对慢性难治性肌肉骨骼疼痛综合征的多模式住院方案立即反应的临床预测因素-一项横断面研究。

IF 2.1 Q3 RHEUMATOLOGY
Rheumatology Advances in Practice Pub Date : 2025-03-18 eCollection Date: 2025-01-01 DOI:10.1093/rap/rkaf024
Tiffany Pretat, Thomas Hügle, Johanna Mettler, Marc Suter, Sandy Jean-Scherb, Pedro Ming-Azevedo
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引用次数: 0

摘要

慢性疼痛(CP)影响了全球约20%的人口,导致严重的残疾和经济负担。多模式规划(MMPs)是管理肌肉骨骼慢性疼痛综合征(MCPS)最有效的短期干预措施。然而,患者的特点影响治疗反应,需要个性化的方法。本研究旨在确定对难治性MCPS进行2周MMP治疗后即刻反应的临床、社会和心理行为预测因素。方法:一项横断面研究分析了2018年3月至2022年11月在瑞士洛桑CHUV完成MMP的207名MCPS患者。有效的问卷评估了疼痛严重程度、影响、运动恐惧症、灾难和其他因素在项目前后。单因素和多因素分析确定了治疗反应的预测因素。结果:12项结果中有9项显著改善,包括疼痛严重程度(P = 0.01)、疼痛影响(P = 0.14)、运动恐惧症(PP)。结论:本研究证实了MMP对难治性MCPS患者有适度但显著的直接益处,并为治疗结果的预测因素及其对各种结果测量的影响提供了更深入的见解。需要进一步的纵向研究来证实这些发现并探索潜在的机制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical predictors of immediate response to a multimodal inpatient programme for chronic refractory musculoskeletal pain syndromes-a cross-sectional study.

Objectives: Chronic pain (CP) affects approximately 20% of the global population, leading to significant disability and economic burden. Multimodal programmes (MMPs) are the most effective short-term interventions for managing musculoskeletal chronic pain syndromes (MCPS). However, patient characteristics influence treatment response, requiring personalized approaches. This study aims to identify clinical, social and psycho-behavioural predictors of immediate response to a 2-week inpatient MMP for refractory MCPS.

Methods: A cross-sectional study analysed 207 MCPS patients who completed an MMP at CHUV Lausanne, Switzerland, from March 2018 to November 2022. Validated questionnaires assessed pain severity, impact, kinesiophobia, catastrophizing and other factors before and after the programme. Univariate and multivariate analyses identified predictors of treatment response.

Results: Significant improvements were observed in 9 out of 12 outcomes, including pain severity (P = 0.01), pain impact (P < 0.01), disability (P = 0.14), kinesiophobia (P<0.001) and catastrophizing (P < 0.001). Non-specific low-back pain, catastrophizing at entry, biomechanical disorders and psychiatric conditions were identified as key predictors of treatment response, respectively influencing 4, 3, 3 and 2 over 9 outcome measures in multivariable analysis. Non-specific low-back pain was linked to worse outcomes, whereas reductions in catastrophizing correlated with improved pain severity and kinesiophobia. Socioeconomic factors, such as disputes over disability financial aid, also influenced outcomes.

Conclusion: This study confirms a modest yet significant immediate benefit of MMP for patients with refractory MCPS and provided a deeper insight into the predictors of treatment outcomes and their influence on various outcome measures. Further longitudinal studies are needed to confirm these findings and explore underlying mechanisms.

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来源期刊
Rheumatology Advances in Practice
Rheumatology Advances in Practice Medicine-Rheumatology
CiteScore
3.60
自引率
3.20%
发文量
197
审稿时长
11 weeks
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