背景:尽管人们普遍认为体力活动和下腰痛(LBP)的耀斑有关,这种关联的方向性的证据是混合的。活动研究研究(FLAReS)的腰背痛耀斑采取了一种新颖的方法来区分特定身体活动对LBP耀斑的短期影响与此类活动的累积影响,通过在队列研究中嵌套进行纵向病例交叉研究。第一个目的是估计特定体育锻炼对退伍军人事务医疗保健系统中初级保健的退伍军人的LBP耀斑的短期影响(≤24小时)。第二个目的是在1年的随访中估计特定活动对LBP相关功能限制的累积影响。
方法:在1年的随访中,多达550名在初级保健中观察到LBP的工作年龄(18-65岁)的成年人完成了多达36项“预定”调查,并在新耀斑发生后完成计划外的“耀斑窗口”调查。每次调查都会询问当前的耀斑以及与LBP相关的其他因素。调查还询问24小时内的活动暴露情况,和2小时,在调查完成之前(非耀斑期间)或耀斑开始之前(耀斑期间)。其他问题评估数字,强度,持续时间,和/或活动暴露的其他特征。其他暴露包括与情绪有关的因素,生活方式,锻炼,同时治疗,和伤害。一些参与者在研究的第1-4周佩戴活动描记器。第一个目标是在1年的随访中检查10个特定活动类别与参与者报告的耀斑之间的关联。第二个目标将检查在随访的1-4周内暴露于10种活动类别的频率与12个月时的长期功能限制之间的关联。所有分析都将使用生物心理社会框架,考虑潜在的混杂因素和效果修饰。
结论:FLAReS将为患有LBP的退伍军人提供特定身体活动的短期和累积影响的经验得出的估计,有助于更好地了解身体活动在LBP患者中的作用。
背景:ClinicalTrials.govNCT04828330,注册于2021年4月2日。
BACKGROUND: Although it is generally accepted that physical activity and flares of low back pain (LBP) are related, evidence for the directionality of this association is mixed. The Flares of Low back pain with Activity Research Study (FLAReS) takes a novel approach to distinguish the short-term effects of specific physical activities on LBP flares from the cumulative effects of such activities, by conducting a longitudinal
case-crossover study nested within a cohort study. The first aim is to estimate the short-term effects (≤ 24 h) of specific physical activities on LBP flares among Veterans in primary care in the Veterans Affairs healthcare system. The second aim is to estimate the cumulative effects of specific activities on LBP-related functional limitations at 1-year follow-up.
METHODS: Up to 550 adults of working age (18-65 years) seen for LBP in primary care complete up to 36 \"Scheduled\" surveys over 1-year follow-up, and also complete unscheduled \"Flare Window\" surveys after the onset of new flares. Each survey asks about current flares and other factors associated with LBP. Surveys also inquire about activity exposures over the 24 h, and 2 h, prior to the time of survey completion (during non-flare periods) or prior to the time of flare onset (during flares). Other questions evaluate the number, intensity, duration, and/or other characteristics of activity exposures. Other exposures include factors related to mood, lifestyle, exercise, concurrent treatments, and injuries. Some participants wear actigraphy devices for weeks 1-4 of the study. The first aim will examine associations between 10 specific activity categories and participant-reported flares over 1-year follow-up. The second aim will examine associations between the frequency of exposure to 10 activity categories over weeks 1-4 of follow-up and long-term functional limitations at 12 months. All analyses will use a biopsychosocial framework accounting for potential confounders and effect modifiers.
CONCLUSIONS: FLAReS will provide empirically derived estimates of both the short-term and cumulative effects of specific physical activities for Veterans with LBP, helping to better understand the role of physical activities in those with LBP.
BACKGROUND: ClinicalTrials.gov NCT04828330 , registered April 2, 2021.