Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Center for Health Services Research in Medicine, Schwabachanlage 6, 91054, Erlangen, Germany.
Interdisciplinary Pain Center, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstr. 12, 91054, Erlangen, Germany.
BMC Neurol. 2022 Apr 21;22(1):149. doi: 10.1186/s12883-022-02646-w.
We do not yet know whether or the extent to which multimodal therapy changes the health behaviors and health service use of chronic headache patients in the long term. Associations are expected between pain symptoms and pain management abilities for patients who are categorized as successfully treated and those who remain unchanged.
Routine longitudinal data of an enrolment period of five years from 101 headache patients treated with a two-week, full-day, semi-inpatient multimodal pain therapy at the Interdisciplinary Pain Center of the University Clinic Erlangen were available when therapy began and 12 months after treatment. To investigate long-term changes in health behavior and health service use as well as their associations with the outcome "reduction in pain days," we used descriptive and inferential statistics (i.e., binary logistic regression).
Patients who underwent interdisciplinary treatment showed statistically significant changes in their health behavior in five areas. Twelve months after treatment, we found a significantly higher frequency of engagement in athletic sports (p < .001) as well as increases in the use of relaxation techniques (p < .001), TENS devices for relaxation purposes (p = .008), psychological coping strategies (p < .001), and mindfulness-based techniques for dealing with pain (p < .001). 52.8% of the sample reported a reduction in the number of pain days 12 months after treatment. Binary logistic regression (χ (12) = 21.419; p = .045; R = .255) revealed that a reduction in pain days 12 months after treatment was positively associated with regular physical activity in the form of muscle strengthening and stretching (athletic sports) (p = .012).
Chronic headache patients acquired long-term skills from an interdisciplinary treatment concerning the use of relaxation techniques, the use of psychological coping strategies, and physical activity in the form of athletic exercise. Of those, regular athletic exercise was positively associated with a smaller number of pain days in the long term. Thus, a physical activity module should be an element of interdisciplinary treatment for chronic headache patients.
我们目前尚不清楚多模式疗法是否会以及在何种程度上改变慢性头痛患者的健康行为和卫生服务利用情况。对于被归类为治疗成功和无变化的患者，预计疼痛症状和疼痛管理能力之间存在关联。
在治疗开始时和治疗后 12 个月，我们获得了 101 例慢性头痛患者在埃朗根大学诊所的跨学科疼痛中心接受为期两周、全日制、半住院多模式疼痛治疗的五年登记期的常规纵向数据。为了研究健康行为和卫生服务利用的长期变化及其与“疼痛天数减少”结果的关系，我们使用了描述性和推理统计（即二元逻辑回归）。
接受跨学科治疗的患者在五个方面的健康行为发生了统计学显著变化。治疗后 12 个月，我们发现参与运动的频率显著增加（p<0.001），以及放松技术的使用增加（p<0.001）、用于放松的 TENS 设备（p=0.008）、心理应对策略（p<0.001）和正念技术处理疼痛（p<0.001）。治疗后 12 个月，样本中有 52.8%报告疼痛天数减少。二元逻辑回归（χ（12）=21.419；p=0.045；R=0.255）显示，治疗后 12 个月疼痛天数减少与定期体育活动（肌肉强化和拉伸形式的运动）呈正相关（p=0.012）。
慢性头痛患者从跨学科治疗中获得了长期技能，涉及放松技术的使用、心理应对策略的使用以及以运动锻炼形式的身体活动。其中，定期运动与长期疼痛天数减少呈正相关。因此，身体活动模块应该成为慢性头痛患者跨学科治疗的一个要素。
