Criteria for inclusion in programs of functional restoration for chronic low back pain: Pragmatic Study
Criteria for inclusion in programs of functional restoration for chronic low back pain: Pragmatic Study
复制标题
DOI：
10.1016/j.rehab.2019.06.019
复制
发表时间：
2020-05-01
影响因子：
4.6
通讯作者：
Gossec, Laure
中科院分区：
文献类型：
--
作者：
Assadourian, Marina;Bailly, Florian;Gossec, Laure
背景：慢性腰痛 (cLBP) 患者可能受益于多模式功能恢复计划 (FRP)。目的：本研究的目的是分析转诊或未转诊至 FRP 的 cLBP 患者的特征。由于 cLBP 是一种生物心理社会疾病，因此对医学和社会参数进行了分析。方法：这是一项 2017 年在法国 6 个三级中心进行的观察性横断面研究。连续去看风湿科医生或物理医学和康复医生的 cLBP 患者也被纳入其中。通过人口特征、过去一年的病假时间、自我报告的体力活动 > 1 小时/周、疼痛（数字评分量表 0-10）、焦虑/抑郁（医院焦虑和抑郁量表）、残疾（Oswestry 残疾指数）和运动恐惧症（坦帕运动恐惧量表）对转介或未转介 FRP 的个人进行比较。进行单变量和多变量逻辑回归分析，估计比值比 (OR) 和 95% 置信区间 (CI)。结果：我们纳入了 147 名 cLBP 患者。平均 (SD) 年龄为 49 (12) 岁，其中 88 名 (60%) 为女性； 58 人 (38%) 被转介至 FRP。在多变量分析中，转诊至 FRP 与疼痛程度减轻（OR：0.95，95% CI：0.91-0.99，疼痛评分每增加 1 分）、自我报告缺乏体力活动（OR：0.84，95% CI：0.72-0.98）和更长的病假（OR：1.03，95% CI： 1.01-1.05，病假多 30 天）。结论：在这项多中心观察性研究中，转诊至 FRP 与疼痛、自我报告的体力活动和病假有关，但与评估的医疗特征无关。这些发现证实了 FRP 治疗 cLBP 的生物心理社会方法。 (C) 2019 Elsevier Masson SAS。版权所有。
Background: Individuals with chronic low back pain (cLBP) may benefit from multimodal functional restoration programs (FRPs). Objective: The aim of this study was to analyze characteristics of individuals with cLBP who were referred or not to an FRP. Because cLBP is a bio-psycho-social disorder, medical and social parameters were analysed.Methods: This was an observational cross-sectional study performed in 2017 in 6 tertiary centres in France. Consecutive individuals with cLBP visiting a rheumatologist or physical medicine and rehabilitation physician were included. Individuals referred or not to an FRP were compared by demographic characteristics, duration of sick leave over the past year, self-reported physical activity > 1 h/week, pain (numeric rating scale 0-10), anxiety/depression (Hospital Anxiety and Depression Scale), disability (Oswestry Disability Index) and kinesiophobia (Tampa Kinesiophobia Scale). Univariate and multivariate logistic regression analyses were performed, estimating odds ratios (ORs) and 95% confidence intervals (CIs).Results: We included 147 individuals with cLBP. The mean (SD) age was 49 (12) years and 88 (60%) were women; 58 (38%) were referred to an FRP. On multivariate analysis, referral to an FRP was associated with reduced pain level (OR: 0.95, 95% CI: 0.91-0.99, for each 1-point increase in pain score), self-reported lack of physical activity (OR: 0.84, 95% CI: 0.72-0.98) and longer sick leave (OR: 1.03, 95% CI: 1.01-1.05, for 30 more days of sick leave).Conclusion: In this multicentric observational study, referral to an FRP was linked to pain, self-reported physical activity and sick leave but not medical characteristics assessed. These findings confirm the bio-psycho-social approach of FRPs for cLBP. (C) 2019 Elsevier Masson SAS. All rights reserved.