Foothills Medical Center, Calgary Headache Assessment and Management Program, Calgary, Alberta, Canada.
Disabil Rehabil. 2012;34(7):611-8. doi: 10.3109/09638288.2011.610496. Epub 2011 Oct 8.
To review the pacing literature; describe the use of pacing in a specialty headache clinic; and provide client feedback regarding the effectiveness of pacing in headache self-management.
The evidence for this report was derived from a structured literature review, an established pacing intervention program for patients with headache, and patient self-report questionnaire.
There are frequent references to pacing in the chronic pain and rheumatic disease literature, but no universal definition and, until recently, few outcome studies. References to pacing in the headache literature are limited. For a small sub-group of clients at a specialty headache clinic (n = 20), pacing principles taught by occupational therapists were reported to prevent increases in headache intensity (70%); decrease headache intensity (65%), and shorten the duration of a headache (40%). Additionally, 70% of respondents used pacing to prevent headache onset. Pacing was seen to contribute to increased quality of life, headache self-efficacy, function, and independence. There were a variety of opinions regarding the most helpful pacing components. The most frequently endorsed were identify and prioritize responsibilities; balance activity and rest; schedule regular rest breaks; and delegate or eliminate tasks.
Pacing appears to play an important role in headache self-management. More pacing research is required in both headache and chronic pain populations.
回顾有关调整节奏的文献；描述在头痛专科诊所使用调整节奏的情况；并提供患者对调整节奏在头痛自我管理中有效性的反馈。
本报告的证据来源于对文献的系统回顾、针对头痛患者的既定调整节奏干预方案，以及患者自我报告问卷。
慢性疼痛和风湿性疾病文献中经常提到调整节奏，但没有通用的定义，而且直到最近，很少有关于调整节奏的结果研究。头痛文献中提到的调整节奏的情况有限。在头痛专科诊所的一小部分患者（n=20）中，职业治疗师教授的调整节奏原则被报告可以预防头痛强度增加（70%）；降低头痛强度（65%），并缩短头痛持续时间（40%）。此外，70%的受访者使用调整节奏来预防头痛发作。调整节奏被认为有助于提高生活质量、头痛自我效能、功能和独立性。对于最有用的调整节奏组成部分，有各种意见。最常被认可的是确定和优先考虑责任；平衡活动和休息；定期安排休息时间；以及委派或消除任务。
调整节奏似乎在头痛自我管理中起着重要作用。在头痛和慢性疼痛人群中都需要进行更多的调整节奏研究。
