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评估头颈部癌症患者的颈部残疾和疼痛的主观和客观测量方法。

Subjective and Objective Measures in Assessing Neck Disability and Pain in Head and Neck Cancer.

机构信息

Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.

Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.

出版信息

Laryngoscope. 2021 Sep;131(9):2015-2022. doi: 10.1002/lary.29488. Epub 2021 Mar 3.

Abstract

OBJECTIVE/HYPOTHESIS: The intensification of treatment for head and neck cancers (HNCs) has created a cohort of patients living with short- and long-term comorbidities and functional deficits. This study aimed to determine whether there is a relationship between patient-reported outcomes (PROs) and objective measures of neck function in survivors of HNCs.

STUDY DESIGN

Cross-sectional study.

METHODS

Thirty-one subjects (aged 64 ± 8.7 years; 28 males and three females) were recruited and completed the Neck Disability Index (NDI) and a numeric pain scale. At the same visit, subjects were fitted with two portable motion sensors to collect range of motion (ROM) and velocity data. Differences between ROM, velocity, and PRO subgroups were assessed using a one-tailed t test (*P < .05). The Pearson correlation coefficient (r) was calculated between the NDI values and the ROM and velocity values for each motion.

RESULTS

A moderate correlation (r = 0.507) was observed between NDI and neck pain. Patients with no disability according to the NDI had significantly higher ROM and velocity than patients with mild to moderate disability. Velocity in all degrees of freedom (axial rotation, flexion and extension, and lateral bending) was significantly lower for patients who perceived higher levels of neck pain and neck disability.

CONCLUSIONS

This study notes that patients who report neck disability and pain have more limited ROM and velocity following HNC treatment. These data may improve treatment planning and care delivery by facilitating an understanding of the experiences of HNC survivors and the pathophysiology that must be targeted to address their psychosocial and functional deficits.

LEVEL OF EVIDENCE

4 Laryngoscope, 131:2015-2022, 2021.

摘要

目的/假设:头颈部癌症(HNC)治疗的强化导致了一群患有短期和长期合并症和功能缺陷的患者。本研究旨在确定 HNC 幸存者的患者报告结局(PRO)与颈部功能的客观测量之间是否存在关系。

研究设计

横断面研究。

方法

招募了 31 名受试者(年龄 64±8.7 岁;28 名男性和 3 名女性),并完成了颈部残疾指数(NDI)和数字疼痛量表。在同一就诊时,为受试者配备了两个便携式运动传感器,以收集运动范围(ROM)和速度数据。使用单尾 t 检验评估 ROM、速度和 PRO 亚组之间的差异(*P<.05)。计算 NDI 值与每个运动的 ROM 和速度值之间的 Pearson 相关系数(r)。

结果

NDI 与颈部疼痛之间观察到中度相关性(r=0.507)。根据 NDI 无残疾的患者的 ROM 和速度明显高于轻度至中度残疾的患者。在所有自由度(轴向旋转、屈伸和侧屈)中,感知到更高水平的颈部疼痛和颈部残疾的患者的速度明显较低。

结论

本研究指出,报告颈部残疾和疼痛的患者在接受 HNC 治疗后 ROM 和速度的限制更大。这些数据可以通过了解 HNC 幸存者的经历和必须针对的病理生理学来改善治疗计划和护理提供,从而解决他们的社会心理和功能缺陷。

证据水平

4 级喉镜,131:2015-2022,2021。

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