Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain; Departament of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; Section of Clinical Research, Hospital Clínico La Florida, Santiago, Chile.
Departament of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; Section of Research, Innovation and Development in Kinesiology, Kinesiology Unit, San José Hospital, Santiago, Chile.
Musculoskelet Sci Pract. 2023 Oct;67:102835. doi: 10.1016/j.msksp.2023.102835. Epub 2023 Jul 28.
Previous studies have shown positive results of pain neuroscience education (PNE) combined with exercise in patients with chronic musculoskeletal disorders. However, the effects of this intervention in patients with carpal tunnel syndrome (CTS) admitted to a telerehabilitation program remain unexplored.
To compare the effectiveness of a 6-week telerehabilitation program based on PNE + exercise versus exercise alone on patient-reported outcomes after treatment and at 6-weeks post-treatment follow-up in patients with CTS awaiting surgery.
Randomized controlled trial.
Thirty participants were randomly assigned to the PNE + exercise or exercise-only group. Outcome measures included pain intensity, pain catastrophizing, kinesiophobia, symptom severity, function, symptoms of anxiety and depression, quality of life, self-perception of improvement. Inferential analyses of the data were performed using a two-factor mixed analysis of variance.
Twenty-five participants completed the study. A significant time × group interaction with a large effect size was observed for kinesiophobia (F = 6.67, p = 0.005, ηp = 0.225) and symptom severity (F = 4.82, p = 0.013, ηp = 0.173). No significant interaction was observed for the other variables (p > 0.05). A significant difference in self-perceived improvement was observed in favor of the PNE + exercise group after treatment (p < 0.05). Although there were significant and clinically relevant improvements within the PNE + exercise group in pain intensity and catastrophizing, there were no significant differences between the groups.
The addition of PNE to a telerehabilitation exercise program showed short-term improvements in kinesiophobia and symptom severity and greater self-perceived improvement in patients with CTS awaiting surgery. This study highlighted the benefits of including PNE in telerehabilitation interventions for patients with CTS.
先前的研究表明，疼痛神经科学教育（PNE）结合运动对慢性肌肉骨骼疾病患者有积极的效果。然而，这种干预措施在接受远程康复计划的腕管综合征（CTS）患者中的效果仍未得到探索。
比较基于 PNE+运动的 6 周远程康复计划与单独运动对接受手术治疗的 CTS 患者治疗后和治疗后 6 周随访时患者报告结局的影响。
随机对照试验。
30 名参与者被随机分配到 PNE+运动组或仅运动组。结局测量包括疼痛强度、疼痛灾难化、运动恐惧、症状严重程度、功能、焦虑和抑郁症状、生活质量、自我改善感知。使用双因素混合方差分析对数据进行推断分析。
25 名参与者完成了研究。观察到运动恐惧（F=6.67，p=0.005，ηp=0.225）和症状严重程度（F=4.82，p=0.013，ηp=0.173）存在显著的时间×组交互作用，具有大的效应量。其他变量未观察到显著的交互作用（p>0.05）。治疗后，PNE+运动组自我感知改善程度显著优于仅运动组（p<0.05）。尽管 PNE+运动组的疼痛强度和灾难化有显著且具有临床意义的改善，但两组之间没有显著差异。
在远程康复运动计划中加入 PNE 可在短期内在 CTS 患者中改善运动恐惧和症状严重程度，并使患者的自我感知改善程度更大。这项研究强调了在 CTS 患者的远程康复干预中纳入 PNE 的益处。
