Sjöström Rita, Asplund Ragnar, Alricsson Marie
Strömsund Health Centre, Jämtland County Council, Strömsund, Sweden.
Work. 2010;37(4):341-8. doi: 10.3233/WOR-2010-1088.
To investigate whether improvement of range of motion (ROM) in persons with musculoskeletal disorders, mainly neck and back pain, was associated with a favourable development regarding physical disability, pain, and health-related quality of life (QoL), and whether such development differed between sick-listed and non-sick-listed persons during and up to 2 years after a multidisciplinary rehabilitation programme.
Ten persons with full-time sick leave (Group I) and 49 with part-time or no sick leave (Group II) at the end of a previous study participated. It was shown in that study that Group I had higher pain rating and higher subjective physical disability than Group II, with little or no improvement during and after rehabilitation. In the present study, all participants were evaluated with neck and back mobility tests: Disability Rating Index (DRI); Pain Intensity Rating on a visual analogue scale (VAS); and Global Self-Efficacy Index (GSI).
Cervical and thoracolumbar spine ROM were lower in Group I than in Group II from the start of rehabilitation to a 2-year follow-up. Only Group II showed a temporal improvement in ROM. No changes in DRI, VAS or GSI were found in parallel with corresponding temporal changes in any of the ROM.
Group II but not Group I improved in active ROM during rehabilitation; further, in Group I active ROM in the cervical and thoracolumbar spine did not improve during the 2-year follow-up. Improvement of ROM showed no correlation with physical disability, pain or QoL.
探讨肌肉骨骼疾病患者(主要是颈部和背部疼痛患者)运动范围(ROM)的改善是否与身体残疾、疼痛及健康相关生活质量(QoL)的良好发展相关,以及在多学科康复计划期间及之后长达2年的时间里,这种发展在病假人员和非病假人员之间是否存在差异。
上一项研究结束时,10名全时病假人员(第一组)和49名非全时病假或无病假人员(第二组)参与了研究。该研究表明,第一组的疼痛评分和主观身体残疾程度高于第二组,在康复期间及之后几乎没有改善。在本研究中,所有参与者均接受颈部和背部活动度测试:残疾评定指数(DRI);视觉模拟量表(VAS)上的疼痛强度评分;以及总体自我效能感指数(GSI)。
从康复开始到2年随访期间,第一组的颈椎和胸腰椎ROM低于第二组。只有第二组的ROM有暂时改善。在任何ROM的相应时间变化过程中,未发现DRI、VAS或GSI有变化。
康复期间,第二组而非第一组的主动ROM有所改善;此外,在第一组中,颈椎和胸腰椎的主动ROM在2年随访期间没有改善。ROM的改善与身体残疾、疼痛或QoL无关。