物理治疗联合疼痛神经科学教育治疗慢性非特异性下腰痛的单盲随机临床试验
Physiotherapeutic treatment associated with the pain neuroscience education for patients with chronic non-specific low back pain-single-blind randomized pilot clinical trial.
机构信息
Programa de Pós-Graduação em Biologia Celular e Molecular Aplicada à Saúde, Laboratório de Genética Molecular Humana, Universidade Luterana do Brasil, Canoas - RS, Brasil.
Curso de Fisioterapia do Centro Universitário Luterano de Palmas - CEULP/ULBRA, Palmas - TO, Brasil.
出版信息
Agri. 2023 Jul;35(3):153-166. doi: 10.14744/agri.2022.33349.
OBJECTIVES
Pain Neuroscience Education (PNE) shows improvement in pain and functional capacity in patients with chronic low back pain (CLBP). Therefore, the study aimed to verify if the physiotherapeutic treatment associated with PNE decreases the functional disability of patients with nonspecific CLBP.
METHODS
Forty patients were clinically evaluated and answered the following questionnaires: Brief pain inventory, Central Sensitization Inventory (CSI), Roland-Morris disability questionnaire, pain catastrophizing scale, Tampa scale of kinesiophobia, hospital anxiety, and depression scale, SF6D quality of life questionnaire and performed quantitative sensory tests (QSTs). Afterward, they were randomly divided into the intervention group (IG, n=20) and the control group (CG, n=20). Both performed kinesiotherapy exercises twice a week for 6 weeks. The IG received 3 individual PNE sessions and answered the pain neurophysiology questionnaire.
RESULTS
IG showed significant improvement for all variables analyzed (p<0.001). The association decreased the kinesiophobia (estimated difference between CG-IG means: 7.6-95% CI: 2.3-12.9) (p=0.006). In the lumbar paravertebral region (CG and IG), there was a statistical difference in the intensity of CLBP in the QSTs (p<0.05).
CONCLUSION
The association showed better results compared to only therapeutic exercises to reduce kinesiophobia and change the perception of pain intensity in the lumbar region.
目的
疼痛神经科学教育(PNE)可改善慢性下腰痛(CLBP)患者的疼痛和功能能力。因此,本研究旨在验证与 PNE 相关的物理治疗是否会降低非特异性 CLBP 患者的功能障碍。
方法
40 名患者进行了临床评估,并回答了以下问卷:简明疼痛量表、中枢敏化量表(CSI)、Roland-Morris 残疾问卷、疼痛灾难化量表、坦帕运动恐惧量表、医院焦虑和抑郁量表、SF6D 生活质量问卷和进行定量感觉测试(QST)。之后,他们被随机分为干预组(IG,n=20)和对照组(CG,n=20)。两组均每周进行两次运动疗法锻炼,共 6 周。IG 接受了 3 次个体 PNE 课程,并回答了疼痛神经生理学问卷。
结果
IG 在所有分析变量上均有显著改善(p<0.001)。这种联合治疗降低了运动恐惧(CG-IG 组间差异估计值:7.6-95%置信区间:2.3-12.9)(p=0.006)。在腰椎旁区域(CG 和 IG),QST 中 CLBP 的强度存在统计学差异(p<0.05)。
结论
与仅进行治疗性运动相比,这种联合治疗在降低运动恐惧和改变腰椎区域疼痛强度方面显示出更好的效果。