Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway.
Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Eur J Pain. 2022 Feb;26(2):531-542. doi: 10.1002/ejp.1879. Epub 2021 Nov 3.
Recent studies with data-driven approaches have established common pain trajectories. It is uncertain whether these trajectory patterns are consistent over time, and if a shorter measurement period will provide accurate trajectories.
We included 1,124 patients with non-specific neck pain in chiropractic practice. We classified patients into pre-defined trajectory patterns in each of four quarters of the follow-up year (persistent, episodic, and recovery) based on measures of pain intensity and frequency from weekly SMS. We explored the shifts between patterns and compared patients with stable and shifting patterns on baseline characteristics and clinical findings.
785 (70%) patients were in the same pattern in 1st and 4th quarters. Patients with episodic pattern in the 1st quarter shifted to other patterns more frequently than patients in the other patterns. A stable persistent pattern was associated with reduced function and higher scores on psychosocial factors. There was a decreased frequency of patients classified as persistent pattern (75% to 63%) and an increase of patients in recovery pattern (4% to 15%) throughout the four quarters. The frequency of patients classified as episodic remained relatively stable (21% to 24%).
We found an overall stability of the persistent pattern, and that episodic patterns have more potential for shifts. Shifts mostly occurred between patterns closest in pain variation. The deviation in pattern distribution compared with previous studies suggests that the duration of measurement periods has an impact on the results of the classification.
Having persistent pain and having very minor pain is relatively stable over one year, while episodic pain has more potential for shifts. The duration of measurement periods appears to have an impact on the results of the classification. The given criteria resulted in a reduced frequency of episodic pattern due to shorter measurement periods. Our findings contribute to improved understanding and predicting NP using a combination of patient characteristics and trajectory patterns.
最近采用数据驱动方法的研究已经确定了常见的疼痛轨迹。尚不确定这些轨迹模式是否随着时间的推移保持一致，以及较短的测量周期是否会提供准确的轨迹。
我们纳入了 1124 名在脊骨神经科诊所接受治疗的非特异性颈痛患者。我们根据每周 SMS 测量的疼痛强度和频率，将患者分为四个季度随访期的预定义轨迹模式（持续型、发作型和恢复型）。我们探讨了模式之间的转变，并比较了稳定和转变模式的患者在基线特征和临床发现方面的差异。
785 名（70%）患者在第 1 季度和第 4 季度处于相同模式。第 1 季度处于发作型模式的患者比其他模式的患者更频繁地转变为其他模式。稳定的持续型模式与功能降低和心理社会因素评分较高相关。在整个四个季度中，持续型模式的患者比例（从 75%降至 63%）减少，而恢复型模式的患者比例（从 4%增加到 15%）增加。发作型模式的患者比例相对稳定（从 21%到 24%）。
我们发现持续型模式总体稳定，而发作型模式更有可能发生转变。转变主要发生在疼痛变化最接近的模式之间。与先前研究相比，模式分布的偏差表明测量周期的持续时间对分类结果有影响。
持续存在疼痛和非常轻微的疼痛在一年中相对稳定，而发作性疼痛更有可能发生转变。测量周期的持续时间似乎对分类结果有影响。由于测量周期较短，给定的标准导致发作型模式的频率降低。我们的发现有助于通过患者特征和轨迹模式的组合，更好地理解和预测 NP。
