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针对持续性肌肉骨骼疼痛障碍自我管理的物理治疗支持

Physiotherapy support for self-management of persisting musculoskeletal pain disorders.

作者信息

Diener Ina

机构信息

Department of Physiotherapy, Faculty of Health Sciences, Stellenbosch University, Stellenbosch, South Africa.

出版信息

S Afr J Physiother. 2021 Oct 29;77(1):1564. doi: 10.4102/sajp.v77i1.1564. eCollection 2021.

Abstract

BACKGROUND

Musculoskeletal pain (MSKP) is an extremely common pain disorder in almost all populations. Self-management (SM) support is a programme to prepare people to self-manage their health condition effectively, while maintaining quality of life. SM is a cost-effective and context-specific strategy to address the global public health burden.

OBJECTIVES

Self-management needs a change in behaviour from seeking unnecessary medical care to safely self-managing symptoms. As changing individuals' behaviour is challenging, the objective of my literature review was to identify the characteristics, in both therapist and patient, to successfully engage in SM.

METHOD

A narrative literature review, that could inform evidence-based support programmes for SM of MSKP.

RESULTS

Studies on successful implementation of SM of MSKP do not report strong outcomes. However, in more recent years a few positive outcomes were reported, possibly as a result of research evidence for the application of psychosocial skills and contemporary pain neuroscience in the management of persistent MSKP.

CONCLUSION

Psychologically-informed physiotherapy, addressing psychosocial barriers to the maintenance of SM programmes, could facilitate more successful outcomes.

CLINICAL IMPLICATIONS

Before engaging in a SM support programme, obstacles to behaviour change must be identified and addressed in a SM support programme, to facilitate individuals towards taking safe responsibility for their healthcare. Therapists working with patients with persistent MSKP, should upskill themselves to be in line with the latest pain and psychosocial research literature. Moreover, communication skills training seems to be a priority for effective SM support programmes.

摘要

背景

肌肉骨骼疼痛(MSKP)在几乎所有人群中都是极为常见的疼痛病症。自我管理(SM)支持是一项帮助人们做好准备,以便在维持生活质量的同时有效自我管理健康状况的计划。自我管理是应对全球公共卫生负担的一种具有成本效益且因地制宜的策略。

目的

自我管理需要人们改变行为,从寻求不必要的医疗护理转变为安全地自我管理症状。由于改变个体行为具有挑战性,我进行文献综述的目的是确定治疗师和患者双方成功参与自我管理的特征。

方法

进行一项叙述性文献综述,为基于证据的肌肉骨骼疼痛自我管理支持计划提供参考。

结果

关于成功实施肌肉骨骼疼痛自我管理的研究并未报告显著成果。然而,近年来有一些积极成果被报道,这可能是由于在持续性肌肉骨骼疼痛管理中应用心理社会技能和当代疼痛神经科学的研究证据所致。

结论

考虑心理因素的物理治疗,解决自我管理计划维持过程中的心理社会障碍,可能会促成更成功的结果。

临床意义

在参与自我管理支持计划之前,必须在自我管理支持计划中识别并解决行为改变的障碍,以促使个体对自身医疗保健承担安全责任。治疗持续性肌肉骨骼疼痛患者的治疗师应提升自身技能,以符合最新的疼痛和心理社会研究文献。此外,沟通技能培训似乎是有效自我管理支持计划的优先事项。

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本文引用的文献

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State of the art: What have the pain sciences brought to physiotherapy?前沿进展:疼痛科学给物理治疗带来了什么?
S Afr J Physiother. 2020 Feb 24;76(1):1390. doi: 10.4102/sajp.v76i1.1390. eCollection 2020.

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