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一项按摩减轻急性康复期脊髓损伤患者疼痛的可行性研究。

A pilot feasibility study of massage to reduce pain in people with spinal cord injury during acute rehabilitation.

机构信息

Patient & Family Education Program, Nursing Deptartment, Craig Hospital, Englewood, Denver, CO, USA.

出版信息

Spinal Cord. 2013 Nov;51(11):847-51. doi: 10.1038/sc.2013.104. Epub 2013 Sep 17.

DOI:10.1038/sc.2013.104
PMID:24042991
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3815956/
Abstract

OBJECTIVE

To determine the feasibility of conducting a randomized controlled trial of massage therapy for patients with a new spinal cord injury (SCI) during acute inpatient rehabilitation.

DESIGN

A pilot single-center, randomized, single-blind, cross-over clinical trial.

SETTING

Free-standing, not-for-profit, comprehensive rehabilitation center specializing in SCI rehabilitation.

PARTICIPANTS

Forty adults ages 18 years and older undergoing acute rehabilitation following an SCI reporting any type of pain.

INTERVENTION

Rehabilitation nurses trained to give broad compression massage (BCM) and a control light contact touch (LCT) treatments. Participants were randomized to receive either BCM or LCT first, in six 20-min treatment sessions over 2 weeks, with a 1-week washout between the 2-week treatment periods.

MAIN OUTCOME MEASURES

Primary outcomes were changes in pain intensity and in fatigue, measured daily. Secondary outcomes included depressive symptoms measured by the Patient Health Questionnaire-9 (PHQ-9) and an assessment of pain medication usage.

RESULTS

Pain intensity was higher at baseline and reduced more in the LCT-first group compared with the BCM-first group in period 1 (P=0.014), although this pattern was not found in period 2 (P=0.58). LCT and BCM groups did not significantly differ on any secondary measures except PHQ-9.

CONCLUSIONS

This study demonstrates the feasibility of using rehabilitation nurses to provide tactile therapy to patients with an SCI and suggests a model for controlled clinical trials examining the efficacy of massage therapies. Although efficacy was difficult to assess, BCM was safe and well tolerated.

摘要

目的

确定在急性住院康复期间对新发脊髓损伤(SCI)患者进行按摩疗法随机对照试验的可行性。

设计

一项单中心、随机、单盲、交叉临床试验的试点研究。

地点

独立的、非营利性的、综合性康复中心,专门从事 SCI 康复。

参与者

40 名年龄在 18 岁及以上的成年人,在 SCI 后接受急性康复治疗,报告有任何类型的疼痛。

干预措施

接受过广泛压缩按摩(BCM)和对照轻触触摸(LCT)治疗培训的康复护士。参与者随机接受 BCM 或 LCT 治疗,共 6 次,每次 20 分钟,2 周治疗期之间有 1 周洗脱期。

主要观察指标

主要结果是每日测量的疼痛强度和疲劳的变化。次要结果包括使用患者健康问卷-9(PHQ-9)测量的抑郁症状和疼痛药物使用情况的评估。

结果

在第 1 期,与 BCM 组相比,LCT 组的基线疼痛强度更高,疼痛强度降低更多(P=0.014),但在第 2 期未发现这种模式(P=0.58)。除 PHQ-9 外,LCT 和 BCM 组在任何次要测量指标上均无显著差异。

结论

本研究证明了使用康复护士为 SCI 患者提供触觉治疗的可行性,并提出了一种用于评估按摩疗法疗效的对照临床试验模型。尽管疗效难以评估,但 BCM 是安全且耐受良好的。

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