The role of anticipation and fear of pain in the persistence of avoidance behavior in patients with chronic low back pain
The role of anticipation and fear of pain in the persistence of avoidance behavior in patients with chronic low back pain
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DOI：
10.1097/00007632-200005010-00014
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发表时间：
2000-05-01
期刊：
影响因子：
3
通讯作者：
Al-Shuwaie, N
中科院分区：
文献类型：
--
作者：
Al-Obaidi, SM;Nelson, RM;Al-Shuwaie, N
研究设计.采用逐步回归分析的相关设计。探讨慢性下腰痛患者脊柱等长肌力的变化，这些变化可以通过疼痛预期、疼痛感觉、功能障碍信念和恐惧回避信念来解释。一些生物行为因素有助于慢性患者疼痛行为的持续性。最近的研究表明，有必要探讨减少的身体表现和疼痛的感觉和认知知觉之间的关系。63名20 - 56岁的慢性腰痛患者参加了这项研究。视觉类比量表、恐惧回避信念问卷和残疾信念问卷被用来测量疼痛的感觉和认知维度。采用Medx腰椎伸展机测量脊柱等长肌力。方差分析和逐步回归分析表明，对疼痛的预期和对体力活动的恐惧-避免信念显着预测脊柱等长肌力缺损的变化P < 0.001。在测试过程中经历的真实疼痛和残疾信念问卷的答案是不相关的。这项研究的结果有力地支持了这一假设，即慢性病的脊柱物理能力不能仅仅由疼痛的感觉来解释。对疼痛的预期和对身体活动的恐惧回避信念是身体表现变化的最强预测因子。
Study Design. A correlative design using stepwise regression analysis.Objective. To explore the variation in spinal isometric strength that can be accounted for by anticipation of pain, sensory perception of pain, functional disability belief, and the fear-avoidance belief in chronic low back pain patients.Summary of the Background Data. Several biobehavioral factors contribute to the persistence of pain behavior in chronic patients. Recent studies suggest a need to explore the relation between reduced physical performance and the sensory and cognitive perception of pain.Methods. Sixty-three patients with chronic low back pain 20 to 56 years of age participated in this study. Visual Analogs Scales, the Fear-Avoidance Belief questionnaire, and the Disability Belief questionnaire were used to measure the sensory and cognitive dimensions of pain. Spinal isometric strength was measured by the Medx lumbar extension machine.Results. Analysis of variance and the stepwise regression analysis demonstrated that anticipation of pain and the fear-avoidance belief about physical activity significantly predicted variation in the spinal isometric strength deficit P < 0.001. True pain experienced during the testing and answers to the Disability Belief questionnaire were not related.Conclusion. The results of this study strongly support the hypothesis that spinal physical capacity in chronicity is not explained solely by the sensory perception of pain. The anticipation of pain and the fear-avoidance belief about physical activities were the strongest predictors of the variation in physical performance.