Rehabilitation Management of Neck Pain—Development of a Diagnostic Framework Based on the Pain and Disability Drivers Management Model

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice Pub Date : 2025-02-03 DOI:10.1111/jep.14299

Thomas Gerard, Florian Naye, Simon Decary, Pierre Langevin, Chad Cook, Yannick Tousignant-Laflamme

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引用次数: 0

Abstract

Rationale

Neck pain is a major cause of disability worldwide, and current rehabilitation strategies show limited effectiveness. Subgrouping patients by their primary pain and disability drivers can help tailor treatments. At this end, the Pain and Disability Drivers Management (PDDM) was developed and has demonstrated preliminary effectiveness in the management of low back pain. Nevertheless, the PDDM model was only validated for this population. Adapting this framework to patients with neck pain would provide a more global view of the patient's experience of pain and support a genuine biopsychosocial intervention.

Aims and Objectives

The aim of this study was to develop and validate the content of the PDDM model for patients living with neck pain.

Methods

Through a modified DELPHI study design, participants with clinical and research expertize in rehabilitation of neck pain were invited to participate. A questionnaire was developed using literature reviews and endorsed by a steering committee. The relevance of each element of the newly adapted model was evaluated on a 4-point Likert scale. An item reached consensus if it obtained the predefined threshold of > 78% “relevant” and “very relevant.” Participants left comments on terminology and recommended items to add in early rounds. Quantitative and qualitative analyses were performed.

Results

An invitation was sent to 1650 potential participants, from which 155 accessed the survey, 64 completed the first round and 55 the second round. A total of 70 elements met consensus and were distributed across six domains: “Nociceptive pain drivers”, “nociplastic pain drivers,” “drivers associated with neuropathic pain”, “comorbidity drivers”, “cognitive-emotional drivers” and “environmental or lifestyle drivers, and social determinants of health.”

Conclusion

Through a modified DELPHI study, the PDDM model was updated and adapted to people with neck pain. Subsequent steps include clinical integration and measures of efficacy when used for assessment/treatment.

Abstract Image

查看原文本刊更多论文

颈部疼痛的康复管理-基于疼痛和残疾驱动因素管理模型的诊断框架的发展。

理由：颈痛是全世界致残的主要原因，目前的康复策略显示效果有限。根据患者的主要疼痛和残疾驱动因素对患者进行亚分组可以帮助定制治疗。为此，疼痛和残疾驱动因素管理（PDDM）被开发出来，并在管理腰痛方面显示出初步的有效性。然而，PDDM模型仅在这一人群中得到验证。将这一框架适用于颈部疼痛患者，将提供一个更全面的视角来了解患者的疼痛经历，并支持真正的生物心理社会干预。目的和目的：本研究的目的是开发和验证颈部疼痛患者的PDDM模型的内容。方法：采用改进的德尔菲研究设计，邀请具有颈部疼痛康复临床和研究经验的参与者参与。在文献综述的基础上编制了一份问卷，并得到指导委员会的认可。新调整模型的每个元素的相关性在4点李克特量表上进行评估。如果一个项目达到预定义的阈值，即“相关”和“非常相关”，则该项目达成共识。参与者对术语和建议在早期几轮中添加的项目发表了评论。进行了定量和定性分析。结果：向1650名潜在参与者发出了邀请，其中155人参加了调查，64人完成了第一轮调查，55人完成了第二轮调查。共有70个要素符合共识，分布在六个领域：“伤害性疼痛驱动因素”、“伤害性疼痛驱动因素”、“与神经性疼痛相关的驱动因素”、“共病驱动因素”、“认知-情感驱动因素”和“环境或生活方式驱动因素以及健康的社会决定因素”。结论：通过改进的DELPHI研究，更新了PDDM模型，使其更适合于颈部疼痛患者。随后的步骤包括临床整合和用于评估/治疗时的疗效测量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of evaluation in clinical practice 医学-卫生保健

CiteScore

4.80

自引率

4.20%

发文量

143

审稿时长

3-8 weeks

期刊介绍： The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.