Low levels of physical activity in back pain patients are associated with high levels of fear-avoidance beliefs and pain catastrophizing
Low levels of physical activity in back pain patients are associated with high levels of fear-avoidance beliefs and pain catastrophizing
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背痛患者运动量少与恐惧逃避信念和疼痛灾难化程度高有关
DOI：
10.1002/pri.355
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发表时间：
2007-03-01
影响因子：
1.7
通讯作者：
Grooten, Wilhelmus
中科院分区：
文献类型：
--
作者：
Elfving, Britt;Andersson, Teresia;Grooten, Wilhelmus
背景和目的。恐惧回避信念是非特异性下腰痛(LBP)患者残疾的重要决定因素。与自我报告的体力活动水平之间的联系则鲜为人知。本研究的目的是描述慢性非特异性LBP患者的体力活动水平及其与恐惧回避信念和疼痛灾变的关系。方法。基层医疗中慢性非特异性下腰痛的横断面研究测量的变量和使用的问卷是：体力活动水平(六级量表)；活动限制(罗兰·莫里斯残疾问卷(RDQ))；恐惧回避信念(坦帕运动恐惧症(TSK)13项和子量表‘活动回避’和‘躯体专注’)；以及疼痛灾变量表(疼痛灾变量表(PCS))。体力活动水平分为低体力活动和高体力活动。TSK和PCS量表上的个人中位数得分被用来将患者分为不同程度的恐惧回避信念和疼痛灾难。采用单因素Logistic回归计算低体力活动的优势比。结果。体力活动少的患者在恐惧回避信念和疼痛灾害化方面得分显著较高(p<；0.05)。对于具有高度恐惧回避信念或中等/高度疼痛大灾难的患者，低水平体力活动的优势比在4到8之间(p<；0.05)。结论。这项研究表明，对于初级保健的物理治疗师来说，衡量恐惧回避信念或疼痛灾难的水平似乎很重要。特别是，TSK的两个子量表对于临床医生在做出关于慢性LBP患者的体育运动疗法的治疗决策时可能具有实际价值。版权所有(C)2007 John Wiley&Sons，Ltd.
Background and Purpose. Fear-avoidance beliefs are important determinants for disability in patients with non-specific low-back pain (LBP). The association with self-reported level of physical activity is less known. The aim of the present study was to describe the level of physical activity in patients with chronic non-specific LBP and its relation to fear-avoidance beliefs and pain catastrophizing. Method. A cross-sectional study on 64 patients with chronic non-specific LBP in primary healthcare. The variables measured and the questionnaires used were: level of physical activity (six-graded scale); activity limitations (Roland Morris Disability Questionnare (RDQ)); fear-avoidance beliefs (Tampa Scale of Kinesiophobia (TSK) 13-item and sub-scales ` activity avoidance' and ` somatic focus'); and pain catastrophizing (Pain Catastrophizing Scale (PCS)). The level of physical activity was dichotomised into low and high physical activity. Individual median scores on the TSK and PCS scales were used to group the patients into different levels of fear-avoidance beliefs and pain catastrophizing. Univariate logistic regressions were used to calculate odds ratios for having low physical activity. Results. Patients with low physical activity had signifi cantly higher scores in fear-avoidance beliefs and pain catastrophizing (p < 0.05). Odds ratios for low level of physical activity were between 4 and 8 (p < 0.05) for patients with high fear-avoidance beliefs or medium/ high pain catastrophizing. Conclusions. This study indicates that it seems important for physiotherapists in primary care to measure levels of fear-avoidance beliefs or pain catastrophizing. In particular, the two subscales of the TSK could be of real value for clinicians when making treatment decisions concerning physical exercise therapy for patients with chronic LBP. Copyright (C) 2007 John Wiley & Sons, Ltd.