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联合疼痛教育策略与物理治疗干预对慢性疼痛患者的影响:一项随机对照试验的系统评价和荟萃分析。

The impact of combining pain education strategies with physical therapy interventions for patients with chronic pain: A systematic review and meta-analysis of randomized controlled trials.

机构信息

Department of Physical Therapy, Walsh University; North Canton, OH, USA.

School of Medicine, Public Health and Community Medicine, Tufts University, Boston, MA, USA.

出版信息

Physiother Theory Pract. 2021 Apr;37(4):461-472. doi: 10.1080/09593985.2019.1633714. Epub 2019 Jun 28.

Abstract

: Systematic Review with meta-analysis.: Rehabilitation providers have begun to incorporate pain education into their treatment protocols to influence the patient's experience and knowledge to improve their condition. The purpose of this systematic review is to determine if the addition of pain education strategies to physical therapy treatments is beneficial in reducing pain intensity and disability for those with chronic musculoskeletal pain.: A systematic database search was conducted for randomized control trials that investigated the concurrent use of pain education and physical therapy. Standardized methods for article identification, inclusion, and quality appraisal was utilized. Where possible, studies were pooled for meta-analysis, with pain and disability as the primary outcomes.: Fourteen articles were included in this review, of which all fourteen were rated as high quality using the PEDro scale of quality assessment. Meta-analyses were conducted on pain and disability constructs at short term (< 12 weeks) and long-term (≥ 12 weeks) for the studies that allowed for quantitative pooling of effect sizes. Thirteen out of the fourteen included studies demonstrated a decrease in pain and disability with the use of combined interventions. There was a large effect on short-term pain (SMD 0.837), long-term pain (SMD 0.964), and long-term disability (SMD 1.374). A moderate effect on with short-term disability (SMD 0.791).: The results of this systematic review support the conclusion that utilizing pain education strategies in conjunction with interventions provided by physical therapists demonstrates a moderate to large effect sizes on pain and disability constructs but lack pooled statistical significance.

摘要

系统评价与荟萃分析

康复提供者已开始将疼痛教育纳入其治疗方案中,以影响患者的体验和知识,从而改善他们的病情。本系统评价的目的是确定在物理治疗中加入疼痛教育策略是否有益于减轻慢性肌肉骨骼疼痛患者的疼痛强度和残疾程度。

对调查疼痛教育与物理治疗同时使用的随机对照试验进行了系统的数据库搜索。采用了标准化的文章识别、纳入和质量评估方法。在可能的情况下,对研究进行了荟萃分析,以疼痛和残疾为主要结局。

本综述共纳入了 14 篇文章,其中所有 14 篇文章均使用 PEDro 量表进行质量评估,被评为高质量。对允许定量汇总效应大小的研究进行了短期(<12 周)和长期(≥12 周)的疼痛和残疾结构的荟萃分析。在使用联合干预措施的 14 项研究中,有 13 项研究显示疼痛和残疾程度降低。短期疼痛(SMD 0.837)、长期疼痛(SMD 0.964)和长期残疾(SMD 1.374)的效果较大。短期残疾(SMD 0.791)的效果中等。

本系统评价的结果支持以下结论

在物理治疗师提供的干预措施中加入疼痛教育策略,对疼痛和残疾结构有中度到较大的效果,但缺乏汇总的统计学意义。

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