Tatta Joe, Nijs Jo, Elma Ömer, Malfliet Anneleen, Magnusson Dawn
Integrative Pain Science Institute, New York, New York, USA.
Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
Phys Ther. 2022 Apr 1;102(4). doi: 10.1093/ptj/pzab296.
Physical therapists have unique education in the comprehensive biopsychosocial assessment and treatment of chronic pain and its mechanisms. Recently, physical therapists have raised awareness regarding the impact of nutrition on promoting health and managing noncommunicable diseases. Robust evidence supports the implementation of nutrition in physical therapist education and practice. Of particular interest for the physical therapist are investigations that use dietary interventions for the treatment of chronic pain. Yet physical therapists have received little guidance regarding their role in nutrition care for pain management and may pass on opportunities to counsel their patients on the connection between nutrition and pain. Therefore, a clinical paradigm shift and unified voice within the profession is called on to encourage physical therapists to develop tailored multimodal lifestyle interventions that include nutrition care for the management of chronic pain. This Perspective describes evidence supporting the implementation of nutrition care in physical therapist practice, supports the role of nutritional pain management for physical therapists, and encourages the use of nutrition care for primary, secondary, tertiary, prevention, health promotion, and wellness related to chronic pain. To achieve these aims, this Perspective offers suggestions for how physical therapists can (1) enhance clinical decision making; (2) expand professional, jurisdictional, and personal scope of practice; (3) evolve entry-level education; and (4) stimulate new investigations in nutrition care and pain science research. In doing so, physical therapists can assert their role throughout the pain management continuum, champion innovative research initiatives, and enhance public health by reducing the impact of chronic pain.
The nutrition care process for pain management is defined as the basic duty to provide adequate and appropriate nutrition education and counseling to people living with pain. Including the nutrition care process as part of a multimodal approach to pain management provides an opportunity for physical therapists to assert their role throughout the pain management continuum. This includes championing innovative research initiatives and enhancing public health by reducing the impact of chronic pain for over 50 million Americans.
物理治疗师在慢性疼痛及其机制的综合生物心理社会评估和治疗方面接受过独特的教育。最近，物理治疗师提高了对营养在促进健康和管理非传染性疾病方面影响的认识。有力的证据支持在物理治疗师的教育和实践中实施营养相关内容。对物理治疗师特别有意义的是那些使用饮食干预来治疗慢性疼痛的研究。然而，物理治疗师在疼痛管理的营养护理方面所扮演的角色几乎没有得到指导，可能会错过为患者提供关于营养与疼痛之间联系咨询的机会。因此，需要该行业进行临床范式转变并形成统一的声音，以鼓励物理治疗师制定量身定制的多模式生活方式干预措施，包括针对慢性疼痛管理的营养护理。本观点阐述了支持在物理治疗师实践中实施营养护理的证据，支持物理治疗师在营养性疼痛管理中的作用，并鼓励将营养护理用于与慢性疼痛相关的一级、二级、三级预防、健康促进和健康维护。为实现这些目标，本观点就物理治疗师如何能够：（1）加强临床决策；（2）扩大专业、管辖和个人的实践范围；（3）改进入门级教育；以及（4）激发营养护理和疼痛科学研究的新调查，提供了建议。通过这样做，物理治疗师可以在整个疼痛管理连续过程中确立自己的角色，支持创新研究计划，并通过减少慢性疼痛的影响来改善公众健康。
疼痛管理的营养护理过程被定义为向疼痛患者提供充分和适当的营养教育与咨询的基本职责。将营养护理过程纳入疼痛管理的多模式方法中，为物理治疗师在整个疼痛管理连续过程中确立自己的角色提供了机会。这包括支持创新研究计划，并通过减少慢性疼痛对超过5000万美国人的影响来改善公众健康。
