颅脑损伤后合并颈痛的退伍军人中，创伤后头痛的严重程度和功能影响更大。
Greater Severity and Functional Impact of Post-traumatic Headache in Veterans With Comorbid Neck Pain Following Traumatic Brain Injury.
机构信息
Department of Orthopaedic Surgery, University of California San Diego, La Jolla, CA 92037, USA.
Department of Physical Therapy, San Diego State University, School of Exercise and Nutritional Sciences, San Diego, CA 92182, USA.
出版信息
Mil Med. 2021 Nov 2;186(11-12):1207-1214. doi: 10.1093/milmed/usaa532.
BACKGROUND
Post-traumatic headache (PTH) is a commonly experienced symptom after mild traumatic brain injury (mTBI). Blast injury- or blunt injury-related mechanisms for mTBI in veterans can also affect musculoskeletal structures in the neck, resulting in comorbid neck pain (NP). However, it is unknown whether the presence of comorbid NP may be associated with a different pattern of headache symptoms, physical functioning, or emotional functioning compared to those without comorbid NP. The purpose of this study is to examine the role of comorbid NP in veterans with mTBI and PTH.
DESIGN AND METHODS
This was a cross-sectional investigation of an existing dataset that included 33 veterans who met inclusion criteria for PTH after mTBI. Standardized measures of headache severity and frequency, insomnia, fatigue, mood disorders, and physical and emotional role function were compared between groups with and without comorbid NP.
RESULTS
The majority of participants with PTH reported comorbid NP (n = 22/33, 67%). Those with comorbid NP experienced more headache symptoms that were severe or incapacitating, as compared to mild or moderate for those without NP (φ = 0.343, P = .049); however, no differences in headache frequency (φ = 0.231, P = .231) or duration (φ = 0.129, P = .712) were observed. Participants with comorbid NP also reported greater insomnia (d = 1.16, P = .003) and fatigue (d = 0.868, P = .040) as well as lower physical functioning (d = 0.802, P = .036) and greater bodily pain (d = 0.762, P = .012). There were no differences in anxiety, depression, mental health, emotional role limitations, vitality, or social functioning between those with and without comorbid NP (d ≤ 0.656, P ≥ .079).
CONCLUSIONS
A majority of veterans with mTBI and PTH in our sample reported comorbid NP that was associated with greater headache symptom severity and physical limitations, but not with mood or emotional limitations. Preliminary findings from this small convenience sample indicate that routine assessment of comorbid NP and associated physical limitations should be considered in veterans with mTBI and PTH.
背景
创伤后头痛（PTH）是轻度创伤性脑损伤（mTBI）后常见的症状。创伤后引起的冲击伤或钝伤相关机制也会影响颈部的肌肉骨骼结构，导致并发颈部疼痛（NP）。然而，目前尚不清楚并发 NP 是否与头痛症状、身体功能或情绪功能模式不同，与无并发 NP 的患者相比。本研究的目的是研究并发 NP 在 mTBI 伴 PTH 的退伍军人中的作用。
设计和方法
这是一项对现有数据集的横断面调查，该数据集包括符合 mTBI 后 PTH 纳入标准的 33 名退伍军人。对头痛严重程度和频率、失眠、疲劳、情绪障碍以及身体和情绪角色功能的标准化测量在有和无并发 NP 的组之间进行比较。
结果
大多数 PTH 患者报告并发 NP（n=33，67%）。与无 NP 的患者相比，有 NP 的患者头痛症状更严重或更致残（φ=0.343，P=0.049），而头痛频率（φ=0.231，P=0.231）或持续时间（φ=0.129，P=0.712）无差异。有 NP 的患者还报告了更多的失眠（d=1.16，P=0.003）和疲劳（d=0.868，P=0.040），以及更低的身体功能（d=0.802，P=0.036）和更多的身体疼痛（d=0.762，P=0.012）。有和无并发 NP 的患者在焦虑、抑郁、心理健康、情绪角色限制、活力或社会功能方面无差异（d≤0.656，P≥0.079）。
结论
在我们的样本中，大多数患有 mTBI 和 PTH 的退伍军人报告并发 NP，这与更严重的头痛症状和身体限制有关，但与情绪或情感限制无关。来自这个小便利样本的初步研究结果表明，在患有 mTBI 和 PTH 的退伍军人中，应考虑常规评估并发 NP 及相关的身体限制。
Zotero 插件