运动性疼痛，被动屈膝受限，屈髋肌力减弱，髋外展肌力减弱和俯卧位下躯干等长伸展肌力减退等的几率较只有一项或没有非器质性体征者高。许多研究也证实，肌肉、关节活动度和运动技巧等方面的检查结果与非器质性体征也有类似的相关性。尽管直腿抬高试验、俯卧位屈膝试验等一直被认为是衡量躯体功能损害的客观指标，但Maruta、Novy等认为：脊柱运动受限，屈-伸力矩的比例降低、直腿抬高度降低等均与痛阈或/和耐受力降低有关，其与心理痛苦的关系比神经系统的损害更加密切［24，26］。

　　四、启示

　　LBP社会心理因素的关系是密切的，在LBP的处理上，同样重视心理和躯体成份，也许能更好地解释我们的一些临床问题，可以设想，尤其在一 些慢性LBP的处理中，采用费用昂贵的检查,劝告限止活动，在治疗和评估过程中过分的注意疼痛，劝告用助行器和腰围，过多注意姿势、过份夸大LBP的危害性、不良预后等，都可以引起和/或加重抑郁、疑病、癔病等症状，以及因此而引起的医源性功能障碍，并造成“LBP-心理障碍-LBP加重-心理障碍加重”这样一种恶性循环。相信由于心理学对LBP治疗及康复的介入，必将为LBP的诊断、治疗和预后判断带来一个新的思路。

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