Predicting Recurrence of Low Back Pain - Study #2

描述(由申请人提供)：本提案的主要目的是确定身体和心理因素在腰痛首次发作后的康复过程中如何相互作用，并确定这些因素如何导致复发风险。具体地说，我们建议评估运动协调策略(腰椎和骨盆运动模式的变化)和运动恐惧症(对身体运动后疼痛再受伤的恐惧)之间的关系。提出了两项研究。 研究1将检验运动恐惧症程度高和低的下腰痛患者在执行标准化到达任务时的运动模式。参与者将在症状出现后3周、6周和12周接受评估，以跟踪运动协调性的变化。通过检查高运动恐惧症和低运动恐惧症下腰痛患者使用的腰部和骨盆运动的相对幅度，这一设计将使我们能够跟踪急性下腰痛康复过程中运动协调和运动恐惧症之间的动态关系的变化。我们假设，在运动恐惧症程度高与低的下腰痛患者中，腰椎运动将显着减少。 研究2将检查最近从下腰痛中恢复的个体在标准化到达任务中的运动模式。使用纵向设计，我们将开发一个生存模型，基于脊柱运动和运动恐惧症的测量，评估首次发生下腰痛后一年内复发的风险。我们假设背部疼痛复发的风险最高的是那些运动恐惧症程度高的人，他们表现出脊柱运动减少。 目前的建议汇集了来自运动协调和健康心理学文献的有希望的想法，以创新地整合复发性下腰痛的最佳预测因素。这项研究的短期目标是描述脊柱运动参数和运动恐惧症如何相互作用来促进或推迟急性下腰痛的恢复。我们的长期目标是利用这些信息开发一种易于应用于临床实践的评估方案。

DESCRIPTION (provided by applicant): The primary aims of this proposal are to determine how physical and psychological factors interact in the recovery process following an initial episode of low back pain and to determine how these factors contribute to risk for recurrence. Specifically, we propose to assess the relationship between motor coordination strategies (changes in lumbar and pelvic movement patterns) and levels of kinesiophobia (fear of painful re-injury upon physical movement) following an initial episode of low back pain. Two studies are proposed. Study 1 will examine movement patterns during performance of standardized reaching tasks in low back pain patients with high versus low levels of kinesiophobia. Participants will be assessed at 3, 6, and 12 weeks after onset of symptoms to track changes in motor coordination. By examining the relative magnitude of lumbar and pelvic motions used by low back pain patients who are high and low kinesiophobia, this design will allow us to track changes in the dynamic relationship between motor coordination and kinesiophobia during the process of recovery from acute low back pain. We hypothesize that lumbar motion will be significantly reduced in low back pain patients who are high versus low in kinesiophobia. Study 2 will examine movement patterns during standardized reaching tasks in individuals who have recently recovered from low back pain. Using a longitudinal design, we will develop a survival model to assess the risk for recurrence in the year following an initial episode of low back pain based on measures of spinal motion and kinesiophobia. We hypothesize that the highest risk of recurrent back pain will be observed in those who are high in kinesiophobia and who exhibit reduced spinal motion. The current proposal brings together promising ideas from motor coordination and health psychology literatures to provide an innovative integration of the best predictors of recurrent low back pain. The short-term goal of this research is characterize how spinal motion parameters and kinesiophobia interact to promote or delay recovery from acute low back pain. Our long-term goal is to use this information to develop an assessment protocol that can be easily adopted into clinical practice.