Bluth Martin H, Thomas Ronald, Cohen Cindy, Bluth Amanda C, Goldberg Elimelech
Department of Pathology, Wayne State University School of Medicine, Detroit, MI.
Kids Kicking Cancer, Southfield, MI.
Pediatric Health Med Ther. 2016 Jul 8;7:79-87. doi: 10.2147/PHMT.S104021. eCollection 2016.
Martial arts intervention in disease has been mostly limited to adult inflammatory, musculoskeletal, or motor diseases, where a mechanical intervention effects positive change. However, the application and benefit to pain management in childhood malignancy are not well described. Here, we assess the effects of defined martial arts intervention in children with cancer with respect to their pain perception and management.
Sixty-four children with childhood malignancies were enrolled in a martial arts program, which encompassed both meditation and movement modalities. Pain scores (0-10) were recorded pre- and post- 1-hour session intervention. Pain scores were crossed by total visits and tabulated by whether participant pain reduced at least 1 unit, stayed the same, or increased in intensity immediately after (post) participation session. Differences in pain scores were further compared by age and sex.
Prepain and postpain scale data were measured for 64 participants, 43 males (67.2%) and 21 females (32.8%), ranging from 3 years to 19 years. Preintervention and postintervention data were obtained for 223 individual session visits. Mean number of patient participation visits was 1.8±1.6 (range one to nine visits). Of 116 individual measured sessions where the participants began with a pain score of at least 1, pain intensity reduced ≥1 unit in 85.3% (99/116) of visits, remained the same in 7.8% (9/116), and increased in 6.9% (8/116). For the majority (96.3%; 77/80) of sessions, participants began with a prepain intensity score of at least 5-10 with reduction in pain intensity following the session. The overall mean pain score presession visit was reduced bŷ40% (pre: 5.95±2.64 and post: 3.03±2.45 [95% CI: 2.34-3.50]; ≤0.001). Median pain intensity scores had greater reductions with increased age of participants (3-6 years [-1], 7-10 years [-2], 11-14 years [-3], and 15-19 years [-4]).
Martial arts intervention can provide a useful modality to decrease pain in childhood cancer, with greater effect achieved with higher baseline pain scores and patient age. Martial arts intervention may improve patient compliance with respect to medical and surgical management, thus reducing disease morbidity and health care costs.
武术干预疾病大多局限于成人的炎症性、肌肉骨骼或运动疾病,在这些疾病中机械干预能产生积极变化。然而,武术干预在儿童恶性肿瘤疼痛管理中的应用及益处尚未得到充分描述。在此,我们评估特定武术干预对癌症患儿疼痛感知和管理的影响。
64名患有儿童恶性肿瘤的患儿参加了一个武术项目,该项目包括冥想和运动方式。在1小时课程干预前后记录疼痛评分(0 - 10分)。疼痛评分按总就诊次数进行交叉分析,并按参与者疼痛在课程结束后(课后)强度至少降低1分、保持不变或增加进行列表统计。疼痛评分的差异进一步按年龄和性别进行比较。
对64名参与者(43名男性[67.2%]和21名女性[32.8%],年龄范围为3岁至19岁)测量了课前和课后疼痛量表数据。获得了223次个人课程就诊的干预前和干预后数据。患者参与就诊的平均次数为1.8±1.6次(范围为1至9次就诊)。在116次个人测量课程中,参与者开始时疼痛评分至少为1分,其中85.3%(99/116)的就诊疼痛强度降低≥1分,7.8%(9/116)保持不变,6.9%(8/116)增加。在大多数(96.3%;77/80)课程中,参与者开始时课前疼痛强度评分为至少5 - 10分,课程结束后疼痛强度降低。课程前就诊的总体平均疼痛评分降低了40%(课前:5.95±2.64,课后:3.03±2.45[95%CI:2.34 - 3.50];P≤0.001)。随着参与者年龄增加,疼痛强度中位数评分降低幅度更大(3 - 6岁[-1],7 - 10岁[-2],11 - 14岁[-3],15 - 至19岁[-4])。
武术干预可为减轻儿童癌症疼痛提供一种有用的方式,基线疼痛评分越高和患者年龄越大,效果越好。武术干预可能会提高患者对医疗和手术管理的依从性,从而降低疾病发病率和医疗保健成本。