Center for Clinical Research Dalarna, Falun, Sweden.
Spine (Phila Pa 1976). 2011 Dec 1;36(25):2105-15. doi: 10.1097/BRS.0b013e3182028b04.
A 2-year follow-up of a randomized controlled trial.
To compare long-term effects of (a) a multicomponent pain and stress self-management group intervention (PASS) and (b) individually administered physical therapy (IAPT) on patients with persistent tension-type neck pain in a primary health care (PHC) setting.
In a previously reported short-term follow-up, PASS had better effects on pain control, pain-related self-efficacy, disability, and catastrophizing than IAPT. Long-term effects of self-management interventions for persistent neck pain, for example, maintenance of improvement and adherence to coping skills are sparsely investigated.
Persons with persistent tension-type neck pain seeking physical therapy treatment at nine PHC centers in Sweden were randomly assigned to either PASS or IAPT. Before intervention, at 10 and 20 weeks and at 1 and 2 years after the intervention, 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, and questions regarding neck pain and analgesics. Analyses were performed using linear mixed models for repeated measures.
The study included 156 participants (PASS n = 77, IAPT n = 79). Between baseline, 10-week, 20-week, 1-year, and 2-year follow-up, significant time-by-group interaction effects were found in favor of PASS regarding the primary outcomes ability to control pain (P < 0.001) and self-efficacy for performing activities in spite of pain (P = 0.002), and the secondary outcome catastrophic thinking (P < 0.001) but not in neck pain-related disability.
The initial treatment effects of a self-management group intervention were largely maintained over a 2-year follow-up period and with a tendency to have superior long-term effects as compared to individually-administered physical therapy, in the treatment of persistent tension-type neck pain with regard to coping with pain, in terms of pain control, self-efficacy, and catastrophizing.
一项为期 2 年的随机对照试验随访。
比较（a）多组分疼痛和应激自我管理小组干预（PASS）和（b）在初级保健（PHC）环境中对持续性紧张型颈痛患者个体进行的物理治疗（IAPT）的长期效果。
在之前报道的短期随访中，PASS 在疼痛控制、与疼痛相关的自我效能、残疾和灾难化方面的效果优于 IAPT。对于持续性颈痛的自我管理干预的长期效果，例如，改善的维持和应对技能的坚持，研究甚少。
在瑞典的 9 个 PHC 中心寻求物理治疗的持续性紧张型颈痛患者被随机分配到 PASS 或 IAPT 组。在干预前、10 周、20 周、干预后 1 年和 2 年，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以及关于颈部疼痛和止痛药的问题。分析采用重复测量线性混合模型进行。
该研究共纳入 156 名参与者（PASS 组 n = 77，IAPT 组 n = 79）。与基线、10 周、20 周、1 年和 2 年随访相比，PASS 在主要结局（疼痛控制能力（P < 0.001）和疼痛活动时的自我效能（P = 0.002））和次要结局（灾难化思维（P < 0.001））方面表现出显著的时间-组交互效应，但在颈部疼痛相关残疾方面没有显著差异。
在为期 2 年的随访期间，自我管理小组干预的初始治疗效果基本保持不变，与个体进行的物理治疗相比，在治疗持续性紧张型颈痛方面具有更好的长期效果，在应对疼痛方面，在疼痛控制、自我效能和灾难化方面具有优势。
