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- Marije van der Hulst, Miriam M Vollenbroek-Hutten, Karlein M Schreurs, Johan S Rietman, and Hermanus J Hermens.
- Roessingh Research and Development, Enschede, The Netherlands. m.vanderhulst@rrd.nl
- Eur J Pain. 2010 Jul 1;14(6):640-7.
BackgroundConcerning chronic low back pain (CLBP), different cognitive-behavioral models have hypothesized that coping strategies play a role in the chronification of pain by changes in physical activity. Strategies such as avoidance - or persistent coping may be related to changes in (lumbar) muscle activity.AimInvestigate the different coping strategies present in CLBP and whether these are differentially related to lumbar muscle activity during walking.MethodsIn a cross sectional study, 63 subjects with CLBP walked on a treadmill at 3.8 km/h. Coping strategies were measured with the Dutch version of the Coping Strategies Questionnaire and three factors were identified with principal component analysis. Surface electromyography data of the erector spinae were obtained and smooth rectified electromyography (SRE) values were averaged per periods of swing and double support. The ratio of SRE values (swing/double support) was used as a measure of relaxation. The relation between SRE values and coping strategies was analyzed with random coefficient analysis.ResultsThree coping strategies (i.e. "catastrophizing", "distraction" and "persistence and control") could be discerned. "Catastrophizing" was positively related to (natural logarithm) SRE values (beta=0.06, 95% CI=0.01-0.10; R(2)=7.7%). "Distraction" was negatively associated with SRE ratios (beta=-0.03, 95% CI=-0.05 to -0.01; R(2)=7.5%). No relation was found between "persistence and control" and SRE values or ratios.ConclusionsIn CLBP, a maladaptive coping strategy like "catastrophizing" is related to increased lumbar muscle activity, and an adaptive strategy like "distraction" to increased lumbar muscle relaxation during walking.Copyright (c) 2009. Published by Elsevier Ltd.
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