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慢性疼痛患者的疼痛神经生理学知识与恐惧回避之间的关系:一项横断面观察性研究。

The relationship between knowledge of pain neurophysiology and fear avoidance in people with chronic pain: A point in time, observational study.

作者信息

Fletcher Claire, Bradnam Lynley, Barr Christopher

机构信息

a Physiotherapy Department , North Eastern Rehabilitation Centre , Ivanhoe , VIC , Australia.

d Department of Rehabilitation, Aged and Extended Care, School of Health Sciences, Faculty of Medicine, Nursing and Health Sciences , Flinders University , Adelaide , Australia.

出版信息

Physiother Theory Pract. 2016 May;32(4):271-6. doi: 10.3109/09593985.2015.1138010. Epub 2016 Apr 6.

Abstract

Chronic pain is prevalent in the western world; however fear of pain often has a greater impact than the degree of initial injury. The aim of this study was to explore the relationship between knowledge of the neurophysiology of pain and fear avoidance in individuals diagnosed with chronic pain. Twenty-nine people with chronic musculoskeletal pain were recruited and completed questionnaires to determine their understanding of pain neurophysiology and the degree of their fear avoidance beliefs. There was an inverse relationship between knowledge of pain neurophysiology and the level of fear avoidance. Patients with higher pain knowledge reported less fear avoidance and lower perceived disability due to pain. There was no relationship with the educational level or compensable status for either variable. The findings suggest that fear avoidance is positively influenced by neurophysiology of pain education, so that a higher level of pain knowledge is associated with less activity-related fear. The clinical implication is that reducing fear avoidance/kinesiophobia using neurophysiology of pain education in people with chronic pain may provide an effective strategy to help manage fear avoidance and related disability in the chronic pain population in order to improve treatment outcomes.

摘要

慢性疼痛在西方世界很普遍;然而,对疼痛的恐惧往往比最初的损伤程度影响更大。本研究的目的是探讨被诊断为慢性疼痛的个体对疼痛神经生理学的了解与恐惧回避之间的关系。招募了29名患有慢性肌肉骨骼疼痛的人,并让他们完成问卷,以确定他们对疼痛神经生理学的理解以及恐惧回避信念的程度。疼痛神经生理学知识与恐惧回避水平之间存在负相关。疼痛知识较高的患者报告的恐惧回避较少,因疼痛导致的感知残疾也较低。这两个变量与教育水平或可补偿状态均无关系。研究结果表明,疼痛教育的神经生理学对恐惧回避有积极影响,因此,更高水平的疼痛知识与较少的与活动相关的恐惧相关。临床意义在于,在慢性疼痛患者中使用疼痛教育的神经生理学来减少恐惧回避/运动恐惧症,可能为帮助管理慢性疼痛人群中的恐惧回避和相关残疾以改善治疗效果提供一种有效策略。

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