伯尔尼门诊跨专业康复（BAI-Reha）项目对慢性肌肉骨骼疼痛患者的有效性：一项队列研究。

Effectiveness of the Bern Ambulatory Interprofessional Rehabilitation (BAI-Reha) programme for patients with chronic musculoskeletal pain: a cohort study.

作者信息

Gantschnig Brigitte Elisabeth, Heigl Franziska, Widmer Leu Colette, Bütikofer Lukas, Reichenbach Stephan, Villiger Peter Matthias

机构信息

Department of Rheumatology, Immunology, Allergology, University Hospital (Inselspital) and University of Bern, Switzerland; Institute of Occupational Therapy, School of Health Professions, ZHAW Zurich University of Applied Sciences, Switzerland.

Department of Rheumatology, Immunology, Allergology, University Hospital (Inselspital) and University of Bern, Switzerland.

出版信息

Swiss Med Wkly. 2017 May 8;147:w14433. doi: 10.4414/smw.2017.14433. eCollection 2017.

DOI:10.4414/smw.2017.14433

PMID:28488263

Abstract

QUESTIONS UNDER STUDY

Chronic pain has a high impact on individuals and society. (Cost-)effective interventions are desperately needed. We evaluated short- and long-term effects of the Bern Ambulatory Interprofessional Rehabilitation (BAI-Reha) for patients with chronic musculoskeletal pain.

METHODS

We analysed data prospectively collected from patients with chronic musculoskeletal pain before and after BAI-Reha (at 12 weeks, 1 year and 2 years) using linear mixed-models and logistic generalised estimating equations.

RESULTS

The first thirty consecutive patients with chronic musculoskeletal pain, aged between 20 and 73 years (mean 44.83, standard deviation 12.57 years) were included. We found significant changes over time compared with baseline for return to work (p <0.001), Euro quality of life visual analogue scale score (p = 0.026), burden of suffering (p = 0.001), self-rated and observed quality of daily life task motor performance (p <0.001 and p = 0.012, respectively) but not for pain intensity (p = 0.16) and observed quality of daily life task process performance (p = 0.28). At the first postintervention visit we found significant differences compared with baseline in return to work (odds ratio 5.26, 95% confidence interval [CI] 1.80-15.39], burden of suffering (mean difference 5.26, 95% CI 2.09-8.44], self-rated quality (mean difference 2.31, 95% CI 1.57-3.05) and satisfaction (mean difference 2.80, 95% CI 1.95-3.66) with daily life task performance, and observed quality with daily life task motor performance (mean difference 0.31, 95% CI 0.02-0.60).

CONCLUSIONS

This study confirms earlier data and supports the effectiveness of interprofessional rehabilitation for patients with chronic musculoskeletal pain.

摘要

研究的问题

慢性疼痛对个人和社会有很大影响。迫切需要（具有成本效益的）有效干预措施。我们评估了伯尔尼门诊跨专业康复（BAI-Reha）对慢性肌肉骨骼疼痛患者的短期和长期影响。

方法

我们使用线性混合模型和逻辑广义估计方程，分析了从慢性肌肉骨骼疼痛患者在BAI-Reha之前和之后（12周、1年和2年）前瞻性收集的数据。

结果

纳入了前30例年龄在20至73岁之间（平均44.83岁，标准差12.57岁）的慢性肌肉骨骼疼痛患者。我们发现，与基线相比，随时间推移，在重返工作（p<0.001）、欧洲生活质量视觉模拟量表评分（p = 0.026）、痛苦负担（p = 0.001）、自我评定和观察到的日常生活任务运动表现质量（分别为p<0.001和p = 0.012）方面有显著变化，但在疼痛强度（p = 0.16）和观察到的日常生活任务过程表现质量（p = 0.28）方面没有变化。在首次干预后访视时，我们发现与基线相比，在重返工作（优势比5.26，95%置信区间[CI]1.80 - 15.39）、痛苦负担（平均差异5.26，95%CI 2.09 - 8.44）、自我评定质量（平均差异2.31，95%CI 1.57 - 3.05）和对日常生活任务表现的满意度（平均差异2.80，95%CI 1.95 - 3.66）以及观察到的日常生活任务运动表现质量（平均差异0.31，95%CI 0.02 - 0.60）方面存在显著差异。