RESUMO
Purpose: This study aimed to juxtapose the circadian rhythm of pain with the conventional 7-day assessment and ascertain the feasibility of condensing the evaluation of the circadian rhythm of pain into a 3-day timeframe. Patients and Methods: Seventy-three patients with pain persisting for a minimum of 3 months and a numerical rating scale (NRS) score of ≥2 were recruited from three medical centers. The circadian patterns of pain were appraised over a 7-day period by quantifying the intensity of pain at six temporal junctures each day using a 10-cm visual analog scale (VAS). Cluster analysis was performed using six standardized variables derived from the VAS score of each participant at six designated time points to identify cohorts with analogous circadian rhythms of pain. The clusters were discerned for the 7- and 3-day assessments (Tuesday-Thursday, Friday-Sunday, and Sunday-Tuesday), according to the research objectives. Cohen's kappa coefficient was calculated to gauge the intra-observer variability to assess the consistency between the outcomes of the cluster analysis for the 7-day assessment and each of the 3-day assessments. Results: The highest Cohen's kappa coefficient was observed for the 3-day evaluation spanning from Friday to Sunday, indicating a substantial concordance with the results of the 7-day assessment. Conclusion: Our results suggest that it may be prudent to consider implementing a condensed 3-day evaluation of the circadian rhythm of pain that is tailored to individual characteristics. This approach will allow a better understanding of the diurnal rhythms of chronic pain in patients and implement more targeted and specific pain management strategies. Furthermore, it will contribute to increased patient satisfaction through early intervention.
RESUMO
Introduction: Kinematic data obtained during a movement task by individuals with chronic low back pain seem to be related to pain-related fear. General kinesiophobia assessments, such as Tampa Scale for Kinesiophobia, are often used to assess pain-related fear. However, these questionnaires could suffer from a lack of sensitivity and do not measure the fear of specific movements. Objectives: The purpose of this study was to investigate whether the task-specific assessment of pain-related fear exhibits a closer association with trunk kinematics during lumbar flexion compared with the general kinesiophobia in individuals with chronic low back pain. Methods: We assessed pain-related factors, task-specific fear, and Tampa Scale for Kinesiophobia-11 scores of 51 company employees. The lumbar angle during a lumbar flexion task was recorded by 2 wireless Axivity Ax3 accelerometers attached to the subject's spinous process (L3) and sacral spine (S2). Only task-specific fear was evaluated after the lumbar flexion task. We calculated the maximum lumbar flexion angle (°) and the peak angular velocity of lumbar flexion/return from flexion (°/s2). We conducted a hierarchical multiple linear regression analysis to determine variance explained in lumbar flexion task performance by task-specific fear after controlling for demographic, pain, and general kinesiophobia. Results: The results showed that task-specific fear was associated with the peak angular velocity of lumbar return from flexion (R 2 adj. = 0.36, P < 0.01) and lumbar flexion (R 2 adj. = 0.3, P = 0.01). Discussion: Our results suggest that clinicians should consider the potential added value of task-specific fear assessment over the sole use of conventional kinesiophobia assessment.