Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, SE-901 87 Umeå, Sweden.
J Rehabil Med. 2013 Nov;45(10):1049-57. doi: 10.2340/16501977-1218.
To follow up 2 rehabilitation strategies for patients with chronic pain: a 2-day interdisciplinary team assessment followed by either (i) a 4-week outpatient multimodal rehabilitation programme, or (ii) a subsequent rehabilitation plan.
After a 2-day interdisciplinary team assessment at our pain rehabilitation clinic, 296 consecutive patients were selected to undergo either multimodal rehabilitation programme (n = 76) or rehabilitation plan (n = 220). They completed questionnaires regarding beliefs about the future (only at assessment), Multidimensional Pain Inventory and sick leave, both at assessment, and at 1-year follow-up.
Both the rehabilitation plan and multimodal rehabilitation programme groups improved significantly as regards decreased sick leave and the Multidimensional Pain Inventory scales Pain severity, Interference, and Support. The multimodal rehabilitation programme group also improved significantly regarding Life control and Affective distress. For men, low disability level and for women a positive expectation about work was associated with no sick leave at follow-up.
The multimodal rehabilitation programme had long-term positive effects on sick leave and all Multidimensional Pain Inventory scales. However, a less intense intervention (rehabilitation plan) with follow-up in primary care can decrease levels of sick leave and improve some Multidimensional Pain Inventory scales. An interdisciplinary team assessment of patients with chronic pain seems to be useful for selecting which patients should undergo different rehabilitation interventions.
对两种慢性疼痛患者康复策略进行随访:为期 2 天的跨学科团队评估后,分别(i)进行为期 4 周的门诊多模式康复计划,或(ii)进行后续康复计划。
在我们的疼痛康复诊所进行为期 2 天的跨学科团队评估后,选择 296 名连续患者接受多模式康复计划(n = 76)或康复计划(n = 220)。他们在评估时和 1 年随访时填写了关于对未来的信念(仅在评估时)、多维疼痛量表和病假的问卷。
康复计划组和多模式康复组在病假和多维疼痛量表的疼痛严重程度、干扰和支持方面均显著改善。多模式康复组在生活控制和情感困扰方面也有显著改善。对于男性来说,低残疾水平和对工作的积极期望与随访时无病假相关。
多模式康复计划对病假和多维疼痛量表的所有方面均有长期积极影响。然而,在初级保健中进行随访的强度较低的干预(康复计划)可以降低病假水平并改善一些多维疼痛量表。对慢性疼痛患者进行跨学科团队评估似乎有助于选择哪些患者应接受不同的康复干预。