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社会和心理因素影响了手臂、颈部和肩部不适的病程。

Social and psychological factors influenced the course of arm, neck and shoulder complaints.

作者信息

Karels C H, Bierma-Zeinstra S M A, Burdorf A, Verhagen A P, Nauta A P, Koes B W

机构信息

Department of General Practice, Erasmus MC, The Netherlands.

出版信息

J Clin Epidemiol. 2007 Aug;60(8):839-48. doi: 10.1016/j.jclinepi.2006.11.012. Epub 2007 Mar 26.

Abstract

OBJECTIVE

To investigate the clinical course and prognostic factors of complaints of arm, neck, and shoulder.

STUDY DESIGN AND SETTING

A prospective cohort study in physical therapy practice. Participating physiotherapists recruited new consulters with musculoskeletal complaints of the neck and/or upper extremities. Participants filled in questionnaires at baseline, 3 months, and 6 months. The main outcome measure was the persistence of complaints over 6-month follow-up. Possible predictors like social and psychological factors, physical factors, and complaint specific factors were tested in univariate and multivariate logistic regression analyses for repeated measurements.

RESULTS

Of the 624 participants at baseline 543 (87%) returned at least one follow-up questionnaire. At 6-month follow-up, 40% had persisting pain and discomfort. Somatization, kinesiophobia, catastrophizing, and a long duration of complaints at baseline were significantly related to the persistence of complaints over 6 months in the total population. In those with paid work (77%), catastrophizing, low decision authority at work, and a long duration of complaints at baseline were significantly related to the persistence of complaints over 6 months.

CONCLUSION

40% of the participants had persisting pain and discomfort after 6 months and mainly social and psychological factors played a role in this course.

摘要

目的

探讨手臂、颈部和肩部不适的临床病程及预后因素。

研究设计与背景

一项在物理治疗实践中的前瞻性队列研究。参与研究的物理治疗师招募了有颈部和/或上肢肌肉骨骼不适的新咨询者。参与者在基线、3个月和6个月时填写问卷。主要结局指标是6个月随访期间不适症状的持续情况。在重复测量的单因素和多因素逻辑回归分析中,对社会和心理因素、身体因素以及特定不适因素等可能的预测因素进行了检验。

结果

在基线时的624名参与者中,543名(87%)至少返回了一份随访问卷。在6个月随访时,40%的人仍有持续的疼痛和不适。在总体人群中,躯体化、运动恐惧、灾难化思维以及基线时不适症状持续时间较长与6个月以上不适症状的持续显著相关。在有带薪工作的人群中(77%),灾难化思维、工作中决策权低以及基线时不适症状持续时间较长与6个月以上不适症状的持续显著相关。

结论

40%的参与者在6个月后仍有持续的疼痛和不适,在此病程中主要是社会和心理因素起了作用。

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