Center for Clinical Research Dalarna, Falun, Sweden.
Eur J Pain. 2010 Jul;14(6):630.e1-630.e11. doi: 10.1016/j.ejpain.2009.10.004. Epub 2009 Nov 25.
Studies regarding self-management of persistent neck pain are infrequent.
to compare treatment effects of (a) a multi-component pain and stress self-management group intervention (PASS) and (b) individually administered physical therapy (IAPT) for patients with persistent musculoskeletal tension-type neck pain.
Persons seeking physical therapy treatment due to persistent tension-type neck pain at nine primary health care centers in Sweden were randomly assigned to either PASS or IAPT. Before treatment (baseline) and at 10- and 20-weeks the participants completed a self-assessment questionnaire comprising: the Self-Efficacy Scale, the Neck Disability Index, the Coping Strategies Questionnaire, the Hospital Anxiety and Depression Scale, the Fear-Avoidance Beliefs Questionnaire and questions regarding neck pain, analgesics and utilization of health care. Intention-to-treat analyses were performed using repeated measures analysis of variance between baseline, 10-week and 20-week follow-up.
One hundred and fifty six participants were included (PASS n=77, IAPT n=79). On average participants receiving PASS attended seven treatment sessions and participants receiving IAPT 11 sessions over the 20-week follow-up period. Repeated measures ANCOVA showed significant time x group interaction effects for ability to control pain (p<0.001), self-efficacy regarding pain-interfering activities (p=0.005), disability due to neck pain (p=0.001) and levels of catastrophic thinking (p<0.001) in favour of PASS.
PASS had a better effect than IAPT in the treatment of persistent musculoskeletal tension-type neck pain regarding coping with pain, in terms of patients' self-reported pain control, self-efficacy, disability and catastrophizing, over the 20-week follow-up.
针对持续性颈部疼痛的自我管理研究较为少见。
比较（a）多组分疼痛和压力自我管理小组干预（PASS）和（b）个体实施的物理治疗（IAPT）对持续性肌肉骨骼紧张型颈部疼痛患者的治疗效果。
在瑞典的 9 个初级保健中心，因持续性紧张型颈部疼痛寻求物理治疗的患者被随机分配到 PASS 或 IAPT 组。在治疗前（基线）和第 10 周和第 20 周，参与者完成了一份自我评估问卷，包括：自我效能感量表、颈部残疾指数、应对策略问卷、医院焦虑和抑郁量表、恐惧-回避信念问卷以及颈部疼痛、镇痛药和医疗保健使用情况的问题。使用重复测量方差分析进行意向治疗分析，比较基线、第 10 周和第 20 周随访的结果。
共纳入 156 名参与者（PASS 组 77 人，IAPT 组 79 人）。平均而言，接受 PASS 治疗的患者接受了 7 次治疗，接受 IAPT 治疗的患者在 20 周的随访期间接受了 11 次治疗。重复测量方差分析显示，在控制疼痛的能力（p<0.001）、与疼痛相关的活动的自我效能感（p=0.005）、颈部疼痛引起的残疾（p=0.001）和灾难化思维水平（p<0.001）方面，PASS 组的时间与分组之间存在显著的交互作用。
在 20 周的随访中，PASS 在治疗持续性肌肉骨骼紧张型颈部疼痛方面比 IAPT 更有效，表现在患者自我报告的疼痛控制、自我效能感、残疾和灾难化思维方面。
