). Main Outcome Measures. Pain intensity, falls-related self-efficacy and intrinsic constructs in the FABM were evaluated. Postural steadiness (centre of pressure (COP)) and mobility functions were assessed. Linear relationships of FABM variables with COP and mobility score were estimated. Results. CLBP showed lower mobility score compared to controls. CLBP presented lower falls-related self-efficacy and it was associated with reduced mobility scores. FABM variables and falls-related self-efficacy were correlated with postural steadiness. Physical activity was reduced in CLBP, but no between-group difference was evident for knee extensor strength. No systematic linkages were observed between FABM variables with mobility score or postural steadiness. Conclusions. Back pain status affects balance and mobility functions in older women. Falls-related self-efficacy is lower in CLBP and is associated with reduced mobility. Disuse syndrome in CLBP elderly is partly supported by the results of this preliminary study.">
平衡、Falls-Related自我效能感和心理因素在老年妇女患有慢性下腰痛:初步病例对照研究</t我tle>
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<h1 class="articleHeader__title">平衡、Falls-Related自我效能感和心理因素在老年妇女患有慢性下腰痛:初步病例对照研究</h1>
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<span class="articleHeader__authors_author">Annick香槟<!-- -->,<年代up>1</年代up></span>
<span class="articleHeader__authors_author">弗朗索瓦王子<!-- -->,<年代up>1</年代up></span>
<span class="articleHeader__authors_author">Vicky Bouffard<!-- -->,<年代up>1</年代up></span>
<span class="articleHeader__authors_author">和<年代trong>Danik Lafond</年代trong><a href="//www.newsama.com/cdn-cgi/l/email-protection" aria-label="Mail Option"><span role="img" class="anticon">
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<span>莫林·西蒙兹</年代pan>
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<span>2012年1月13日</年代pan>
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<span>2012年4月20日</年代pan>
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<h4 class="header" id="abstract">文摘</h4>
<p><i>客观的</我>。调查在老年妇女和平衡功能评估协会fear-avoidance信仰模型(FABM)平衡和流动性能的因素。<我>参与者</我>。15 CLBP患者与年龄没有痛苦的控件(<年代vg height="11.1" id="M1" style="vertical-align:-0.17555pt;width:42.912498px;" version="1.1" viewbox="0 0 42.912498 11.1" width="42.912498" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,11.1)">
<g transform="translate(72,-63.12)">
<text transform="matrix(1,0,0,-1,-71.95,63.35)">
<tspan style="font-size: 12.50px; " x="0" y="0">
</t年代pan>
<tspan style="font-size: 12.50px; " x="9.6773224" y="0">
=</t年代pan>
<tspan style="font-size: 12.50px; " x="21.71771" y="0">
1</t年代pan>
<tspan style="font-size: 12.50px; " x="27.969212" y="0">
5</t年代pan>
</text>
</g>
</g>
</svg>)。<我>主要结果测量</我>。疼痛强度,falls-related FABM自我效能感和内在结构的评估。姿势稳定性(压力(COP)的中心)和移动功能评估。FABM变量的线性关系与警察和机动性的分数估计。<我>结果</我>。CLBP显示低流动性得分比控制。CLBP呈现低falls-related自我效能得分减少流动性有关。FABM变量和falls-related自我效能与姿势稳定。在CLBP体力活动减少,但没有明显的伸膝力量群体间的差异。没有观察到系统联系FABM变量与迁移分数之间或姿势稳定。<我>结论</我>。背部疼痛状态影响老年妇女和移动功能平衡。在CLBP Falls-related自我效能感较低,能降低流动性。废弃CLBP老年综合症是部分支持这项初步研究的结果。</p>
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<h4 id="introduction">1。介绍</h4>
<p>背痛是最重要的影响因素在老年人健康状况和功能能力(<一个href="#B1">1</一个>),受试者的12 - 42%的患病率超过65岁(<一个href="#B1">1</一个>]。在老年妇女比男性更常见(<一个href="#B2">2</一个>),而女性更可能有疼痛长时间(<一个href="#B3">3</一个>]。Leveille et al。<一个href="#B1">1</一个>)确定严重的背痛残疾的可能性增加3 - 4倍,而轻度或中度背痛不是与日常生活的功能活动。下腰痛(LBP)被发现与2倍大的困难在日常生活活动和下降的风险<一个href="#B4">4</一个>]。情景性慢性下腰痛(CLBP)时代的推进可能导致神经生理学与年龄相关的变化,可能会进一步影响恶化的姿势控制(<一个href="#B5">5</一个>]。</p>
<p>根据FABM [<一个href="#B6">6</一个>),疼痛反应行为如避免身体活动和过度警觉的后果加以曲解或想法/信仰引发的痛苦经历。与CLBP年轻人,海拔的恐惧导致疼痛反应提高残疾(<一个href="#B7">7</一个>]。然而,有越来越多的证据表明,疼痛恐惧没有系统地影响身体活动减少或停止使用综合症的出现<一个href="#B8">8</一个>- - - - - -<一个href="#B10">10</一个>]。在年轻人和枸杞多糖,它似乎是可信的,避免恐惧引起疼痛反应行为与特定的运动,被认为是潜在的痛苦或reinjury的危险,而不是影响一般体育活动参与(<一个href="#B8">8</一个>]。</p>
<p>然而,fear-avoidance信仰模型的构造还没有被广泛的研究与枸杞多糖在老年人在年轻的成年人。例如,Kovacs et al。<一个href="#B11">11</一个>)发现残疾不会受到fear-avoidance信仰与西班牙老年人身体活动有关。枸杞多糖老年人较多fear-avoidance和感知功能的能力,但没有显示减少体育活动相比,控制(<一个href="#B12">12</一个>]。此外,fear-avoidance信仰建立使用特定运动方法被发现预测功能能力但不是一个好体育活动参与的预测(<一个href="#B12">12</一个>]。高水平的fear-avoidance信仰与下降(<一个href="#B13">13</一个>,<一个href="#B14">14</一个>),而经验常常有助于减少自信下降运动和平衡(<一个href="#B15">15</一个>在社区老年个体。减少活动由fear-avoidance信仰也影响体能(<一个href="#B13">13</一个>]。尽管老年人盛行的枸杞多糖及其对健康的影响结果,信息几乎没有关于枸杞多糖和fear-avoidance信仰对平衡的影响和移动功能以及在社区老年人不用综合症。重要的信息可以从直接测量聚集人口的平衡和迁移功能。事实上,疼痛恐惧与身体功能下降有关,比如减少步行速度和下肢力量<一个href="#B16">16</一个>在年轻人和枸杞多糖。</p>
<p>因此,这项初步研究的目的是双重的:(1)评估资产和流动性功能相比,老年妇女的样本通过直接测量与控制和(2)检查如果falls-related fear-avoidance信仰的自我效能和构造模型与贫穷的平衡和迁移功能。我们希望以下结果:(1)老年人与CLBP falls-related自我效能感较低,(2)他们将降低平衡和迁移功能。虽然废弃综合症尚未最终观察到老年人脊柱疼痛(<一个href="#B12">12</一个>),我们保持以下假设:(1)CLBP科目将更少的体力活动和(2)falls-related自我效能感,害怕运动,残疾,废弃的结果将是线性相关的平衡和迁移功能与CLBP老年人。</p>
<h4 id="materials-and-methods">2。材料和方法</h4>
<h5 id="sec2.1">2.1。参与者</h5>
<p>15 CLBP妇女和15个女性控制没有报告疼痛,超过60岁,是从当地社区招募(表<一个href="//www.newsama.com/journals/rerp/2012/430374/tab1/" target="_blank">1</一个>)。肌肉骨骼疼痛的控制是免费的在去年报道从未经历过禁用枸杞多糖。CLBP参与者包括如果他们发生LBP至少6个月,连续或偶然,和紧张,疼痛,背部地区和/或刚度与辐射疼痛局限于臀部。枸杞多糖的排除标准是已知的原因、神经或前庭疾病,头晕,严重的视觉或听觉障碍,急性疾病或痛苦,认知障碍,医疗条件可能使测试潜在的不安全。慢性疾病和药物筛选项访谈式问卷调查从参与者的响应,一个扩展版的身体活动准备问卷。受试者回答“是(1)”或“无(0)”当被问及目前患有疾病或服用药物,和积极的答案总结。所有科目给他们通知,书面同意根据大学伦理委员会批准的协议(cer - 10 - 156 - 04 - 02.01)。</p>
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主题特点。</div>
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<h5 id="sec2.2">2.2。Falls-Related自我效能</h5>
<p>参与者被指示完成Activities-specific平衡信心(ABC)规模评估falls-related自我效能感(<一个href="#B17">17</一个>]。他们还被要求回忆落在过去的6个月。下降被定义为任何导致计划外的事件,意外接触支承面。</p>
<h5 id="sec2.3">2.3。背部疼痛的结果</h5>
<p>当天的测试中,参与者被告知率背痛规模四数字疼痛强度(QNPS) [<一个href="#B18">18</一个>]。枸杞多糖功能残疾相关评估修改的法国版本得以残疾指数(ODI) [<一个href="#B19">19</一个>9日)计算项目没有取代由就业/家政能力[关于性行为的问题<一个href="#B20">20.</一个>]。疼痛的恐惧运动评估与法国版本的坦帕量表Kinesiophobia(啧啧)[<一个href="#B21">21</一个>]。</p>
<p>Baecke问卷(BPAQ)估计身体活动水平(<一个href="#B22">22</一个>]。只有体育活动在体育和休闲时间索引计算;体育活动参与的求和提供索引(PASL)。最大等长伸膝(KE)每条腿的力量估计有一个负载细胞在坐的位置和膝盖在90°。两个5 s试验最大等长努力进行,和峰值表示为一个相对强弱指数强度比身体成分(身体质量指数BMI)测量。科实力很平均,因为没有发现面之间的区别。PASL和KE力量被用来推断废弃综合症。</p>
<h5 id="sec2.4">2.4。感觉运动功能、平衡功能</h5>
<p>感觉运动功能几个方面影响平衡,如视力、触觉敏感,动觉研究[<一个href="#B23">23</一个>]。视力检查与斯内伦视力表,Semmes-Weinstein-type压力触觉计评估触觉灵敏度外踝的脚踝。膝部定位误差(扩展)和树干5试验期间(弯曲)计算。对于每个部分,受试者开始在一个中立的位置,达到一个目标大约15°角,担任十年代,并返回到初始位置。目标角度和位置之间的绝对差异度达到平均(绝对误差)。可变误差被认为是测量不一致。节段性角度计算与光电系统(Optotrak Certus, NDI,滑铁卢,安大略省,加拿大)。</p>
<p>姿势稳定性评价是指导受试者尽可能依然直立,睁开了眼睛,在一个力板(AMTI or6——2000年,水城,妈,美国其他地方描述根据过程(<一个href="#B24">24</一个>]。压力中心(COP)的速度和频率被用来推断姿势稳定。连续累积计算从windows 0.1赫兹的频率宽度和总功率表示为百分数在0和4赫兹之间。前庭,它已经表明,视觉和本体感受的贡献在平衡控制与特定频段的警察信号(<一个href="#B25">25</一个>]。总功率在3频段计算:B1 =(0 - 0.1赫兹)的视觉;B2为前庭=(0.1 - -0.5赫兹);本体感受B3 =(0.5 - -1.0赫兹)。</p>
<p>时间了,(拉)<一个href="#B26">26</一个>),一条腿的姿态测试(OLS) (<一个href="#B27">27</一个>)管理。实践的审判被允许,2后续试验取平均值。最大步行速度估计的增量穿梭行走测试(<一个href="#B28">28</一个>]。这些测试(拖轮、OLS和步行速度)是由于1到4分使用四分位数的性能(<年代vg height="14.1875" id="M8" style="vertical-align:-2.72116pt;width:95.949997px;" version="1.1" viewbox="0 0 95.949997 14.1875" width="95.949997" xmlns="http://www.w3.org/2000/svg">
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</svg>)提出的价值观Choquette et al。<一个href="#B29">29日</一个>),总结产生流动性分数(经历)。拖船分数逆转,较低的分数反映出更好的性能。</p>
<h5 id="sec2.5">2.5。统计分析</h5>
<p>数据正态分布和方差的同质性进行了探讨。数据显示倾斜分布log-10-transformed之前推论分析和提出了作为中间值25 th -第75百分位数。学科特点,psycho-behavioural变量、感觉运动功能的措施和disuse-related变量比较组间的独立<我>t</我>以及。我们进行了单向重复测量方差分析与方向试因素比较组警察措施。事后Tukey-HSD分析意义重大<年代vg height="10.325" id="M10" style="vertical-align:-0.0pt;width:12.05px;" version="1.1" viewbox="0 0 12.05 10.325" width="12.05" xmlns="http://www.w3.org/2000/svg">
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</svg>测试。我们考虑混杂变量,如年龄、BMI、药物治疗,和许多慢性疾病。年龄和笔并发症并不保留混杂变量,因为他们没有与任何警察措施和机动性的分数。协方差分析与枸杞多糖作为一个主题之间的因素和BMI PASL相比协变量。单变量的比较是用皮尔逊相关系数来确定FABM-related变量之间的关联的强度与流动性CLBP组的得分。药物局部相关性,纠正,量化疼痛级别之间的线性关系最糟糕的是,和相关的变量。统计学意义是<年代vg height="11.25" id="M11" style="vertical-align:-0.30096pt;width:56.150002px;" version="1.1" viewbox="0 0 56.150002 11.25" width="56.150002" xmlns="http://www.w3.org/2000/svg">
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<h4 id="results">3所示。结果</h4>
<p>展示在表主题特征<一个href="//www.newsama.com/journals/rerp/2012/430374/tab1/" target="_blank">1</一个>。人体测量特征无显著差异观察和感觉运动功能(视力、触觉灵敏度和定位错误在树干和膝盖)。</p>
<p>CLBP受试者认为falls-related自我效能低于对照组(79.5和93.5%),显示更多的害怕运动/ re-injury(43.8和33.4)。感知障碍相对较低的水平(值= 15.4%)。</p>
<p>表<一个href="//www.newsama.com/journals/rerp/2012/430374/tab2/" target="_blank">2</一个>3日报告性能测试的流动性,流动性分数和disuse-related变量。控制的表现要好于拖船和步行速度比CLBP科目。OLS次没有发现群体间的差异。控制的流动得分显著高于CLBP科目。他们比CLBP同行更活跃但KE强度没有明显的群体间的差异明显。表<一个href="//www.newsama.com/journals/rerp/2012/430374/tab3/" target="_blank">3</一个>披露的水平在CLBP psychobehavioural变量之间的联系。ABC分数与增加ODI评分。Falls-related自我效能感表现出轻微的无意义的相关性水平最糟糕和PASL疼痛。</p>
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流动性和disuse-related变量的函数。</div>
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psychobehavioural自变量间相关系数和不使用变量CLBP组。</div>
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<p>警察速度没有明显的群体间的差异明显,姿势稳定(图<一个href="//www.newsama.com/journals/rerp/2012/430374/fig1/" target="_blank">1(一)</一个>)。图<一个href="//www.newsama.com/journals/rerp/2012/430374/fig1/" target="_blank">1 (b)</一个>说明了频带的功率(B1 B3)为每个组。CLBP表现显著降低功率的B3频带控件(相比<年代vg height="11.1" id="M16" style="vertical-align:-0.17555pt;width:63.962502px;" version="1.1" viewbox="0 0 63.962502 11.1" width="63.962502" xmlns="http://www.w3.org/2000/svg">
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<td>老CLBP女人之间的姿势比较稳定(灰色)和控制(黑)。(一)中心(COP)的压力,在前后的速度(a / P)和中间外侧的(M / L)的方向;(b)电源频率乐队(B1 B3)为每个组,表示为一个百分比的警察信号的总功率。数据平均±标准差;*<年代vg height="11.25" id="M17" style="vertical-align:-0.30096pt" version="1.1" viewbox="0 0 56.150002 11.25" width="56.150002" xmlns="http://www.w3.org/2000/svg">
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<p>表<一个href="//www.newsama.com/journals/rerp/2012/430374/tab4/" target="_blank">4</一个>报告水平的关联psychobehavioural结果和disuse-related变量以警察的速度和机动性CLBP组的得分。迁移分数没有与任何psychobehavioural结果和disuse-related变量(<年代vg height="11.0625" id="M18" style="vertical-align:-0.30096pt;width:99.974998px;" version="1.1" viewbox="0 0 99.974998 11.0625" width="99.974998" xmlns="http://www.w3.org/2000/svg">
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<span class="caption-text">表4</年代pan>
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皮尔森相关系数和偏相关流动分数和警察措施CLBP集团(睁大眼睛条件)。</div>
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<h4 id="discussion">4所示。讨论</h4>
<p>初步研究表明,老年人CLBP显示减少流动性能和姿势的变化控制。它还强调协会FABM结果和falls-related自我效能与平衡功能后占协变量的关键。老年妇女较低的温和的背部疼痛falls-related较低自我效能与减少流动性的功能。falls-related自我效能感较低,流动性下降功能,减少体育活动参与,在这项研究中,观察到可能是重要的预测因素下降,功能下降的风险更高CLBP女性(<一个href="#B1">1</一个>,<一个href="#B4">4</一个>]。</p>
<p>fear-avoidance信念模型提出了解释的发展CLBP [<一个href="#B6">6</一个>]。痛苦的经历被认为开始害怕痛苦和害怕运动/ reinjury最终导致回避行为。因此,痛苦和刺激恐惧已经与物理性能降低任务年轻CLBP成人(<一个href="#B16">16</一个>]。能力和体力活动的减少由于回避行为被称为废弃综合症(<一个href="#B30">30.</一个>]。然而,废弃综合症在年轻CLBP成人是一个有争议的问题<一个href="#B31">31日</一个>]。最近,巴斯勒et al。<一个href="#B12">12</一个>)调查的有效性fear-avoidance信念模型在大样本的老年CLBP PASL下降,并没有发现比控制。他们报告说,预测身体残疾但不是PASL fear-avoidance信仰。相反,我们的结果显示,老年CLBP没有相应减少PASL柯的力量,作为物理退化的指标,而控制。因此,Bousema et al。<一个href="#B32">32</一个>]指出身体活动的减少没有年轻CLBP成年人身体退化的迹象。我们观察到明显残疾之间的显著相关性由于背部疼痛和刺激的恐惧。然而,在与巴斯勒et al。<一个href="#B12">12</一个>),减少PASL无关刺激恐惧在目前的研究。这个分歧关于减少PASL老年CLBP可以解释的事实PASL与Baecke评估问卷之前验证CLBP学科(<一个href="#B22">22</一个>]。</p>
<p>Fear-avoidance信仰相关的特定组件的物理功能,比如膝盖两种力量和警察位移,样本的虚弱,老年人,包括伐木工和多个跌幅(<一个href="#B13">13</一个>]。样本的老年人CLBP没有经历频繁的瀑布,这可以解释为什么我们的数据没有显示显著关联与膝盖啧啧两种力量和警察速度,分别。老年CLBP Fear-avoidance信仰可能与更大的障碍,如枸杞多糖的年轻人(<一个href="#B33">33</一个>]。我们的结果没有透露一个重要fear-avoidance信仰和背痛残疾之间的联系。Kovacs et al。<一个href="#B34">34</一个>]也看出fear-avoidance信仰有关体育活动没有关系在老年CLBP背痛残疾。在美国老年人更大的样本,锡安,希克斯(<一个href="#B35">35</一个>]建立fear-avoidance信仰只占3%的方差ODI评分,但高fear-avoidance信仰与大瀑布经历了在过去的一年。</p>
<p>自我效能感,这是很重要的在维护健康老龄化的流动性,是一个独立的物理能力的因素<一个href="#B36">36</一个>]。目前的研究表明减少falls-related自我效能在老年CLBP但没有协会指出falls-related自我效能和disuse-related变量之间的关系。平衡障碍结合弱肌肉力量是假定为独立的跌倒和骨折的风险因素(<一个href="#B37">37</一个>膝盖,两种力量歧视的能力恢复从步态扰动,防止摔倒<一个href="#B38">38</一个>]。膝盖在我们的研究中,两种力量不会受到背部疼痛状态和没有与警察速度或流动性得分。事实上,我们没有看到一个falls-related自我效能和膝盖两种力量之间的联系。然而,无论是背伸肌力量(<一个href="#B39">39</一个>]和耐力<一个href="#B40">40</一个>)进行评估。Falls-related自我效能在老年CLBP可能影响感知能力有关体育活动包括运动。支持这一假说,我们观察到显著相关(<年代vg height="11.0375" id="M20" style="vertical-align:-0.17555pt;width:63.950001px;" version="1.1" viewbox="0 0 63.950001 11.0375" width="63.950001" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,11.0375)">
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<tspan style="font-size: 12.50px; " x="0" y="0">
</t年代pan>
<tspan style="font-size: 12.50px; " x="8.5645552" y="0">
=</t年代pan>
<tspan style="font-size: 12.50px; " x="20.604944" y="0">
−</t年代pan>
<tspan style="font-size: 12.50px; " x="29.169498" y="0">
0</t年代pan>
<tspan style="font-size: 12.50px; " x="35.420998" y="0">
。</t年代pan>
<tspan style="font-size: 12.50px; " x="38.546749" y="0">
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</svg>)falls-related自我效能和感知之间的障碍。</p>
<p>一些研究人员认为,更大的M / L左右增加跌倒的风险(<一个href="#B41">41</一个>]。我们没有观察到的变化姿势稳定在老年CLBP M / L的方向。有趣的是,falls-related自我效能与警察的速度在M / L方向。我们注意到全球警察之间的功率谱频率下降0.5和1.0赫兹,可以推断是一个赤字在躯体感觉输入或姿势控制集成<一个href="#B25">25</一个>]。一些作者认为,疼痛可能干涉躯体感觉一体化进程或改变本体感受的输入灵敏度。这种疼痛的适应现象是假设影响姿势控制(<一个href="#B42">42</一个>]。Brumagne et al。<一个href="#B43">43</一个>)报道,枸杞多糖年轻人减少腰骶的方位感,可能与改变paraspinal肌梭由或中央集成问题。他们还得出结论,枸杞多糖老年人可能主要依靠姿势控制远端躯体感觉输入(<一个href="#B44">44</一个>]。因此,我们最初的预期找到系统增加了状态和大幅下滑的躯干和膝盖在老年CLBP动觉。然而,在我们的研究中,背部疼痛状态不影响联合定位的感官和不解释警察频率结果。戈德堡等。<一个href="#B45">45</一个>)增加了老年balance-impaired学科主干重新定位错误。这些balance-impaired组分类的基础上,一条腿立场时间(< 5 s)。在我们的研究中,4 CLBP 2控制有一条腿立场的时间< 5 s。树干在直立的姿态重新定位错误评估Goldberg et al。<一个href="#B45">45</一个>),而我们有孤立的树干重新定位错误的姿势控制约束。这些协议的差异可以解释差异的结果。</p>
<p>更高的恐惧下降已被证明是与活动相关的限制和可能性的增加下降(<一个href="#B46">46</一个>]。我们看到一个轻微的,无意义的关联(<年代vg height="10.9125" id="M21" style="vertical-align:-0.17555pt;width:53.237499px;" version="1.1" viewbox="0 0 53.237499 10.9125" width="53.237499" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,10.9125)">
<g transform="translate(72,-63.27)">
<text transform="matrix(1,0,0,-1,-71.95,63.5)">
<tspan style="font-size: 12.50px; " x="0" y="0">
</t年代pan>
<tspan style="font-size: 12.50px; " x="8.5645552" y="0">
=</t年代pan>
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0</t年代pan>
<tspan style="font-size: 12.50px; " x="26.856443" y="0">
。</t年代pan>
<tspan style="font-size: 12.50px; " x="29.982195" y="0">
4</t年代pan>
<tspan style="font-size: 12.50px; " x="36.233692" y="0">
4</t年代pan>
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</svg>自我效能与PASL falls-related之间)。样本量在这项研究和瀑布的回顾性设计评估有限的检测跌倒发生和falls-related自我效能感之间的联系或活动限制。很少CLBP受试者下降在过去的6个月的研究。回顾自我报告的使用下降可能导致漏报(<一个href="#B47">47</一个>]。然而,减少体育活动不能仅仅是由于更大的速率下降,因为担心摔倒和活动限制在老遇到那些从未经历过瀑布(<一个href="#B48">48</一个>]。另一个限制是,疼痛持续时间没有评估。然而,随着年龄的增长有枸杞多糖似乎并不是一个累积现象,更可能是一种障碍,源于成年坚持60年来(<一个href="#B3">3</一个>]。因此,评估老年CLBP疼痛持续时间可能会很困难。虽然在背痛骨质疏松症的可能贡献结果和falls-related自我效能不能排除在外,脊椎骨折状态可能是一个因素在疼痛状态而非平衡和功能缺陷(<一个href="#B49">49</一个>]。我们排除了临床相关疾病相关因素,如诊断脊椎骨折,骨质疏松症,腰椎狭窄。抑郁症状没有了,可以禁用枸杞多糖的混杂因素或falls-related自我效能。</p>
<p>总之,我们的工作,进行CLBP老年妇女中,强调falls-related自我效能低于控制和减少有关流动性的功能。姿态控制是影响枸杞多糖在老年妇女的地位,可以解释为躯体感觉集成的变更。这些结果可以帮助临床医生更好地管理CLBP在老年患者,进一步突出的潜在物理和psychobehavioural预测落在这个人口和功能下降。</p>
<h4 id="acknowledgments">确认</h4>
<p>这项工作的部分支持由昏聩institutionnel de la矫揉造作的(UQTR没有。3071081)。香槟是由奖学金从昏聩de la魁北克桑特精心设计的。</p>
</div>
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3197年</div>
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1819年</div>
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