目的:目的是确定特定的身体活动(PA)或心理压力因素是否与不同的爆发定义相关(疼痛定义的耀斑[PDF]:持续至少2小时的疼痛加重期,当疼痛强度明显比最近更糟糕时;和非疼痛定义的耀斑[NPDF]:明显不舒服的感觉,比如疲劳,功能丧失,或情绪/心理波动,在腰椎神经根性疼痛患者中,基于11点量表的疼痛强度没有重大波动)。
方法:这是一项病例交叉研究。患有急性或亚急性腰椎根性疼痛的参与者以3天的间隔完成了为期6周的连续面对面或在线评估,以确定他们在特定类型的PA或心理压力后是否经历了坐骨神经痛发作(PDF/NPDF)。
结果:共有152名参与者入组。有597个PDF和323个NPDF病例期和800个控制期。长时间的步行和站立增加了PDF的几率,长时间坐着会增加NPDF的几率,精神痛苦,和抑郁的情绪。根据多变量分析,长时间坐着(OR:3.0,95%CI:1.7-5.5),长时间行走(OR:6.2,95%CI:3.9-9.9),长时间站立(OR:5.6,95%CI:3.3-9.5)与PDF的几率显着相关,和长时间坐着(OR:3.4,95%CI:1.8-6.2),精神困扰(OR:6.7,95%CI:2.5-17.5),和抑郁情绪(OR:5.8,95%CI:2.6-12.8)与NPDF的几率相关。
结论:长时间坐着,走路,和站立触发了PDF的发生。长时间坐着,精神痛苦,情绪低落引发了NPDF的发生。
OBJECTIVE: The objective was to determine whether specific physical activity (PA) or psychological stress factors are associated with different definitions of
flare-ups (pain-defined flares [PDFs]: periods of increased pain lasting at least 2 h, when pain intensity is distinctly worse than it has been recently; and non-pain-defined flares [NPDFs]: obviously uncomfortable feelings, such as fatigue, loss of function, or emotional/psychosocial fluctuations, without major fluctuations in pain intensity based on 11-point scales) among people with lumbar radicular pain.
METHODS: This was a case-crossover study. Participants with acute or subacute lumbar radicular pain completed serial face-to-face or online assessments for 6 weeks at 3-day intervals to determine whether they experienced sciatica
flare-ups (PDF/NPDF) after specific types of PA or psychological stresses.
RESULTS: A total of 152 participants were enroled. There were 597 PDF and 323 NPDF case periods and 800 control periods. The odds of PDFs were increased by prolonged walking and standing, and the odds of NPDFs were increased by prolonged sitting, mental distress, and depressed mood. According to the multivariable analyses, prolonged sitting (OR: 3.0, 95% CI: 1.7-5.5), prolonged walking (OR: 6.2, 95% CI: 3.9-9.9), and prolonged standing (OR: 5.6, 95% CI: 3.3-9.5) were significantly associated with the odds of PDFs, and prolonged sitting (OR: 3.4, 95% CI: 1.8-6.2), mental distress (OR: 6.7, 95% CI: 2.5-17.5), and depressed mood (OR: 5.8, 95% CI: 2.6-12.8) associated with the odds of NPDFs.
CONCLUSIONS: Prolonged sitting, walking, and standing triggered the occurrence of PDF. Prolonged sitting, mental distress, and depressed mood triggered the occurrence of NPDF.