心理因素与肌肉骨骼疼痛患者的运动诱发疼痛有关吗？系统评价和荟萃分析。
Do psychological factors relate to movement-evoked pain in people with musculoskeletal pain? A systematic review and meta-analysis.
机构信息
Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium; Pain in Motion International Research Group, Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium.
Pain in Motion International Research Group, Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Physical Medicine and Physical Therapy, University Hospital Brussels, Belgium; Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
出版信息
Braz J Phys Ther. 2022 Nov-Dec;26(6):100453. doi: 10.1016/j.bjpt.2022.100453. Epub 2022 Oct 17.
BACKGROUND
A growing body of evidence has demonstrated the importance of implementing movement-evoked pain in conventional pain assessments, with a significant role for psychological factors being suggested. Whether or not to include these factors in the assessment of movement-evoked pain has not yet been determined.
OBJECTIVES
The aim of this systematic review is to explore the association between psychological factors and movement-evoked pain scores in people with musculoskeletal pain.
METHODS
For this systematic review with meta-analysis, four electronic databases (PubMed, Medline, WOS, and Scopus) were searched. Cross-sectional studies, longitudinal cohort studies, and randomized controlled trials investigating the association between movement-evoked pain and psychological factors in adults with musculoskeletal pain were considered. Meta-analysis was conducted for outcomes with homogeneous data from at least 2 studies. Fischer-Z transformations were used as the measure of effect. Quality of evidence was assessed using the National Institutes of Health's Quality assessment tool for observational cohort and cross-sectional studies and Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.
RESULTS
Meta-analyses and grading the quality of evidence revealed moderate evidence for a relation between movement-evoked pain and depressive symptoms (Fisher-z=0.27; 95%CI: 0.17, 0.36; 5 studies (n=440)), pain-related fear (Fisher-z=0.35; 95%CI: 0.26, 0.44; 6 studies (n=492)), and pain catastrophizing (Fisher-z=0.47; 95%CI: 0.36, 0.58; 4 studies (n=312)) in people with musculoskeletal pain.
CONCLUSIONS
Movement-evoked pain is weakly to moderately associated to depressive symptoms, pain-related fear, and pain catastrophizing in people with musculoskeletal pain.
背景
越来越多的证据表明，在常规疼痛评估中实施运动诱发疼痛的重要性，同时也表明心理因素起着重要作用。是否将这些因素纳入运动诱发疼痛的评估尚未确定。
目的
本系统评价旨在探讨心理因素与肌肉骨骼疼痛患者运动诱发疼痛评分之间的关系。
方法
本系统评价采用荟萃分析，检索了四个电子数据库（PubMed、Medline、WOS 和 Scopus）。纳入了横断面研究、纵向队列研究和随机对照试验，这些研究调查了成年人肌肉骨骼疼痛中运动诱发疼痛与心理因素之间的关系。对至少有 2 项研究具有同质数据的结局进行荟萃分析。Fisher-Z 变换被用作效应的度量。使用美国国立卫生研究院（NIH）的观察性队列和横断面研究质量评估工具以及推荐评估、制定与评估（GRADE）框架来评估证据质量。
结果
荟萃分析和证据质量分级显示，运动诱发疼痛与抑郁症状（Fisher-z=0.27；95%CI：0.17，0.36；5 项研究（n=440））、疼痛相关恐惧（Fisher-z=0.35；95%CI：0.26，0.44；6 项研究（n=492））和疼痛灾难化（Fisher-z=0.47；95%CI：0.36，0.58；4 项研究（n=312））之间存在中度关联。
结论
在肌肉骨骼疼痛患者中，运动诱发疼痛与抑郁症状、疼痛相关恐惧和疼痛灾难化之间存在弱到中度的关联。
Zotero 插件