1 The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Frederiksberg, Denmark.
2 Department of Rheumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Frederiksberg, Denmark.
Clin Rehabil. 2019 Aug;33(8):1367-1381. doi: 10.1177/0269215519843986. Epub 2019 Apr 22.
To evaluate the benefit of adding occupational therapy or physiotherapy interventions to a standard rehabilitation programme targeted for chronic widespread pain.
Randomized active-controlled non-blinded trial.
Women with chronic widespread pain recruited in a tertiary outpatient clinic.
Participants were randomized to a two-week, group-based standard rehabilitation programme followed by 16 weeks of group-based occupational therapy (Group B, = 43) or 16 weeks of group-based physiotherapy (Group B, = 42). Group A only received the two-week rehabilitation programme acting as comparator ( = 96).
Primary outcomes were the Assessment of Motor and Process Skills and Short Form-36 (SF36) Mental Component Summary score.
Mean changes in motor and process ability measures were clinically and statistically insignificant and without differences across the three groups assessed 88 weeks from baseline. Motor ability measures: -0.006 (95% confidence interval (CI): -0.244 to 0.233) in Group B; -0.045 (95% CI: -0.291 to 0.202) in Group B; and -0.017 (95% CI: -0.248 to 0.213) in Group A, = 0.903. Process ability measures: 0.087 (95% CI: -0.056 to 0.231) in Group B; 0.075 (95% CI: -0.075 to 0.226) in Group B; and 0.072 (95% CI: -0.067 to 0.211) in Group A, = 0.924. Mean changes in patient-reported outcomes were likewise small; clinically and statistically insignificant; and independent of group allocation, except for the SF36 mental component summary score in the B group: 8.58 (95% CI: 1.75 to 15.41).
Participants were on average stable in observation-based measures of functional ability and patient-reported outcomes, except in overall mental well-being, favouring the enhanced intervention. Efficacy of additional interventions on functional ability remains uncertain.
评估在针对慢性广泛性疼痛的标准康复方案中加入职业治疗或物理治疗干预的益处。
随机对照非盲试验。
在三级门诊诊所招募的患有慢性广泛性疼痛的女性。
参与者被随机分配到为期两周的基于小组的标准康复方案，然后是 16 周的基于小组的职业治疗（B 组，n=43）或 16 周的基于小组的物理治疗（B 组，n=42）。B 组中只有 A 组在基线后 88 周时仅接受为期两周的康复方案作为对照（n=96）。
主要结果是运动和过程能力评估及简短 36 项健康调查（SF36）精神成分综合评分。
从基线 88 周时，运动和过程能力测量的平均变化在临床和统计学上均无显著差异，且三组之间无差异。运动能力测量：B 组-0.006（95%置信区间（CI）：-0.244 至 0.233）；B 组-0.045（95% CI：-0.291 至 0.202）；A 组-0.017（95% CI：-0.248 至 0.213），P=0.903。过程能力测量：B 组 0.087（95% CI：-0.056 至 0.231）；B 组 0.075（95% CI：-0.075 至 0.226）；A 组 0.072（95% CI：-0.067 至 0.211），P=0.924。患者报告结果的平均变化同样较小；临床和统计学上均无显著差异；且独立于分组分配，除 B 组的 SF36 精神成分综合评分外：8.58（95% CI：1.75 至 15.41）。
参与者在功能能力和患者报告结果的观察性测量中平均稳定，除整体心理健康外，增强干预措施更有利。额外干预对功能能力的疗效仍不确定。
