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H波装置刺激对晚期工伤慢性疼痛索赔者的临床及生活质量益处:一项平均为期2年随访的回顾性观察研究

Clinical and Quality of Life Benefits for End-Stage Workers' Compensation Chronic Pain Claimants following H-Wave Device Stimulation: A Retrospective Observational Study with Mean 2-Year Follow-Up.

作者信息

Trinh Alan, Williamson Tyler K, Han David, Hazlewood Jeffrey E, Norwood Stephen M, Gupta Ashim

机构信息

Indiana University School of Medicine, Indianapolis, IN 46202, USA.

University of the Incarnate Word School of Osteopathic Medicine, San Antonio, TX 78235, USA.

出版信息

J Clin Med. 2023 Feb 1;12(3):1148. doi: 10.3390/jcm12031148.

Abstract

Previously promising short-term H-Wave device stimulation (HWDS) outcomes prompted this retrospective cohort study of the longer-term effects on legacy workers' compensation chronic pain claimants. A detailed chart-review of 157 consecutive claimants undergoing a 30-day HWDS trial (single pain management practice) from February 2018 to November 2019 compiled data on pain, restoration of function, quality of life (QoL), and polypharmacy reduction into a summary spreadsheet for an independent statistical analysis. Non-beneficial trials in 64 (40.8%) ended HWDS use, while 19 (12.1%) trial success charts lacked adequate data for assessing critical outcomes. Of the 74 final treatment study group charts, missing data points were removed for a statistical analysis. Pain chronicity was 7.8 years with 21.6 ± 12.2 months mean follow-up. Mean pain reduction was 35%, with 89% reporting functional improvement. Opioid consumption decreased in 48.8% of users and 41.5% completely stopped; polypharmacy decreased in 36.8% and 24.4% stopped. Zero adverse events were reported and those who still worked usually continued working. An overall positive experience occurred in 66.2% ( < 0.0001), while longer chronicity portended the risk of trial or treatment failure. Positive outcomes in reducing pain, opioid/polypharmacy, and anxiety/depression, while improving function/QoL, occurred in these challenging chronic pain injury claimants. Level of evidence: III.

摘要

先前有前景的短期H波装置刺激(HWDS)结果促使对遗留的工伤慢性疼痛索赔者进行了这项关于长期影响的回顾性队列研究。对2018年2月至2019年11月期间连续接受30天HWDS试验(单一疼痛管理实践)的157名索赔者进行了详细的图表审查,将疼痛、功能恢复、生活质量(QoL)和多药治疗减少的数据整理到一个汇总电子表格中,用于独立的统计分析。64例(40.8%)无益处的试验结束了HWDS的使用,而19例(12.1%)试验成功的图表缺乏评估关键结果的充分数据。在74份最终治疗研究组图表中,去除了缺失的数据点以进行统计分析。疼痛慢性期为7.8年,平均随访21.6±12.2个月。平均疼痛减轻35%,89%的人报告功能有所改善。48.8%的使用者阿片类药物消费量减少,41.5%的使用者完全停用;多药治疗减少的比例为36.8%,24.4%的人停用。未报告不良事件,仍在工作的人通常继续工作。66.2%的人有总体积极体验(<0.0001),而疼痛慢性期越长,试验或治疗失败的风险越大。在这些具有挑战性的慢性疼痛损伤索赔者中,在减轻疼痛、阿片类药物/多药治疗以及焦虑/抑郁方面取得了积极结果,同时改善了功能/生活质量。证据级别:III。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/277b/9917372/86a85a5c851d/jcm-12-01148-g001.jpg

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