Conclusions
Pain-related and cognitive-emotional measures of spinal motor behaviour were associated with reduction in disability following an IRP. Future research is needed to further investigate causal relationships between spinal motor behaviour and disability.
Significance statement
This study supports a multidimensional understanding and analysis of spinal motor behaviour, integrating the cognitive-emotional, pain-related and biomechanical domains. It also supports the consideration of spinal motor behaviour as a potentially important treatment target in chronic low back pain management. Moreover, it suggests that reducing movement-evoked pain and task-specific fear may have more influence on disability than changing lumbar amplitude, lumbar angular velocity or erector muscle activity, which may have important implications for rehabilitation.
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.
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