Fear Avoidance Predicts Persistent Pain in Young Adults With Low Back Pain: A Prospective Study.
Fear Avoidance Predicts Persistent Pain in Young Adults With Low Back Pain: A Prospective Study.
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DOI：
10.2519/jospt.2021.9828
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发表时间：
2021-08
期刊：
影响因子：
--
通讯作者：
Santayana N
中科院分区：
文献类型：
--
作者：
Smith JA;Russo L;Santayana N
以(I)量化年轻人的LBP症状、体力活动和心理社会特征之间的关系，以及(Ii)识别具有不同疼痛轨迹的年轻人的亚类。前瞻性队列研究包括120名成年人(年龄20.8±2.6岁，99名女性)，随访12个月。参与者完成了一项基线调查，衡量了焦虑、抑郁、恐惧回避、生活质量以及任何LBP的历史和影响。参与者每3个月完成一次跟踪调查，为期一年。基于疼痛轨迹随时间变化的子类通过潜在类别分析进行识别，并评估基线时类别成员的预测因子。基线时腰痛患者的身体生活质量得分低于背部健康受试者(P=0.01)。亚类1(25%的LBP患者)在1年的研究期间有持续的中等/高度疼痛。在为期一年的研究期间，第二类患者(75%)的疼痛明显改善。在基线水平上，较高的恐惧回避(生理分量表)和疼痛干扰与较高的1亚类成员的优势比(优势比分别为1.2(95%可信区间1.01~0.1.32)和1.4(95%可信区间1.15~1.64))相关。大多数患有LBP的年轻人的症状随着时间的推移而改善。恐惧回避和疼痛干预的水平可能有助于识别生命早期有持续性疼痛风险的个人。
To (i) quantify relationships between LBP symptoms, physical activity, and psychosocial characteristics in young adults and (ii) identify sub-classes of young adults with distinct pain trajectories. Prospective cohort study with 12 months follow-up 120 adults (age 20.8±2.6 years, 99 women) participated. Participants completed a baseline survey that measured anxiety, depression, fear avoidance, quality of life, and history and impact of any LBP. Participants completed follow up surveys every 3 months for one year. Sub-classes based on pain trajectories over time were identified using latent class analysis and predictors of class membership at baseline were assessed. Individuals with LBP at baseline had lower physical quality of life scores than back-healthy participants (P = 0.01). Sub-class 1 (25% of individuals with LBP) had persistent moderate/high intensity of pain over the 1-year study period. Sub-class 2 (75%) had significantly improving pain over the 1-year study period. Higher fear avoidance (physical subscale) and pain interference at baseline were associated with greater odds of membership of sub-class 1 (odds ratios 1.2 (95% CI 1.01– 0.1.32) and 1.4, (95% CI 1.15 – 1.64) respectively). Most young adults with LBP had symptoms that improved over time. Levels of fear avoidance and pain interference may help to identify individuals at risk of persistent pain early in the lifespan.
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