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脊髓损伤患者疼痛和疲劳的管理:一项检验按摩疗法疗效的随机对照试验可行性研究

Managing pain and fatigue in people with spinal cord injury: a randomized controlled trial feasibility study examining the efficacy of massage therapy.

作者信息

Lovas J, Tran Y, Middleton J, Bartrop R, Moore N, Craig A

机构信息

John Walsh Centre for Rehabilitation Research, Northern Clinical School, Sydney Medical School, University of Sydney, Kolling Institute of Medical Science, RNSH, St Leonards, New South Wales, Australia.

Key University Centre for Health Technologies, University of Technology Sydney, Broadway, New South Wales, Australia.

出版信息

Spinal Cord. 2017 Feb;55(2):162-166. doi: 10.1038/sc.2016.156. Epub 2016 Nov 29.

Abstract

STUDY DESIGN

A randomized controlled trial (RCT).

OBJECTIVES

To determine the efficacy of massage therapy (MT) as a treatment that could be implemented to reduce pain and fatigue in people with chronic spinal cord injury (SCI).

SETTING

Laboratory setting in Sydney, Australia.

METHODS

Participants included 40 people with SCI living in the community who were randomly assigned into one of two RCT arms: MT (Swedish massage to upper body) or an active concurrent control (guided imagery (GI) relaxation). All participants received 30 min once a week of either massage or GI over 5 consecutive weeks. In addition to sociodemographic and injury factors, assessments and reliable measures including the short-form McGill Pain Questionnaire and Chalder's Fatigue Scale were validated.

RESULTS

Chronic pain and fatigue were significantly reduced in the massage group when assessed at the end of 5 weeks (P<0.05), with large effect sizes. Interestingly, GI was as effective as MT in reducing pain and fatigue. Pain scores were reduced significantly over time in both MT and GI groups (P=0.049 and P=0.032, respectively). Total fatigue scores were also reduced in both MT and GI groups (P=0004 and P=0.037, respectively.)Conclusions:Massage and GI are both active treatments that provide potential clinical benefits for adults with SCI. Future research should clarify the role of massage and GI in managing pain and fatigue in SCI and assess outcomes into the longer-term.

摘要

研究设计

一项随机对照试验(RCT)。

目的

确定按摩疗法(MT)作为一种可用于减轻慢性脊髓损伤(SCI)患者疼痛和疲劳的治疗方法的疗效。

地点

澳大利亚悉尼的实验室环境。

方法

参与者包括40名居住在社区的SCI患者,他们被随机分配到两个RCT组之一:MT组(对上身进行瑞典式按摩)或积极的同期对照组(引导式意象(GI)放松)。所有参与者连续5周每周接受一次30分钟的按摩或GI治疗。除了社会人口统计学和损伤因素外,还验证了包括简式麦吉尔疼痛问卷和查尔德疲劳量表在内的评估和可靠测量方法。

结果

在5周结束时评估,按摩组的慢性疼痛和疲劳显著减轻(P<0.05),效应量较大。有趣的是,GI在减轻疼痛和疲劳方面与MT一样有效。MT组和GI组的疼痛评分均随时间显著降低(分别为P=0.049和P=0.032)。MT组和GI组的总疲劳评分也均降低(分别为P=0.004和P=0.037)。结论:按摩和GI都是有效的治疗方法,对SCI成人患者具有潜在的临床益处。未来的研究应阐明按摩和GI在管理SCI患者疼痛和疲劳方面的作用,并评估长期效果。

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