Relationship Between Patient-reported Outcome Measures and Accelerometer-measured Physical Activity and Sleep in Patients With Postherpetic Neuralgia.

IF 3.1 3区 医学 Q2 ANESTHESIOLOGY
Hiromichi Takai, Natsuko Nozaki-Taguchi, Koyo Shono, Yasunori Sato, Shiroh Isono
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Abstract

Objective: Available treatment for chronic neuropathic pain is still limited, and the positive effects are modest. Thus, clinicians aim to improve activity and quality of life despite pain. The objective monitoring of activity is attracting attention in chronic pain assessments. Therefore, we objectively evaluated daytime activity and sleep in patients with postherpetic neuralgia (PHN), using actigraphy to determine risk factors for decreased activity.

Methods: Participants with PHN wore an actigraph (a wristwatch-like accelerometer) on the nondominant hand. The actigraph measured day-time activity and sleep, which were compared with participant-reported subjective pain and sleep assessments.

Results: Fifty-four individuals with PHN who visited our outpatient clinic completed questionnaires and a week of actigraph monitoring. Subjective scores of pain intensity, neuropathic pain, disability in daily life, pain-catastrophizing thoughts, and insomnia were all well correlated. However, the actigraph-monitored activity levels, using 2 equations, and sleep quality were not associated with any pain or sleep-related subjective scores.

Conclusion: The discrepancy between the subjective and objective scores in this study may be due to (1) features of PHN, an archetype of peripheral neuropathic pain affecting no motor nerves, (2) actigraph measurement limitations regarding the sedentary life of the elderly, or (3) activity misperception, a new proposition explaining the discrepancy between subjective and objective measures of activity, similar to the sleep state misperception. In patients with PHN, high pain intensity may be reported in those with highly maintained activity, in which treatment must be selected cautiously to prevent interruption of their physical abilities.

带状疱疹后遗神经痛患者的患者报告结果测量与加速度计测量的体力活动和睡眠之间的关系。
目的:目前,针对慢性神经病理性疼痛的治疗方法仍然有限,且疗效不佳。因此,临床医生的目标是在疼痛的情况下改善患者的活动能力和生活质量。在慢性疼痛评估中,对活动的客观监测备受关注。因此,我们对带状疱疹后遗神经痛患者的日间活动和睡眠情况进行了客观评估,并使用活动记录仪确定活动减少的风险因素:方法:带状疱疹后遗神经痛患者在非惯用手佩戴动图仪(一种类似手表的加速度计)。结果:54 名带状疱疹后遗神经痛患者在他们的非惯用手部佩戴了运动计(一种类似手表的加速计),运动计测量了他们白天的活动和睡眠情况,并与患者主观疼痛报告和睡眠评估结果进行了比较:结果:54 名到我们门诊就诊的带状疱疹后遗神经痛患者完成了问卷调查和为期一周的活动计监测。疼痛强度、神经病理性疼痛、日常生活残疾、疼痛灾难化想法和失眠的主观评分都有很好的相关性。然而,通过两个方程监测到的活动水平和睡眠质量与任何与疼痛或睡眠相关的主观评分都没有关联:讨论:本研究中主观评分和客观评分之间的差异可能是由于:1)带状疱疹后遗神经痛的特征,这是一种不影响运动神经的周围神经痛的典型类型;2)老年人久坐导致的活动记录仪测量局限性;或3)活动误认,这是解释活动的主观测量和客观测量之间差异的一个新命题,与睡眠状态误认类似。在带状疱疹后遗神经痛患者中,高度保持活动的患者可能会报告出较高的疼痛强度,在这种情况下,必须谨慎选择治疗方法,以防止患者的体能受到影响。
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来源期刊
Clinical Journal of Pain
Clinical Journal of Pain 医学-临床神经学
CiteScore
5.40
自引率
3.40%
发文量
118
审稿时长
4-8 weeks
期刊介绍: ​​​The Clinical Journal of Pain explores all aspects of pain and its effective treatment, bringing readers the insights of leading anesthesiologists, surgeons, internists, neurologists, orthopedists, psychiatrists and psychologists, clinical pharmacologists, and rehabilitation medicine specialists. This peer-reviewed journal presents timely and thought-provoking articles on clinical dilemmas in pain management; valuable diagnostic procedures; promising new pharmacological, surgical, and other therapeutic modalities; psychosocial dimensions of pain; and ethical issues of concern to all medical professionals. The journal also publishes Special Topic issues on subjects of particular relevance to the practice of pain medicine.
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