The Relationship Between Pain-Related Threat and Motor Behavior in Nonspecific Low Back Pain: A Systematic Review and Meta-Analysis

被引:18
|
作者
Ippersiel, Patrick [1 ,2 ]
Teoli, Anthony [1 ,2 ]
Wideman, Timothy H. [1 ,2 ]
Preuss, Richard A. [1 ,2 ]
Robbins, Shawn M. [1 ,2 ]
机构
[1] McGill Univ, Sch Phys & Occupat Therapy, Montreal, PQ, Canada
[2] Lethbridge Layton Mackay Rehabil Ctr, Ctr Interdisciplinary Res Rehabil Greater Montrea, Montreal, PQ, Canada
来源
PHYSICAL THERAPY | 2022年 / 102卷 / 02期
关键词
Biomechanics; Chronic Pain; Low Back Pain; Medical; Psychology; Rehabilitation; FEAR-AVOIDANCE BELIEFS; COGNITIVE FUNCTIONAL THERAPY; PSYCHOLOGICAL-FACTORS; MUSCLE-ACTIVITY; MUSCULOSKELETAL PAIN; TRUNK COORDINATION; PHYSICAL-ACTIVITY; LUMBAR FLEXION; SPINAL MOTION; TAMPA SCALE;
D O I
10.1093/ptj/pzab274
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Objective Although pain-related fear and catastrophizing are predictors of disability in low back pain (LBP), their relationship with guarded motor behavior is unclear. The aim of this meta-analysis was to determine the relationship between pain-related threat (via pain-related fear and catastrophizing) and motor behavior during functional tasks in adults with LBP. Methods This review followed PRISMA guidelines. MEDLINE, Embase, PsychINFO, and CINAHL databases were searched to April 2021. Included studies measured the association between pain-related fear or pain catastrophizing and motor behavior (spinal range of motion, trunk coordination and variability, muscle activity) during movement in adults with nonspecific LBP. Studies were excluded if participants were postsurgery or diagnosed with specific LBP. Two independent reviewers extracted all data. The Newcastle-Ottawa Scale was used to assess for risk of bias. Correlation coefficients were pooled using the random-effects model. Results Reduced spinal range of motion during flexion tasks was weakly related to pain-related fear (15 studies, r = -0.21, 95% CI = -0.31 to -0.11) and pain catastrophizing (7 studies, r = -0.24, 95% CI = -0.38 to -0.087). Pain-related fear was unrelated to spinal extension (3 studies, r = -0.16, 95% CI = -0.33 to 0.026). Greater trunk extensor muscle activity during bending was moderately related to pain-related fear (2 studies, r = -0.40, 95% CI = -0.55 to -0.23). Pain catastrophizing, but not fear, was related to higher trunk activity during gait (2 studies, r = 0.25, 95% CI = 0.063 to 0.42). Methodological differences and missing data limited robust syntheses of studies examining muscle activity, so these findings should be interpreted carefully. Conclusion This study found a weak to moderate relationship between pain-related threat and guarded motor behavior during flexion-based tasks, but not consistently during other movements. Impact These findings provide a jumping-off point for future clinical research to explore the advantages of integrated treatment strategies that target both psychological and motor behavior processes compared with traditional approaches.
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页数:15
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