AI Insight
This study examined whether sensorimotor factors measured during acute low back pain could predict long-term pain and disability outcomes in 99 participants followed for 12 months. Greater activation of back muscles during the acute phase was associated with lower disability at both 6 and 12 months, suggesting muscle activation may be protective during recovery. The relationship between pain sensitivity and long-term outcomes was less clear, with only limited statistical evidence supporting an association.
Why it matters
If muscle activation during acute episodes helps prevent chronic low back pain, this could inform early intervention strategies that focus on maintaining or enhancing muscle function rather than rest. Understanding protective factors in the acute phase may lead to more effective treatments that prevent the transition from acute to chronic pain.
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⚠️ Preprint – Noch nicht peer-reviewed
Dieser Artikel wurde noch nicht von unabhängigen Experten begutachtet. Die Ergebnisse sind vorläufig und sollten mit Vorsicht interpretiert werden.
Treatments for chronic low back pain (LBP) provide only small improvements in pain and disability compared with placebo. Targeting mechanisms involved in the persistence of pain and disability following an episode of acute LBP (ALBP) may enhance treatment effectiveness. Sensorimotor alterations have been observed in individuals with chronic LBP (CLBP), but their role in the development of CLBP remains unclear. In this secondary analysis of longitudinal data from 99 participants with ALBP, the causal associations between pain sensitivity and erector spinae muscle activation measured in the acute phase of LBP and pain and disability at 6- and 12-month follow-ups were explored. Negative binomial regressions revealed that greater lumbar muscle activation at baseline was associated with lower disability at 6 months (incidence rate ratio [IRR] 0.33 [95% CI 0.13 to 0.85], p=0.02). Higher lumbar pressure pain threshold was also associated with lower disability at 6 months (IRR 0.87 [95% CI 0.79 to 0.97], p=0.009). At 12 months, greater lumbar and thoracic muscle activation were associated with lower disability (IRR 0.11 [95% CI 0.03 to 0.35], p<0.001 and IRR 0.09 [95% CI 0.02 to 0.33], p<0.001, respectively). The findings suggest that increased thoracolumbar muscle activation during the acute phase may act as a protective mechanism and support recovery. However, the association with pain sensitivity should be interpreted with caution, as only one of 16 models reached statistical significance. Longitudinal studies assessing the evolution of these sensorimotor factors could improve the understanding of their contribution in the development of CLBP. Perspective: This article presents exploratory analyses of causal associations between sensorimotor outcomes in acute low back pain and levels of pain and disability in the long-term. Increased muscle activation explained better long-term outcomes, whereas increased pain sensitivity explained poorer long-term outcomes.