Disuse and physical deconditioning in the first year after the onset of back pain

被引:120
作者
Bousema, Eric J.
Verbunt, Jeanine A.
Seelen, Henk A. M.
Vlaeyen, Johan W. S.
Knottnerus, J. Andre
机构
[1] Rehabil Fdn Limburg, NL-6430 AB Hoensbroek, Netherlands
[2] Hlth Promot Work, NL-6127 RJ Sittard, Netherlands
[3] Univ Hosp Maastricht, Pain Management & Res Ctr, NL-6202 AZ Maastricht, Netherlands
[4] Maastricht Univ, Dept Med Clin & Expt Psychol, NL-6200 MD Maastricht, Netherlands
[5] Maastricht Univ, Dept Gen Pract, NL-6200 MD Maastricht, Netherlands
关键词
chronic low back pain; physical deconditioning; disuse; longitudinal cohort; physical activity;
D O I
10.1016/j.pain.2007.03.024
中图分类号
R614 [麻醉学];
学科分类号
100217 [麻醉学];
摘要
For years, physical deconditioning has been thought to be both a cause and a result of back pain. As a consequence physical reconditioning has been proposed as treatment-goal in patients with chronic low back pain (LBP). However, it is still unclear whether a patient's physical fitness level really decreases after pain-onset. The objectives of the present study were, firstly, to test the assumption that long-term non-specific LBP leads to a decrease of the level of physical activity (disuse), secondly, to evaluate any development of physical deconditioning as a result of disuse in CLBP, and thirdly, to evaluate predictors for disuse in CLBP. A longitudinal cohort study over one year including 124 patients with sub-acute LBP (i.e., 4-7 weeks after pain onset) was performed. Main outcome measures were change in physical activity level (PAL) and physical fitness (measured by changes in body weight, body fat and muscle strength) over one year. Hypothesized predictors for disuse were: pain catastrophizing; fear of movement; depression: physical activity decline; the perceived level of disability and PAL prior to pain. Results showed that only in a subgroup of patients a PAL-decrease had occurred after the onset of pain, whereas no signs of physical deconditioning were found. Negative affect and the patients' perceived physical activity decline in the subacute phase predicted a decreased level of PAL over one year. Based on these results, we conclude that as to the assumption that patients with CLBP suffer from disuse and physical deconditioning empirical evidence is still lacking. (C) 2007 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:279 / 286
页数:8
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