评估非特异性（亚）急性颈痛患者个体化治疗的有效性

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice Pub Date : 2024-11-25 DOI:10.1016/j.msksp.2024.103235

M. Chys, K. De Meulemeester, M. De Sloovere, I. De Greef, V. Dewitte, B. Cagnie

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引用次数: 0

摘要

背景：在关于非特异性颈痛（NSNP）的最佳实践管理的争论中，一个重要的问题是定制干预与普遍干预的有效性。方法将（亚）急性NSNP患者随机分为患者定制治疗组（PTT）、非患者定制治疗组（NPTT）和对照组（不进行干预）。结果测量为疼痛（NPRS）、残疾（NDI）、整体感知效果和满意度（GPES）、生产成本和医疗消费。患者在基线、干预后、干预后3个月、6个月和12个月进行评估。在干预期间记录患者的主诉、治疗依从性和药物摄入的演变情况。线性混合模型用于检验相互作用效应以及组间和组内差异。结果共纳入61名受试者。所有结果测量都没有“组x时间”的相互作用效应。然而，所有组在疼痛和残疾的所有时间点都显示出显著的临床相关组内差异(p <；0.001)。在6个月的随访中，NPTT在减轻疼痛方面优于PTT，但在减轻残疾方面优于PTT。1年后，NPTT组的应答者数量（75%）仍然高于PTT组（40%）。结论：本研究发现，在所有组中，疼痛和残疾的减轻都具有显著的临床意义。针对患者量身定制的治疗以及NPTT可以被认为是短期（12周）减轻疼痛和残疾的有效方法。然而，NPTT似乎在1年的随访中更有效，治疗师应该考虑自发恢复。研究结果应谨慎解读，进一步的研究是有必要的。

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Evaluating the effectiveness of patient-tailored treatment for patients with non-specific (sub)acute neck pain

Background

An important issue in the debate about best practice management of non-specific neck pain (NSNP) is the effectiveness of tailored versus generalized interventions.

Methods

Participants with (sub)acute NSNP were randomly allocated to a patient-tailored treatment (PTT), non-patient-tailored treatment (NPTT) or control group (no intervention). The outcome measures were pain (NPRS), disability (NDI), global perceived effect and satisfaction (GPES), productivity costs, and medical consumption. Patients were assessed at baseline, post-intervention, and at 3-, 6-, and 12-months post-intervention. Evolution of the complaints, treatment adherence, and medication intake was registered during the intervention period. Linear mixed models were used to examine interaction effects as well as between- and within-group differences.

Results

Sixty-one participants were included. There was no “Group x Time”-interaction effect for all outcome measures. Nevertheless, all groups showed significant and clinically relevant within-group differences at all time points for pain and disability (p < 0.001). At 6 months follow-up, NPTT was superior to PTT for reductions in pain but not for disability. At 1 year, the number of responders in the NPTT group remained higher (75%) compared to the PTT group (40%).

Conclusion

This study found a significant and clinically relevant reduction of pain and disability within all groups. Patient-tailored treatment as well as NPTT can be considered an effective method when aiming for a reduction in pain and disability at short-term (12 weeks). However, NPTT seemed to be more effective at 1-year follow-up and therapists should consider spontaneous recovery. The results should be interpreted with caution and further research is warranted.

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来源期刊

Musculoskeletal Science and Practice Health Professions-Physical Therapy, Sports Therapy and Rehabilitation

CiteScore

4.10

自引率

8.70%

发文量

152

审稿时长

48 days

期刊介绍： Musculoskeletal Science & Practice, international journal of musculoskeletal physiotherapy, is a peer-reviewed international journal (previously Manual Therapy), publishing high quality original research, review and Masterclass articles that contribute to improving the clinical understanding of appropriate care processes for musculoskeletal disorders. The journal publishes articles that influence or add to the body of evidence on diagnostic and therapeutic processes, patient centered care, guidelines for musculoskeletal therapeutics and theoretical models that support developments in assessment, diagnosis, clinical reasoning and interventions.