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首页> 外文期刊>Physiotherapy research international: the journal for researchers and clinicians in physical therapy >Directional preference, cognitive behavioural interventions, and outcomes among patients with chronic low back pain
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Directional preference, cognitive behavioural interventions, and outcomes among patients with chronic low back pain

机译：慢性低腰疼患者的定向偏好，认知行为干预和结果

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Abstract Objectives Graded activity and graded exposure are recommended cognitive behavioural approaches to improve function and pain outcomes for patients receiving physiotherapy for chronic nonspecific low back pain. Directional preference identified following the McKenzie method is also associated with favourable patient outcomes. Study objectives were to examine associations between graded activity and/or graded exposure, and directional preference or no directional preference combined with or without graded activity/graded exposure subgroups, and function and pain outcomes among patients with chronic nonspecific low back pain managed by clinicians credentialed in the McKenzie approach. Method Cohort study: Subjects ( n ?=?801) with chronic nonspecific low back pain completed intake surveys, that is, the Lumbar Computer Adaptive Test measuring function and the Numeric Pain Rating Scale measuring pain, and questions addressing their demographic, lifestyle, and health status. Directional preference was determined at intake. Treatment with graded activity/graded exposure during the episode of care was recorded. Function and pain measures were repeated at discharge. Two models were developed controlling for potential confounding effects. The first model examined associations between patients receiving versus not receiving graded activity/graded exposure. The second model examined interaction effects between four combinations of directional preference and graded activity/graded exposure. Outcome measures were changes in function and pain during rehabilitation. Results Regarding the first objective, there were no clinically relevant differences between treatment versus no treatment with graded activity/graded exposure, and functional outcomes. Regarding the second objective, patients in the no‐directional preference group were more likely to see benefits from the addition of graded activity/graded exposure to their treatment groups than those with a directional preference. Conclusion Clinicians using McKenzie methods might attain improved patient functional outcomes when augmenting treatment with graded activity and/or graded exposure among patients who do not demonstrate directional preference.
机译：摘要目的是评分活动和评分曝光是推荐的认知行为方法，以改善接受物理治疗的患者患者慢性非特异性低腰疼的患者的功能和疼痛结果。在McKenzie方法后确定的定向偏好也与有利的患者结果相关。研究目标是研究分级活性和/或分级曝光的关联，以及定向偏好或无定向偏好或没有分级活性/分级暴露亚组，临床医生患者的慢性非特异性低腰疼痛患者的功能和疼痛结果在McKenzie方法中。方法队列研究：受试者（n？=？801），慢性非特异性低腰疼痛完成进气调查，即腰椎计算机自适应测试测量功能和数字疼痛评定量表测量疼痛，以及解决他们的人口统计，生活方式的问题健康状况。在摄入时确定定向偏好。记录了在护理发作期间进行分级活性/分级曝光的治疗。在出院时重复功能和疼痛措施。制定了两种模型，控制潜在的混杂效果。第一种模型检查接受患者与未接收分级活动/分级曝光的患者之间的关联。第二种模型检查了四种方向偏好和分级活动/分级曝光的四种组合之间的相互作用效应。结果措施是康复期间功能和疼痛的变化。结果关于第一个目的，治疗与患者活动/分级暴露的治疗无临床相关差异，以及功能结果。关于第二个目的，在无定向偏好组中的患者更有可能从添加分级活性/分级暴露于它们的治疗组的益处而不是具有定向偏好的那些。结论使用MCKENENIE方法的临床医生可能在不证明定向偏好的患者中使用分级活性和/或分级暴露时增强患者功能结果。

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