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The influence of pain, kinesiophobia and psychological comorbidities on the accuracy of rating of perceived exertion in UK military spinal rehabilitation
  1. Dean Conway1,
  2. A Bliss2 and
  3. S D Patterson2
  1. 1Complex Trauma Department, Defence Medical Rehabilitation Centre, Loughborough, UK
  2. 2The Faculty of Sport, Allied Health and Performance Science, St Mary's University Twickenham, Twickenham, London, UK
  1. Correspondence to Dean Conway, Complex Trauma Department, Defence Medical Rehabilitation Centre, Loughborough LE12 5BL, UK; dean.conway103{at}mod.gov.uk

Abstract

Introduction Chronic low back pain (CLBP) is a leading cause of disability in the UK Military. Pain and psychological comorbidities have been reported to influence the rating of perceived exertion (RPE). Exercise rehabilitation can be monitored using RPE; however, the accuracy of RPE in inpatient CLBP rehabilitation is unknown.

Methods A prospective cohort correlation study of 40 UK Military inpatients with CLBP was completed. Disability (ODI), kinesiophobia (TSK), anxiety (GAD-7) and depression (PHQ-9) were subjectively reported at the beginning and end of a 3 week intervention. Pain (VAS) and HR were recorded in the first aerobic exercise (AE) session (T1) and the final aerobic exercise session (T2). RPE was reported for each AE session.

Results At T1, a positive correlation was observed between RPE accuracy (−7.2±20.9), and pre-exercise pain (2.7 mm ±1.6 mm) (p>0.001) and ODI (31.0±16.9) (p>0.05), and a negative relationship between RPE accuracy and average HR (135 bpm ±22 bpm) (p>0.001) was observed. At T2, there was no significant correlation between RPE accuracy (−4.4±22.6) and pre-exercise pain (2.8 mm ±1.6 mm) or ODI (34.0±16.5) (p>0.05). The strong negative relationship between RPE accuracy and average HR (137 bpm ±20 bpm) remained at T2. Improved RPE accuracy over the 3-week rehabilitation programme was correlated to the change in average HR (r=−0.314, p<0.05).

Conclusions Comorbidities may negatively affect RPE accuracy in CLBP, but the magnitude of the influence reduces over intensive rehabilitation.

  • rehabilitation medicine
  • back pain
  • musculoskeletal disorders

Data availability statement

Data are available on reasonable request. The data are deidentified participant data and can be provided by the lead author on reasonable request.

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Data availability statement

Data are available on reasonable request. The data are deidentified participant data and can be provided by the lead author on reasonable request.

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Footnotes

  • Twitter @stephen_patt

  • Contributors DC conceived and carried out the research project as part of an MSc dissertation. SP and AB supervised the project throughout data collection. DC wrote the first draft. SP and AB reviewed and provided recommendations for final manuscript. All authors approved of final draft for submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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