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探讨慢性非特异性颈痛患者的太极练习时间、疼痛和情绪的个体内和个体间差异:一项随机对照试验的二次分析。

Investigating Inter- and Intra-individual Differences in Tai Chi Practice Time, Pain, and Mood Among Participants with Chronic Nonspecific Neck Pain: Secondary Analysis of a Randomized Controlled Trial.

机构信息

War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, CA, USA.

Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.

出版信息

J Integr Complement Med. 2023 Apr;29(4):234-240. doi: 10.1089/jicm.2022.0789. Epub 2023 Mar 17.

Abstract

Tai Chi is emerging as a promising treatment for a variety of pain conditions, including chronic nonspecific neck pain. Given this trend, it is important to better understand the dose-response relationship and how pain, anxiety, and depression impact this relationship. This secondary analysis used data from the Tai Chi arm (age = 52.03 ± 10.92 years; 73.68% female;  = 38) of a randomized controlled trial for chronic nonspecific neck pain. The authors tested whether (1) greater home practice time or cumulative practice time during the intervention predicted greater post-treatment reductions in neck pain intensity and (2) reporting greater neck pain intensity during the current week relative to other weeks was associated with lower home practice time during the current week. analyses were conducted to evaluate whether baseline anxiety and depression levels moderated the association between weekly pain intensity and weekly home practice time. While cumulative Tai Chi practice time (i.e., home practice + class time) was associated with post-treatment reductions in neck pain intensity, home practice time alone was not associated with post-treatment reductions in neck pain. Participants with low and moderate baseline anxiety were found to practice less than usual on weeks when pain intensity was worse, while participants with high baseline anxiety were found to practice more than usual on weeks when pain intensity was worse. Baseline depression levels did not moderate the effect of weekly pain intensity on weekly home practice time. Combined class and at-home exposure to Tai Chi appears to be critical to reductions in chronic nonspecific neck pain. In addition, anxiety may be an important characteristic that partially governs the dose-response relationship in participants with chronic nonspecific neck pain. NCT02222051.

摘要

太极拳作为一种有前途的治疗方法,正在逐渐应用于多种疼痛病症,包括慢性非特异性颈痛。鉴于这一趋势,了解剂量反应关系以及疼痛、焦虑和抑郁如何影响这种关系变得非常重要。本二次分析使用了一项慢性非特异性颈痛随机对照试验中太极拳组(年龄=52.03±10.92 岁;73.68%为女性;n=38)的数据。作者检验了(1)干预期间家庭练习时间或累计练习时间是否与治疗后颈痛强度降低有关,以及(2)当前周相对于其他周报告的颈痛强度更大,是否与当前周家庭练习时间减少有关。进行了分析,以评估基线焦虑和抑郁水平是否调节每周疼痛强度与每周家庭练习时间之间的关系。虽然累计太极拳练习时间(即家庭练习+课堂时间)与治疗后颈痛强度降低有关,但家庭练习时间本身与治疗后颈痛强度降低无关。基线焦虑程度较低和中度的参与者在疼痛强度更严重的周练习量会减少,而基线焦虑程度较高的参与者在疼痛强度更严重的周练习量会增加。基线抑郁水平并未调节每周疼痛强度对每周家庭练习时间的影响。综合课堂和家庭接触太极拳似乎对慢性非特异性颈痛的缓解至关重要。此外,焦虑可能是一个重要特征,它部分决定了慢性非特异性颈痛患者的剂量反应关系。NCT02222051。

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