The association between mechanical temporal summation, state anxiety at baseline, and persistent low back pain: a 12-month prospective cohort study
Abstract Background Persons with acute low back pain (LBP) have a good prognosis for regaining function, while pain often persists. Neurobiological and psychosocial factors are recognized to amplify pain responses, as reported for central sensitization. This study investigated the combination of mec...
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-023-07046-w |
| _version_ | 1797398258145820672 |
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| author | Nicole Dietrich Hannu Luomajoki Sabina Hotz-Boendermaker |
| author_facet | Nicole Dietrich Hannu Luomajoki Sabina Hotz-Boendermaker |
| author_sort | Nicole Dietrich |
| collection | DOAJ |
| description | Abstract Background Persons with acute low back pain (LBP) have a good prognosis for regaining function, while pain often persists. Neurobiological and psychosocial factors are recognized to amplify pain responses, as reported for central sensitization. This study investigated the combination of mechanical temporal summation (TS) chosen to characterize central sensitization and state anxiety representing a psychological factor and their association with persistent pain. Methods A longitudinal prospective cohort study including 176 participants aged between 18 and 65 with acute LBP was performed. The following independent variables were analyzed at baseline: The mechanical TS at the lower back, of whom the Wind-up ratio (WUR) was calculated, and the state anxiety level measured with the State and Trait Anxiety Inventory (STAI-S). The outcome pain intensity was assessed at baseline and 2,3,6 and 12 months after the onset of acute LBP with the Numeric Rating Scale 0–10 (NRS). Linear mixed models (LMM) were used to analyze the association of the independent variables with pain intensity over time. Results The mean baseline WUR was 1.3 (SD 0.6) for the right and 1.5 (SD 1.0) for the left side. STAI-S revealed a mean score of 43.1 (SD 5.2). Pain intensity was, on average, 5.4 points (SD 1.6) on the NRS and decreased over one year to a mean of 2.2 (SD 2.4). After one year, 56% of the participants still experienced pain. The LMM revealed a considerable variation, as seen in large confidence intervals. Therefore, associations of the independent variables (WUR and STAI-S) with the course of the outcome pain intensity over one year were not established. Conclusion This investigation did not reveal an association of mechanical TS and state anxiety at baseline with pain intensity during the one-year measurement period. Pain persistence, mediated by central sensitization, is a complex mechanism that single mechanical TS and state anxiety cannot capture. |
| first_indexed | 2024-03-09T01:23:01Z |
| format | Article |
| id | doaj.art-f9145fb19b924737b6947a86c5cb3096 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-03-09T01:23:01Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-f9145fb19b924737b6947a86c5cb30962023-12-10T12:04:13ZengBMCBMC Musculoskeletal Disorders1471-24742023-12-012411910.1186/s12891-023-07046-wThe association between mechanical temporal summation, state anxiety at baseline, and persistent low back pain: a 12-month prospective cohort studyNicole Dietrich0Hannu Luomajoki1Sabina Hotz-Boendermaker2School of Health Professions, Zurich University of Applied Sciences (ZHAW), Institute of Physiotherapy,School of Health Professions, Zurich University of Applied Sciences (ZHAW), Institute of Physiotherapy,School of Health Professions, Zurich University of Applied Sciences (ZHAW), Institute of Physiotherapy,Abstract Background Persons with acute low back pain (LBP) have a good prognosis for regaining function, while pain often persists. Neurobiological and psychosocial factors are recognized to amplify pain responses, as reported for central sensitization. This study investigated the combination of mechanical temporal summation (TS) chosen to characterize central sensitization and state anxiety representing a psychological factor and their association with persistent pain. Methods A longitudinal prospective cohort study including 176 participants aged between 18 and 65 with acute LBP was performed. The following independent variables were analyzed at baseline: The mechanical TS at the lower back, of whom the Wind-up ratio (WUR) was calculated, and the state anxiety level measured with the State and Trait Anxiety Inventory (STAI-S). The outcome pain intensity was assessed at baseline and 2,3,6 and 12 months after the onset of acute LBP with the Numeric Rating Scale 0–10 (NRS). Linear mixed models (LMM) were used to analyze the association of the independent variables with pain intensity over time. Results The mean baseline WUR was 1.3 (SD 0.6) for the right and 1.5 (SD 1.0) for the left side. STAI-S revealed a mean score of 43.1 (SD 5.2). Pain intensity was, on average, 5.4 points (SD 1.6) on the NRS and decreased over one year to a mean of 2.2 (SD 2.4). After one year, 56% of the participants still experienced pain. The LMM revealed a considerable variation, as seen in large confidence intervals. Therefore, associations of the independent variables (WUR and STAI-S) with the course of the outcome pain intensity over one year were not established. Conclusion This investigation did not reveal an association of mechanical TS and state anxiety at baseline with pain intensity during the one-year measurement period. Pain persistence, mediated by central sensitization, is a complex mechanism that single mechanical TS and state anxiety cannot capture.https://doi.org/10.1186/s12891-023-07046-wWind-up ratioState anxietyPainLow back painMechanical temporal summationLinear mixed models |
| spellingShingle | Nicole Dietrich Hannu Luomajoki Sabina Hotz-Boendermaker The association between mechanical temporal summation, state anxiety at baseline, and persistent low back pain: a 12-month prospective cohort study BMC Musculoskeletal Disorders Wind-up ratio State anxiety Pain Low back pain Mechanical temporal summation Linear mixed models |
| title | The association between mechanical temporal summation, state anxiety at baseline, and persistent low back pain: a 12-month prospective cohort study |
| title_full | The association between mechanical temporal summation, state anxiety at baseline, and persistent low back pain: a 12-month prospective cohort study |
| title_fullStr | The association between mechanical temporal summation, state anxiety at baseline, and persistent low back pain: a 12-month prospective cohort study |
| title_full_unstemmed | The association between mechanical temporal summation, state anxiety at baseline, and persistent low back pain: a 12-month prospective cohort study |
| title_short | The association between mechanical temporal summation, state anxiety at baseline, and persistent low back pain: a 12-month prospective cohort study |
| title_sort | association between mechanical temporal summation state anxiety at baseline and persistent low back pain a 12 month prospective cohort study |
| topic | Wind-up ratio State anxiety Pain Low back pain Mechanical temporal summation Linear mixed models |
| url | https://doi.org/10.1186/s12891-023-07046-w |
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