Association between low back pain and various everyday performances Activities of daily living, ability to work and sexual function
Association between low back pain and various everyday performances Activities of daily living, ability to work and sexual function
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DOI：
10.1007/s00508-019-01542-7
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发表时间：
2019-11-01
影响因子：
2.6
通讯作者：
Dorner, Thomas Ernst
中科院分区：
文献类型：
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作者：
Grabovac, Igor;Dorner, Thomas Ernst
下背痛（LBP）是一种广泛流行的慢性疼痛疾病，与个人和社会的高负担有关。在LBP患者的主观感知中，与LBP相关的最重要的健康结果可能是影响日常表现的结果。这些结果包括日常生活活动（ADL），工作能力（WA）和性功能的降低。本综述旨在（1）检查LBP与上述三种日常表现结果之间的关联，（2）解释促进这些关联的可能中介因素，（3）讨论治疗和康复的可能影响。研究表明，LBP可以产生运动焦虑，导致运动回避（恐惧回避信念），这可能导致失调，并进一步增加ADL，WA和性功能下降的问题。此外，常见的精神障碍，例如抑郁症、焦虑症和压力相关疾病，也经常与腰痛同时发生，可能会对日常表现产生不利影响，反之亦然，可能是此类问题的后果并加剧腰痛。虽然没有普遍接受的治疗方式，适合每一个LBP患者，体育训练，全面的病人教育，工作场所或家庭的修改已被证明能够中断LBP和所描述的介导因素之间的相互影响，并对ADL，WA和性功能有有益的影响。为此，多学科的方法是必要的，其中包括多专业护理团队，患者的参与，以及不同环境的参与，如工作场所，家庭和体育训练设施。
Low back pain (LBP) is a widely prevalent chronic pain disorder associated with a high burden on individuals and society. In the subjective perception of patients with LBP, probably the most important health outcomes associated with LBP are those that effect everyday performance. Such outcomes include reduction in activities of daily living (ADL), in work ability (WA), and in sexual function. This narrative review aimed to (1) examine the association between LBP and the three mentioned outcomes of everyday performance, (2) to explain possible mediating factors promoting these associations, and (3) to discuss possible implications for treatment and rehabilitation. Studies have shown that LBP can generate anxiety of movement leading to movement avoidance (fear-avoidance beliefs), which may lead to deconditioning and further increasing problems with ADL, WA and decreasing sexual function. Furthermore, common mental disorders, such as depression, anxiety, and stress-related disorders, which also often co-occur with LBP can lead to adverse effects on everyday performance and vice versa, can be the consequence of such problems and aggravate LBP. Although there is no universally accepted treatment modality that fits every patient with LBP, physical training, comprehensive patient education, and workplace or home modifications have been shown to be able to interrupt the mutual influence between LBP and the described mediating factors, and have a beneficial effect on ADL, WA, and sexual function. For this, a multidisciplinary approach is necessary which includes multiprofessional care teams, participation of the patients, and involvement of different settings, such as workplace, home, and physical training facilities.