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基层医疗物理治疗中的肌肉骨骼疼痛:与人口统计学和一般健康特征的关联。

Musculoskeletal pain in Primary Care Physiotherapy: Associations with demographic and general health characteristics.

机构信息

Physiotherapy Department, St John's Community Hospital, Enniscorthy, Co., Wexford, Ireland.

Department of Mathematics and Statistics, University of Limerick, Limerick, Ireland.

出版信息

Musculoskelet Sci Pract. 2018 Jun;35:61-66. doi: 10.1016/j.msksp.2018.03.001. Epub 2018 Mar 8.

Abstract

BACKGROUND

Many patients reporting musculoskeletal pain present to Primary Care Physiotherapy with costly comorbid overlapping complaints that remain medically unexplained. These subjective health complaints (SHC) incorporate coexisting multi-site musculoskeletal pain and varied non-musculoskeletal complaints (e.g. anxiety, tiredness). The role of these non-musculoskeletal complaints is acknowledged in spinal musculoskeletal disorders, but less so for peripheral musculoskeletal disorders.

OBJECTIVE

This cross-sectional study explored the relationships between self-reported musculoskeletal pain sites, non-musculoskeletal complaints and disability among people reporting spinal or peripheral musculoskeletal pain.

METHODS

Fifty individuals with spinal musculoskeletal pain and fifty with peripheral musculoskeletal pain provided data on disability, number of musculoskeletal pain sites and non-musculoskeletal complaints. Relationships between these variables were examined for each group using Pearson's correlation coefficient and linear regression analysis.

RESULTS

Participants with spinal musculoskeletal pain recorded significantly more pain sites and non-musculoskeletal complaints than participants with peripheral musculoskeletal pain. However, there was no significant difference in disability between the groups. Non-musculoskeletal complaints were significantly associated with disability (correlation = 0.41, p < 0.01) and number of pain sites (correlation = 0.42, p < 0.01). Number of pain sites and disability were not significantly associated in either group. Participants with spinal musculoskeletal pain reported more tiredness, dizziness, anxiety and sleep problems. Participants reporting dizziness, anxiety, sadness/depression and sleep problems had higher disability.

CONCLUSION

Further studies must confirm the robustness of these associations, to permit comparisons between clinical and general populations and aid identification of causal factors. Considering SHC within individualised management programmes may improve outcomes.

摘要

背景

许多报告肌肉骨骼疼痛的患者到初级保健物理治疗就诊,同时伴有昂贵的重叠合并症和仍无法用医学解释的症状。这些主观健康抱怨(SHC)包括共存的多部位肌肉骨骼疼痛和各种非肌肉骨骼抱怨(例如焦虑、疲劳)。这些非肌肉骨骼抱怨在脊柱肌肉骨骼疾病中得到承认,但在周围肌肉骨骼疾病中则较少。

目的

本横断面研究探讨了报告有脊柱或周围肌肉骨骼疼痛的人群中,自我报告的肌肉骨骼疼痛部位、非肌肉骨骼抱怨与残疾之间的关系。

方法

50 名患有脊柱肌肉骨骼疼痛的患者和 50 名患有周围肌肉骨骼疼痛的患者提供了残疾、肌肉骨骼疼痛部位数量和非肌肉骨骼抱怨的数据。使用 Pearson 相关系数和线性回归分析分别检查了每组这些变量之间的关系。

结果

患有脊柱肌肉骨骼疼痛的参与者记录的疼痛部位和非肌肉骨骼抱怨明显多于患有周围肌肉骨骼疼痛的参与者。然而,两组之间的残疾程度没有显著差异。非肌肉骨骼抱怨与残疾(相关性=0.41,p<0.01)和疼痛部位数量(相关性=0.42,p<0.01)显著相关。在两组中,疼痛部位数量和残疾程度均无显著相关性。患有脊柱肌肉骨骼疼痛的参与者报告更多的疲劳、头晕、焦虑和睡眠问题。报告头晕、焦虑、悲伤/抑郁和睡眠问题的参与者残疾程度更高。

结论

需要进一步的研究来确认这些关联的稳健性,以便在临床和一般人群之间进行比较,并帮助确定因果因素。在个体化管理计划中考虑 SHC 可能会改善结果。

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