Abstract
Background:
This study evaluated (1) the relationship between physical fitness and somatosensory sensitivity in chronic lower back pain (CLBP) subjects, and compared that to the healthy controls (HCs); (2) the use of Central Sensitization Inventory (CSI) to measure somatosensory sensitivity against quantitative sensory tests (QST).
Purpose:
The relationship between physical fitness and somatosensory sensitivity in the CLBP population has not been fully established. As previous studies have highlighted the psychological influences on pain, this study would have psychological components considered as mediating factors, while expanding consideration on physical fitness domains under endurance, strength and aerobic capacity. Secondly, the association analysis between QST and CSI would reflect whether these sensitization assessment tools could be used complementarily.
Methods:
Eighteen healthy individuals and eighteen CLBP subjects all completed (1) QST performed at the lower back and peripheral regions, including pressure pain threshold (PPT), vibration detection threshold (VDT) and mechanical temporal summation (MTS), (2) CSI, (3) physical fitness tests including the 6-Minute Walk Test, Back Extension Endurance Test, and Modified Bruce Treadmill Test. Questionnaires consisting of the Pain Catastrophizing Scale, the Hospital Anxiety and Depression Scale, and the Oswestry Disability Index were administered to assess subjects’ psychological profiles. After comparing the two group’s performance in the above-mentioned measures, a correlation analysis between (1) the QST and physical fitness performance, with psychological factors considered as mediators, and (2) the QST and CSI, were also performed in both groups.
Results:
The CLBP group had significantly lower VDT (Z= -3.338, p= < 0.001) and poorer 6-Minute Walk Test (t= 2.124; p= 0.041). Anxiety and depression were higher (t= -2.376;p= 0.023) in the CLBP group, also for disability (t= -4.276; p= < 0.001), catastrophizing (Z= -2.146; p= 0.032) and CSI (t= 0.982; p= 0.035). The 6-Minute Walk Test moderately correlated with PPT at the lower back (r(11)= 0.687, p= 0.01) and peripheral limb (r(11)= 0.594, p= 0.032), while Back Extension Endurance Test and Modified Bruce Treadmill Test moderately correlated with VDT at the radial styloid process (r(11)= -0.604, p= 0.031) and PPT at the lower back (r(11)= 0.598, p= 0.031) respectively, after psychological factors were adjusted. Regarding the HC group, the 6-Minute Walk Test moderately correlated with VDT at the radial styloid process, MTS at both the lower back and the hand.
Conclusion(s):
Physical fitness is associated with somatosensory sensitivity in both groups, both with and without the consideration of psychological profiles. CSI is correlated with the QST, only in the healthy control group. Such findings were attributed to the relatively short history of LBP and low pain severity in the CLBP group. Future research is warranted to recruit subjects with higher pain severity and chronicity of lower back pain.
Implications:
As significant and moderate correlations were found between different physical fitness tests and various somatosensory sensitivity, it is implied that both physical fitness and QST could be assessed separately to complement different domains.
This study evaluated (1) the relationship between physical fitness and somatosensory sensitivity in chronic lower back pain (CLBP) subjects, and compared that to the healthy controls (HCs); (2) the use of Central Sensitization Inventory (CSI) to measure somatosensory sensitivity against quantitative sensory tests (QST).
Purpose:
The relationship between physical fitness and somatosensory sensitivity in the CLBP population has not been fully established. As previous studies have highlighted the psychological influences on pain, this study would have psychological components considered as mediating factors, while expanding consideration on physical fitness domains under endurance, strength and aerobic capacity. Secondly, the association analysis between QST and CSI would reflect whether these sensitization assessment tools could be used complementarily.
Methods:
Eighteen healthy individuals and eighteen CLBP subjects all completed (1) QST performed at the lower back and peripheral regions, including pressure pain threshold (PPT), vibration detection threshold (VDT) and mechanical temporal summation (MTS), (2) CSI, (3) physical fitness tests including the 6-Minute Walk Test, Back Extension Endurance Test, and Modified Bruce Treadmill Test. Questionnaires consisting of the Pain Catastrophizing Scale, the Hospital Anxiety and Depression Scale, and the Oswestry Disability Index were administered to assess subjects’ psychological profiles. After comparing the two group’s performance in the above-mentioned measures, a correlation analysis between (1) the QST and physical fitness performance, with psychological factors considered as mediators, and (2) the QST and CSI, were also performed in both groups.
Results:
The CLBP group had significantly lower VDT (Z= -3.338, p= < 0.001) and poorer 6-Minute Walk Test (t= 2.124; p= 0.041). Anxiety and depression were higher (t= -2.376;p= 0.023) in the CLBP group, also for disability (t= -4.276; p= < 0.001), catastrophizing (Z= -2.146; p= 0.032) and CSI (t= 0.982; p= 0.035). The 6-Minute Walk Test moderately correlated with PPT at the lower back (r(11)= 0.687, p= 0.01) and peripheral limb (r(11)= 0.594, p= 0.032), while Back Extension Endurance Test and Modified Bruce Treadmill Test moderately correlated with VDT at the radial styloid process (r(11)= -0.604, p= 0.031) and PPT at the lower back (r(11)= 0.598, p= 0.031) respectively, after psychological factors were adjusted. Regarding the HC group, the 6-Minute Walk Test moderately correlated with VDT at the radial styloid process, MTS at both the lower back and the hand.
Conclusion(s):
Physical fitness is associated with somatosensory sensitivity in both groups, both with and without the consideration of psychological profiles. CSI is correlated with the QST, only in the healthy control group. Such findings were attributed to the relatively short history of LBP and low pain severity in the CLBP group. Future research is warranted to recruit subjects with higher pain severity and chronicity of lower back pain.
Implications:
As significant and moderate correlations were found between different physical fitness tests and various somatosensory sensitivity, it is implied that both physical fitness and QST could be assessed separately to complement different domains.
Original language | English |
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Publication status | Published - 6 Jul 2024 |
Event | International Federtation of Orthopaedic and Maniulative Physical Therapist Conference 2024 - Basel, Basel, Switzerland Duration: 4 Jul 2024 → 6 Jul 2024 https://www.ifomptbasel2024.org/frontend/index.php |
Conference
Conference | International Federtation of Orthopaedic and Maniulative Physical Therapist Conference 2024 |
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Abbreviated title | IFOMPT 2024 |
Country/Territory | Switzerland |
City | Basel |
Period | 4/07/24 → 6/07/24 |
Internet address |
Keywords
- Quantitative sensory testing
- Physical fitness
- Psychological profiles
- Chronic low back pain