膝关节或髋关节骨性关节炎患者每周的疼痛轨迹,参与以数字方式提供的一线运动和教育治疗。

IF 2.9 3区 医学 Q1 ANESTHESIOLOGY
Pain Medicine Pub Date : 2024-04-03 DOI:10.1093/pm/pnad167
Ali Kiadaliri, Helena Hörder, L Stefan Lohmander, Leif E Dahlberg
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引用次数: 0

摘要

目的:在骨关节炎(OA)的治疗中,越来越多地使用数字化自我管理计划。人们对这些项目的不同反应模式知之甚少。我们描述了膝关节或髋关节OA患者在参加数字化自我管理项目长达52周的时间里每周的疼痛轨迹:在 2019 年 1 月至 2021 年 9 月期间注册的参与者中开展观察性队列研究,这些参与者参加了至少 4 周、最多 52 周的项目(n = 16274)。我们使用数值评定量表(NRS 0-10)测量疼痛,并应用潜类增长分析来识别具有相似轨迹的类别。我们使用多项式逻辑回归和优势分析法研究了基线特征与轨迹类别之间的关联:结果:我们确定了四个疼痛轨迹等级:结果:我们确定了四个疼痛轨迹等级:"轻度-基本改善"(30%)、"中度-基本改善"(34%)、"中度以上-改善"(24%)和 "重度-持续"(12%)。在疼痛减轻的班级中,头 20 周的疼痛减轻幅度最大,此后保持稳定。男性、年龄较大、体重指数(BMI)较低、身体功能较好、活动障碍较小、焦虑/抑郁较少、受教育程度较高、膝关节有 OA、无行走困难、无手术意愿以及体力活动较多,这些都是入组时的测量指标,与其他等级相比,这些指标与更高的 "轻度-明显改善 "等级成员概率相关。显性分析表明,活动能力受损、希望手术和行走困难是最重要的轨迹等级成员预测因素:我们的研究结果凸显了在OA患者出现严重疼痛、健康状况不佳和希望手术治疗之前为其提供一线治疗的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Weekly pain trajectories among people with knee or hip osteoarthritis participating in a digitally delivered first-line exercise and education treatment.

Objective: Digital self-management programs are increasingly used in the management of osteoarthritis (OA). Little is known about heterogeneous patterns in response to these programs. We describe weekly pain trajectories of people with knee or hip OA over up to 52-week participation in a digital self-management program.

Methods: Observational cohort study among participants enrolled between January 2019 and September 2021 who participated at least 4 and up to 52 weeks in the program (n = 16 274). We measured pain using Numeric Rating Scale (NRS 0-10) and applied latent class growth analysis to identify classes with similar trajectories. Associations between baseline characteristics and trajectory classes were examined using multinomial logistic regression and dominance analysis.

Results: We identified 4 pain trajectory classes: "mild-largely improved" (30%), "low moderate-largely improved" (34%), "upper moderate-improved" (24%), and "severe-persistent" (12%). For classes with decreasing pain, the most pain reduction occurred during first 20 weeks and was stable thereafter. Male sex, older age, lower body mass index (BMI), better physical function, lower activity impairment, less anxiety/depression, higher education, knee OA, no walking difficulties, no wish for surgery and higher physical activity, all measured at enrolment, were associated with greater probabilities of membership in "mild-largely improved" class than other classes. Dominance analysis suggested that activity impairment followed by wish for surgery and walking difficulties were the most important predictors of trajectory class membership.

Conclusions: Our results highlight the importance of reaching people with OA for first-line treatment prior to developing severe pain, poor health status and a wish for surgery.

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来源期刊
Pain Medicine
Pain Medicine 医学-医学:内科
CiteScore
6.50
自引率
3.20%
发文量
187
审稿时长
3 months
期刊介绍: Pain Medicine is a multi-disciplinary journal dedicated to pain clinicians, educators and researchers with an interest in pain from various medical specialties such as pain medicine, anaesthesiology, family practice, internal medicine, neurology, neurological surgery, orthopaedic spine surgery, psychiatry, and rehabilitation medicine as well as related health disciplines such as psychology, neuroscience, nursing, nurse practitioner, physical therapy, and integrative health.
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