| Abstract | Leđna bol veliki je zdravstveni problem u cijelom svijetu i vodeći je globalni uzrok onesposobljenosti.
Cilj: Cilj ovog istraživanja bio je ispitati je li osobe sa visokim rizikom za lošiji ishod, tj. osobe koje imaju psihosocijalne prepreke oporavku imaju nepovoljnije funkcionalne ishode u fizioterapiji kod leđne boli.
Metode i ispitanici: U istraživanje je uključeno 60 ispitanika s leđnom boli, prosječna dob ispitanika je M=51,71, od kojih veći udio od 34 (57,6%) ispitanika čine žene. Ispitanici su zaprimljeni u desetodnevni ciklus ambulantne fizikalne terapije u Klinički Zavod za rehabilitaciju i ortopedska pomagala KBC Zagreb u periodu od svibnja do kolovoza 2021. godine. Inicijalno je provedena stratifikacija bolesnika prema riziku za loš ishod putem Start Back upitnika za probir bolesnika s križoboljom kategorizirajući bolesnike u tri kategorije rizika od lošeg ishoda - niski, srednji i visoki rizik. Procjena stupnja onesposobljenosti kod leđne boli ispitana je Rolland Morrisov-im upitnikom (od engl. Roland Morris Disability Questionnaire- RMDQ), a procjena je provedena na početku i na kraju ciklusa fizioterapije. Procjena boli ispitana je Numeričkom skalom boli (od eng. Numerical Rating Scale -NRS), a procjena je provedena na početku i na kraju ciklusa fizioterapije. Rezultati: Iz rezultata analize varijance je vidljivo da postoji značajna statistička razlika u rezultatima Roland Morris upitnika prije terapije, gdje ispitanici koji imaju visok rizik za lošiji ishod imaju statistički značajno lošije rezultate u odnosu na grupu niskog rizika za lošiji ishod (F(2,56)=11,906, p<0,05). Slični rezultati su vidljivi i u mjerenju nakon terapije (F(2,56)=7,838, p<0,05). Značajno bolji rezultat stupnja onesposobljenosti potvrđuje t-test za zavisne uzorke (t(58)=8,474, p<0,05). Nije bilo razlike u riziku za lošiji ishod između mlađih i starijih ispitanika (F(2,56)=1,449, p=0,243), žena i muškaraca (χ2 (2,59)=2,758, p=0,252), kategorija obrazovanja (χ2 (2,59)= 6,097, p=0,412) ili u nekoj od grupa povezanim sa statusom zaposlenja (χ2 (4,59)=5,051, p=0,282). Proporcija ispitanika bez obzira na pojavnost epizode leđne boli (inicijalna epizoda ili recidiv) u svim kategorijama rizika je podjednaka (χ2 (2,59)=1,763, p=0,414). Ispitanici koji imaju visoki rizik za lošiji ishod imali su statistički značajno višu razinu boli u odnosu na grupu s niskim rizikom za lošiji ishod (F(2,56)=5,982, p<0,05). Slični rezultati su vidljivi i u mjerenju nakon terapije (F(2,56)=9,971, p<0,05). Značajno bolji rezultat u smislu smanjena boli, između dva testiranja, potvrđuje t-test za zavisne uzorke (t(58)=10,814, p<0,05).
Zaključak: Osobe koje imaju visok rizik od lošeg ishoda imaju nepovoljnije funkcionalne ishode u fizioterapiji kod leđne boli i višu razinu percipirane boli. |
| Abstract (english) | Back pain is a major health problem worldwide and is the leading global cause of disability. Aim: The aim of this study was to examine whether people at high risk for a poorer outcome, i.e., people who have psychosocial barriers to recovery, have more unfavorable functional outcomes in physiotherapy for back pain. Methods and participants: The study included 60 subjects with back pain, the average age of subjects was M = 51.71, of which a larger proportion of 34 (57.6%) subjects were women. Participants were admitted to a ten-day cycle of outpatient physical therapy at the Clinical Institute for Rehabilitation and Orthopedic Aids KBC Zagreb in the period from May to August 2021. Initially, patients were stratified according to the risk of poor outcome through the Start Back screening questionnaire for patients with low back pain, categorizing patients into three categories of risk of poor outcome - low, medium and high risk. Assessment of the degree of disability in back pain was examined with the Rolland Morris Disability Questionnaire (RMDQ), and the assessment was performed at the beginning and end of the physiotherapy cycle. Pain assessment was examined with the Numerical Rating Scale (NRS), and the assessment was performed at the beginning and end of the physiotherapy cycle. Results: The results of the analysis of variance show that there is a significant statistical difference in the results of the Roland Morris questionnaire before therapy, where participants at high risk for poorer outcome had statistically significantly worse results compared to the low risk group for poorer outcome (F (2.56 ) = 11.906, p <0.05). Similar results are visible in the measurement after therapy (F (2.56) = 7.838, p <0.05). A significantly better result of the degree of disability is confirmed by the t-test for dependent samples (t (58) = 8.474, p <0.05). There was no difference in risk for poorer outcome between younger and older respondents (F (2.56) = 1.449, p = 0.243), women and men (χ2 (2.59) = 2.758, p = 0.252), education category (χ2 (2.59) = 6.097, p = 0.412) or in one of the groups related to employment status (χ2 (4.59) = 5.051, p = 0.282). The proportion of participants regardless of the occurrence of an episode of back pain (initial episode or relapse) in all risk categories is equal (χ2 (2.59) = 1.763, p = 0.414). Participants at high risk for poorer outcome had a statistically significantly higher level of pain compared with the low-risk group for poorer outcome (F (2.56) = 5.982, p <0.05). Similar results were seen in the measurement after therapy (F (2.56) = 9.971, p<0.05). A significantly better result in terms of reduced pain, between the two tests, is confirmed by the t-test for dependent samples (t (58) = 10,814, p <0.05). Conclusion: People at high risk of poor outcome have less favorable functional outcomes in physiotherapy for back pain and higher levels of perceived pain. |
