Department of Orthopedics and Sports Medicine, Seattle, WA.
Department of Orthopedics and Sports Medicine, Seattle, WA; Department of Adolescent Medicine, Seattle Children's Hospital, Seattle, WA; Department of Pediatrics, University of Washington, Seattle, WA.
J Hand Surg Am. 2021 Feb;46(2):152.e1-152.e6. doi: 10.1016/j.jhsa.2020.09.005. Epub 2020 Nov 19.
Biofeedback is a self-regulation technique in which patients learn to control what were once thought to be involuntary bodily processes. The goal of this study was to examine a sample of adolescents with persistent, nonspecific wrist and forearm pain to assess whether biofeedback can improve symptoms. A secondary goal was to identify any shared characteristics.
This is a retrospective case series of patients seen by an upper-extremity surgeon and a biofeedback expert at a pediatric hospital from 2011 through 2017. Data collected included Multidimensional Anxiety Scale for Children (MASC) and Children's Depression Inventory (CDI) scores, pain intensity, frequency, and duration; as well as self-report of depression, anxiety, self-harm, and/or suicidal ideation. Additional data included biological sex, brace or orthosis wear, history of injury, prior medical or surgical treatments, and the presence of paresthesias. Biofeedback sessions were held every 1 to 2 weeks, for typically 5 sessions.
Sixteen patients met inclusion criteria; 9 completed biofeedback. Eight patients were female (88%) and 1 was male (11%). The dominant extremity was affected in 8 patients (89%). Seven of the 9 patients who completed biofeedback had improvement or resolution of symptoms (78%). Both patients who completed biofeedback but did not have improvement in pain underwent surgery before biofeedback referral. Three patients reported paresthesias; each had an elevated CDI and MASC score (33%). Six patients did not report paresthesias, and one patient had similar elevated CDI and MASC scores CONCLUSIONS: More females than males were seen and referred to biofeedback in this study group. There appears to be an association between underlying anxiety or depression and the report of paresthesias. Biofeedback is an available nonsurgical treatment modality for persistent wrist and forearm pain that should be considered in appropriate patients.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic V.
生物反馈是一种自我调节技术，通过该技术，患者学会控制曾经被认为是无意识的身体过程。本研究的目的是检查一组患有持续性、非特异性腕部和前臂疼痛的青少年患者，以评估生物反馈是否可以改善症状。次要目标是确定任何共同特征。
这是对 2011 年至 2017 年间在一家儿童医院就诊的上肢外科医生和生物反馈专家的一组患者进行的回顾性病例系列研究。收集的数据包括多维焦虑量表儿童版（MASC）和儿童抑郁量表（CDI）评分、疼痛强度、频率和持续时间；以及抑郁、焦虑、自残和/或自杀意念的自我报告。其他数据包括生物性别、支具或矫形器佩戴、受伤史、既往医疗或手术治疗以及感觉异常的存在。生物反馈治疗每 1 到 2 周进行一次，通常进行 5 次。
16 名患者符合纳入标准；9 名患者完成了生物反馈治疗。8 名患者为女性（88%），1 名患者为男性（11%）。优势侧上肢受影响 8 例（89%）。9 名完成生物反馈治疗的患者中有 7 名（78%）症状改善或缓解。两名完成生物反馈治疗但疼痛未改善的患者在接受生物反馈治疗前均接受了手术。3 名患者报告感觉异常；每名患者的 CDI 和 MASC 评分均升高（33%）。6 名患者未报告感觉异常，其中 1 名患者的 CDI 和 MASC 评分相似升高。
在本研究组中，接受生物反馈治疗的女性多于男性，且更多见。在报告感觉异常的患者中，似乎存在潜在的焦虑或抑郁与感觉异常之间的关联。生物反馈是治疗持续性腕部和前臂疼痛的一种可行的非手术治疗方法，应在适当的患者中考虑使用。
研究类型/证据水平：治疗性 V 级。
