Inoue Masayuki, Ikemoto Tatsunori, Inoue Shinsuke, Nakata Masatoshi, Nishihara Makoto, Arai Young-Chang P, Miyagawa Hirofumi, Shimo Kazuhiro, Iida Hiroki, Hasegawa Tomomi, Wakabayashi Toshiko, Sakurai Hiroki, Hasegawa Yoshinobu, Owari Keiko, Hatakeyama Noboru, Ushida Takahiro
Institute of Physical Fitness, Sports Medicine and Rehabilitation, School of Medicine, Aichi Medical University, Aichi, Japan; Multidisciplinary Pain Center, Aichi Medical University, Aichi, Japan.
Institute of Physical Fitness, Sports Medicine and Rehabilitation, School of Medicine, Aichi Medical University, Aichi, Japan; Multidisciplinary Pain Center, Aichi Medical University, Aichi, Japan.
J Orthop Sci. 2017 Nov;22(6):1132-1137. doi: 10.1016/j.jos.2017.07.005. Epub 2017 Aug 5.
Numerous reports indicate that multifaceted pain management programs based on cognitive-behavioral principles are associated with clinically meaningful long-term improvements in chronic pain. However, this has not yet been investigated in Japan. This study investigated the effects of a multifaceted pain management program in Japanese patients with chronic pain, both immediately after the program and 6 months thereafter.
A total of 96 patients, 37 male and 59 female (mean age 63.8 years) experiencing treatment difficulties and suffering from intractable pain for more than 6 months were enrolled in the study. The programs were conducted with groups of 5-7 patients who met weekly for 9 weeks. Weekly sessions of approximately 2 h in duration incorporating a combination of lectures and exercise were conducted. Several measures related to pain and physical function were assessed at the start of the program, the end of the program, and 6 months after completion of the program. The resulting data were analyzed via Wilcoxon signed-rank test, and 'r' estimated by effect size was also assessed.
Of the 96 initial participants, 11 dropped out during the program and 85 completed it. Thereafter, we evaluated 62 subjects at 6 months after the program, while 23 could not be evaluated at that time-point. Pain intensity upon moving, catastrophizing scores, and pain disability scores showed good improvements at the 6-month follow-up, with large efficacy (r > 0.5). Moving capacity and 6-min walking distance also showed good improvements with large efficacy, both at the end of the program and at the 6-month follow-up (r > 0.5).
A multifaceted pain-management program based on cognitive-behavioral principles was effective in Japanese patients with chronic pain, resulting in improved long-term clinical outcomes.
众多报告表明，基于认知行为原则的多方面疼痛管理方案与慢性疼痛临床上有意义的长期改善相关。然而，这在日本尚未得到研究。本研究调查了多方面疼痛管理方案对日本慢性疼痛患者的影响，包括方案结束后即刻以及此后6个月的影响。
共有96例患者（37例男性和59例女性，平均年龄63.8岁）纳入研究，这些患者存在治疗困难且患有顽固性疼痛超过6个月。该方案以5至7名患者为一组进行，每周进行一次，共9周。每周进行约2小时的课程，包括讲座和运动相结合的内容。在方案开始时、结束时以及方案完成后6个月评估了与疼痛和身体功能相关的多项指标。所得数据通过Wilcoxon符号秩检验进行分析，还评估了效应大小估计的“r”值。
96名初始参与者中，11名在方案期间退出，85名完成了方案。此后，我们在方案结束6个月后评估了62名受试者，而23名在该时间点无法进行评估。在6个月随访时，活动时的疼痛强度、灾难化评分和疼痛残疾评分显示出良好改善，效应较大（r>0.5）。活动能力和6分钟步行距离在方案结束时和6个月随访时也显示出良好改善，效应较大（r>0.5）。
基于认知行为原则的多方面疼痛管理方案对日本慢性疼痛患者有效，可带来长期临床结果的改善。
