新诊断脊髓损伤患者的心理社会因素与肌肉骨骼疼痛的关系。
Relationship of psychosocial factors and musculoskeletal pain among individuals with newly acquired spinal cord injury.
机构信息
Department of Physical Therapy and Rehabilitation Science, Drexel University, Philadelphia, PA, USA.
School of Public Health, Drexel University, Philadelphia, PA, USA.
出版信息
Spinal Cord Ser Cases. 2021 Jul 19;7(1):61. doi: 10.1038/s41394-021-00415-4.
STUDY DESIGN
Cross-sectional analysis of baseline data of a longitudinal cohort study.
OBJECTIVES
Little evidence exists on pain-related psychosocial factors in individuals with newly acquired spinal cord injury (SCI). To understand a biopsychosocial model of pain, we must first understand the presenting psychological pain-related factors at injury onset. Therefore, we assessed musculoskeletal pain and pain-related psychological constructs in a group of individuals with newly acquired SCI. We hypothesized that individuals with new SCI would report musculoskeletal shoulder pain with elevated levels of kinesiophobia and pain catastrophizing.
SETTING
Data were collected in three rehabilitation hospitals located in urban and suburban communities.
METHODS
Thirty-five individuals with newly acquired SCI participated. Demographics, Musculoskeletal Pain Survey shoulder subscale, Tampa Kinesiophobia Scale-11, Pain Catastrophizing Scale, Fear of Pain Questionnaire, Chronic Pain Coping Inventory-42, and Subjective Quality of Life Questionnaire were administered. Descriptive analysis of all measures was determined and relationships between pain and psychosocial measures determined.
RESULTS
Moderate shoulder pain existed in 40% of people with new SCI along with clinically elevated kinesiophobia, pain catastrophizing, fear of pain, and reduced quality of life. Shoulder pain was statistically associated with pain catastrophizing (ρ = 0.41, p = 0.01). Kinesiophobia positively correlated with fear of pain (ρ = 0.38, p = 0.02) with an inverse relationship to quality of life (ρ = -0.47, p = 0.01).
CONCLUSIONS
Elevated pain, and pain-related psychological characteristics, such as catastrophizing and kinesiophobia exist during the early stages after SCI. Early identification of pain-related factors can guide clinical intervention potentially ameliorating pain-linked functional impairments.
TRIAL REGISTRY
This trial is registered with ClinTrial.gov ID NCT03137394.
研究设计
对一项纵向队列研究的基线数据进行的横断面分析。
研究目的
在新获得脊髓损伤（SCI）的个体中，与疼痛相关的心理社会因素的证据很少。为了了解疼痛的生物心理社会模型，我们首先必须了解损伤起始时出现的与疼痛相关的心理因素。因此，我们评估了一组新获得 SCI 个体的肌肉骨骼疼痛和与疼痛相关的心理结构。我们假设新 SCI 患者会报告肌肉骨骼肩部疼痛，同时伴有较高水平的运动恐惧和疼痛灾难化。
研究地点
数据收集于位于城市和郊区社区的三家康复医院。
研究方法
35 名新获得 SCI 的患者参与了本研究。评估了人口统计学资料、肌肉骨骼疼痛调查肩部子量表、坦帕运动恐惧量表-11、疼痛灾难化量表、疼痛恐惧问卷、慢性疼痛应对量表-42 和主观生活质量问卷。确定了所有测量指标的描述性分析，并确定了疼痛与心理社会测量指标之间的关系。
研究结果
40%的新 SCI 患者存在中度肩部疼痛，同时伴有明显的运动恐惧、疼痛灾难化、疼痛恐惧和生活质量下降。肩部疼痛与疼痛灾难化呈统计学相关（ρ=0.41，p=0.01）。运动恐惧与疼痛恐惧呈正相关（ρ=0.38，p=0.02），与生活质量呈负相关（ρ=-0.47，p=0.01）。
研究结论
在 SCI 后早期即存在较高的疼痛和与疼痛相关的心理特征，如灾难化和运动恐惧。早期识别疼痛相关因素可以指导临床干预，可能改善与疼痛相关的功能障碍。
临床试验注册号
本试验在 ClinTrial.gov 注册号为 NCT03137394。
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