School of Health Sciences (ESSUA), University of Aveiro, Campus Universitário de Santiago, 3800-193, Aveiro, Portugal.
Center for Health Technology and Services Research (CINTESIS), Piso 2, Edifício nascente, Rua Dr. Plácido da Costa, s/n, 4200-450, Porto, Portugal.
Qual Life Res. 2022 Mar;31(3):803-816. doi: 10.1007/s11136-021-02969-0. Epub 2021 Sep 6.
Neck pain tends to persist for periods of 1 to 4 years of follow-up in adolescents, and a high percentage of them report disability. However, studies assessing the factors associated with persistent neck pain and disability in this age group are scarce. This study aimed to explore the association between psychosocial factors, sleep, and symptoms of central sensitization at baseline and the persistence of neck pain and disability at 6-month follow-up.
A total of 710 adolescents with chronic neck pain were assessed at baseline with an online questionnaire that collected information on sociodemographic data, presence of musculoskeletal pain, pain intensity, physical activity, functional disability, depression, anxiety, stress, quality of sleep, catastrophizing, kinesiophobia, self-efficacy, and symptoms of central sensitization. At 6-month follow-up, adolescents were reassessed for disability and pain intensity and categorized as recovered or reporting persistent neck pain.
Of the 710 participants with neck pain at baseline, 334 were classified as having persistent neck pain and 375 adolescents as being recovered at 6-month follow-up. Multivariable analysis showed that female gender (OR 1.47; p = 0.04) and symptoms of central sensitization (OR 1.02; p = 0.001) at baseline were positively associated with the persistence of neck pain at 6-month follow-up. Similarly, higher levels of disability (β = 0.41; p < 0.001) and symptoms of central sensitization (β = 0.28; p < 0.001) at the baseline were positively associated with disability.
Symptoms of central sensitization and disability at baseline should be considered in the assessment and design of interventions for adolescents with chronic neck pain as an attempt to minimize its future impact on pain persistence and disability.
青少年的颈部疼痛在随访 1 至 4 年内往往会持续存在，其中很大一部分人报告存在残疾。然而，评估该年龄段与持续性颈部疼痛和残疾相关的因素的研究很少。本研究旨在探讨基线时的心理社会因素、睡眠和中枢敏化症状与 6 个月随访时持续性颈部疼痛和残疾之间的关系。
共有 710 名患有慢性颈部疼痛的青少年在基线时通过在线问卷进行评估，该问卷收集了社会人口统计学数据、肌肉骨骼疼痛、疼痛强度、身体活动、功能障碍、抑郁、焦虑、压力、睡眠质量、灾难化、运动恐惧、自我效能和中枢敏化症状等信息。在 6 个月随访时，对青少年的残疾和疼痛强度进行重新评估，并将其分为疼痛缓解或持续性颈部疼痛。
在基线时有颈部疼痛的 710 名参与者中，334 名被归类为持续性颈部疼痛，375 名青少年在 6 个月随访时疼痛缓解。多变量分析显示，女性（OR 1.47；p=0.04）和基线时的中枢敏化症状（OR 1.02；p=0.001）与 6 个月随访时颈部疼痛的持续性相关。同样，较高的残疾水平（β=0.41；p<0.001）和基线时的中枢敏化症状（β=0.28；p<0.001）与残疾呈正相关。
基线时的中枢敏化症状和残疾应在评估和设计青少年慢性颈部疼痛的干预措施时加以考虑，以尽量减少其对疼痛持续存在和残疾的未来影响。
