Hasuo Hideaki, Oomori Hideya, Yoshida Kohei, Fukunaga Mikihiko
Department of Psychosomatic Medicine, Kansai Medical University, Hirakata, Japan.
Front Psychiatry. 2022 Aug 22;13:794425. doi: 10.3389/fpsyt.2022.794425. eCollection 2022.
Expectations for treatment have a favorable effect on the subsequent course of pain and behavior in patients. It is not known whether receiving hydrodissection while patients view their ultrasound image with doctors (visual feedback) is associated with positive treatment expectations. This was an exploratory, prospective, observational clinical trial. We explored the possibility that visual feedback immediately after ultrasound-guided hydrodissection increases the expectations for treatment, which could be one of the related factors for pain reduction. Treatment expectations were set as mediators of pain using path analysis. The primary endpoint was the numerical rating scale to assess expectations for treatment immediately after hydrodissection, between with and without the visual feedback. During 2019 and 2020, 136 outpatients received ultrasound-guided hydrodissection for myofascial pain syndrome. Of these, 65 (47.8%) patients received visual feedback during ultrasound-guided hydrodissection. Compared with the non-visual feedback group, the visual feedback group had higher expectations for treatment immediately after hydrodissection, and their expectations were maintained at day 14 of treatment ( < 0.001). A numerical rating scale (NRS) to assess expectations for treatment was similar before hydrodissection and immediately after hydrodissection was 8.4 (standard deviations, 1.6) in the visual feedback and 5.9 (standard deviations, 2.6) in the visual feedback. The proportion of increased expectations immediately after hydrodissection was 90.8% (95% CI: 83.7-97.9) in visual feedback group and 38.0% (95% CI: 26.7-49.3) in non-visual feedback group ( < 0.001). In the visual feedback group, 67.7% of patients showed improvement in pain numerical rating scale score by 50% or more at day 14, whereas such improvement was observed in only 36.6% of the non-visual feedback group ( < 0.001). Based on path analysis, the visual feedback had the greatest influence on pain numerical rating scale reduction at 14 days, indirectly due to increased expectations for treatment as a mediator (β = 0.434). However, the adjusted values, which is the overall fit of the model, was low at 0.298. Visual feedback during ultrasound-guided hydrodissection increases the expectations for treatment immediately after hydrodissection, which could be one of the related factors for pain reduction in patients with myofascial pain syndrome.
对治疗的期望对患者后续的疼痛过程和行为有积极影响。目前尚不清楚在患者与医生一起查看超声图像（视觉反馈）时接受水分离术是否与积极的治疗期望相关。这是一项探索性、前瞻性、观察性临床试验。我们探讨了超声引导下水分离术后立即给予视觉反馈会增加治疗期望的可能性，而这可能是疼痛减轻的相关因素之一。使用路径分析将治疗期望设定为疼痛的中介因素。主要终点是采用数字评分量表评估水分离术后立即给予或不给予视觉反馈时的治疗期望。在2019年至2020年期间，136例门诊患者因肌筋膜疼痛综合征接受了超声引导下水分离术。其中，65例（47.8%）患者在超声引导下水分离术期间接受了视觉反馈。与非视觉反馈组相比，视觉反馈组在水分离术后立即对治疗的期望更高，且在治疗第14天时仍保持较高期望（<0.001）。在水分离术前和术后立即用于评估治疗期望的数字评分量表（NRS），视觉反馈组为8.4（标准差1.6），非视觉反馈组为5.9（标准差2.6）。水分离术后立即期望增加的比例在视觉反馈组为90.8%（95%CI：83.7 - 97.9），在非视觉反馈组为38.0%（95%CI：26.7 - 49.3）（<0.001）。在视觉反馈组中，67.7% 的患者在第14天时疼痛数字评分量表得分改善了50%或更多，而在非视觉反馈组中只有36.6% 的患者有此改善（<0.001）。基于路径分析，视觉反馈对第14天时疼痛数字评分量表降低的影响最大，这是由于作为中介因素的治疗期望增加间接导致的（β = 0.434）。然而，作为模型整体拟合度的调整后 值较低，为0.298。超声引导下水分离术期间的视觉反馈会增加水分离术后立即的治疗期望，这可能是肌筋膜疼痛综合征患者疼痛减轻的相关因素之一。
J Yeungnam Med Sci. 2024-7
Front Med (Lausanne). 2021-9-13
J Yeungnam Med Sci. 2024-7
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