在存在合并症的情况下，根据主观健康投诉和神经质来预测肩周炎（肩关节囊炎）的预后。
Predicting outcome in frozen shoulder (shoulder capsulitis) in presence of comorbidity as measured with subjective health complaints and neuroticism.
作者信息
Sharma Satya Pal, Moe-Nilssen Rolf, Kvåle Alice, Bærheim Anders
机构信息
Research Group, Section for General Practice, Department of Global health and Primary care, University of Bergen, Kalfarveien 31, N-5018, Bergen, Norway.
Physiotherapy Research Group, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
出版信息
BMC Musculoskelet Disord. 2017 Sep 2;18(1):380. doi: 10.1186/s12891-017-1740-9.
BACKGROUND
There is a substantive lack of knowledge about comorbidity in patients with frozen shoulder. The aim of this study was to investigate whether subjective health complaints and Neuroticism would predict treatment outcome in patients diagnosed with frozen shoulder as measured by the Shoulder Pain and Disability Index (SPADI) and change in SPADI.
METHODS
A total of 105 patients with frozen shoulder were recruited for a randomised controlled trial, where 69 were in the intervention group and received intraarticular corticosteroid injections and 36 patients served as control group. The SPADI was used as the outcome measure after 8 weeks, and change in SPADI from baseline to 8 weeks as a measure of rate of recovery. To examine comorbidities, all participants completed the Subjective Health Complaints (SHC) questionnaire with its five subscales, and the Neuroticism (N) component of the Eysenck Personality Questionnaire Revised. Multiple regression analysis was performed with the baseline comorbidity variables that correlated significantly with SPADI after 8 weeks, and with change in SPADI from baseline to 8 weeks, controlling for the variables intervention, age, gender and duration of pain.
RESULTS
In this study, patients with frozen shoulder had little comorbidity as measured with SHC and scored normally with respect to Neuroticism. Only the Pseudoneurology subscale in SHC correlated significantly with SPADI and had significant predictive power (p < 0.001) for the outcome at 8 weeks. The intervention group exhibited significant statistical predictive power (p < 0.001) for the treatment outcome as measured by a change in SPADI from baseline to 8 weeks. Being female also had some predictive significance for change in SPADI (p < 0.005).
CONCLUSION
Psychometric parameters as measured by the Pseudoneurology subscale in SHC questionnaire did predict the treatment outcome in frozen shoulder as measured by SPADI at 8 weeks, but not by change in SPADI from baseline to 8 weeks. One may conclude that psychometric parameters may affect symptoms, but do not predict the rate of recovery in frozen shoulder.
TRIAL REGISTRATION
ClinicalTrials.gov, identifier: NCT01570985 .
背景
目前对肩周炎患者的合并症了解严重不足。本研究的目的是调查主观健康投诉和神经质是否能预测肩周炎患者的治疗结果，治疗结果通过肩痛和功能障碍指数（SPADI）以及SPADI的变化来衡量。
方法
共招募了105名肩周炎患者进行一项随机对照试验，其中69名在干预组，接受关节内皮质类固醇注射，36名患者作为对照组。8周后使用SPADI作为结果指标，并将从基线到8周的SPADI变化作为恢复率的指标。为了检查合并症，所有参与者完成了包含五个子量表的主观健康投诉（SHC）问卷，以及艾森克人格问卷修订版中的神经质（N）分量表。对与8周后SPADI显著相关的基线合并症变量，以及从基线到8周的SPADI变化进行多元回归分析，同时控制干预、年龄、性别和疼痛持续时间等变量。
结果
在本研究中，用SHC测量的肩周炎患者合并症较少，且在神经质方面得分正常。只有SHC中的假性神经症子量表与SPADI显著相关，并且对8周时的结果具有显著预测力（p < 0.001）。干预组对从基线到8周的SPADI变化所衡量的治疗结果具有显著的统计学预测力（p < 0.001）。女性对SPADI的变化也具有一定的预测意义（p < 0.005）。
结论
SHC问卷中的假性神经症子量表所测量的心理测量参数确实能预测8周时肩周炎患者的治疗结果，这一结果通过SPADI来衡量，但不能预测从基线到8周的SPADI变化。可以得出结论，心理测量参数可能会影响症状，但不能预测肩周炎的恢复速度。
试验注册
ClinicalTrials.gov，标识符：NCT01570985 。
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