OBJECTIFS : Le but de ce travail etait de tester la faisabilite d un programme d evaluation de l ecole du dos dans deux populations de lombalgiques chroniques.METHODES : Vingt-neuf patients ont ete tires au sort (15 en attente d ecole du dos, 14 apres ecole du dos). Le programme d evaluation comprenait la mesure des elements suivants : age, sexe, masse corporelle, douleur (EVA, questionnaire de l hopital Saint-Antoine-QDSA), echelle d anxiete, echelle de depression, reflexe nociceptif RIII, distance doigts-sol, echelle de Dougados, EIFEL, questionnaire de Dallas, force musculaire lombaire des flechisseurs et des extenseurs lombaires evaluee sur dynamometre isocinetique. Le programme d ecole du dos consistait en cinq sessions hebdomadaires (information, ergonomie, gymnastique).RESULTATS : On n a pas observe de differences entre les deux groupes de lombalgiques concernant l age, la masse corporelle, l anxiete, la depression, la douleur (EVA, QDSA, reflexe RIII nociceptif), la raideur lombopelvienne, la fonction et la qualite de vie. Le peak torque des flechisseurs et le ratio flechisseurs/extenseurs etaient plus bas apres ecole du dos. La douleur evaluee par le QDSA est correlee avec le peak torque des flechisseurs, l anxiete, la depression. La douleur mesuree par l EVA est correlee avec l age, la distance doigts-sol, le niveau de depression, la force des muscles flechisseurs a 60 o s-1, le rapport flechisseurs/extenseurs. Le reflexe RIII nociceptif est correle avec le rapport flechisseurs/extenseurs. La comparaison hommes/femmes montre des differences du QDSA et du peak torque des flechisseurs.CONCLUSION : L evaluation s est averee faisable ; l etude qui presente des biais confirme la difference entre intensite, expression, reduction et soulagement de la douleur et attire l attention sur la deficience des muscles flechisseurs observee chez les femmes et apres ecole du dos. Ce programme d evaluation parait susceptible d evaluer l utilite des programmes d ecole du dos.
OBJECTIVES: Testing the feasability of a back school assessment programme in two populations of people suffering with chronic low back pain.MATERIAL: Twenty-nine patients were randomly included in a chronic low back pain assessment programme (15 patients waiting for back school and 14 patients after back school).METHODS: The programme was made of the measure of the age, the sex, the body mass index, the pain (VAS, St Antoine Hospital s Pain Questionnaire - SAPQ), the anxiety, the depression, the RIII nociceptive reflex, the fingertip-floor distance, the strength of the flexors and of the extensors of the lumbar spine (CybexR 6000 isocinetic dynamometer), the lumbar function (EIFEL, Dougados), the Dallas self-questionnaire. The Back School Education programme was made of five sessions (information, ergonomies, extension exercises).RESULTS: Comparing the two populations we didn t observe significant differences concerning the age, the body mass index, the anxiety and depression levels, the pain (VAS, SAPA, RIII nociceptive reflex), the lumbar stiffness, the lumbar disability, the quality of life; the patients who had achieved back school had a peak torque of the flexors and a ratio flexors/extensors significantly lower. Comparing men and women we observed significant differences in the SAPQ and the muscles strength. The SAPQ was correlated with the depression and anxiety levels, the lumbar disability, the peak torque of the flexors. The VAS was correlated with the age, the lumbar stiffness, the depression level, the peak torque of the flexors. The RIII nociceptive reflex was correlated with the ratio flexors/extensors.CONCLUSION: This study present some biases but this objective assessment of chronic low back pain appeared as feasible. The pain must be investigated in term of intensity, expression, alleviation. The impairment of the flexors muscles in women and after back school has to be confirmed. The different tests are relevant to determinate the efficiency of the back school programmes.