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针对膝骨关节炎患者的疼痛告知运动计划的可行性

Feasibility of pain informed movement program for people with knee osteoarthritis.

作者信息

Modarresi Shirin, Pearson Neil, Madden Kim, Fahnestock Margaret, Bowdish Dawn, Carlesso Lisa C

机构信息

Michael DeGroote Institute for Pain Research and Care (IPRC), McMaster University, Hamilton, ON, Canada.

School of Rehabilitation Science, Faculty of Health Science, McMaster University, Hamilton, ON, Canada.

出版信息

Osteoarthr Cartil Open. 2023 Aug 23;5(4):100401. doi: 10.1016/j.ocarto.2023.100401. eCollection 2023 Dec.

Abstract

OBJECTIVE

To establish the feasibility of an intervention consisting of neuromuscular exercise, mind-body techniques, and pain neuroscience education (PNE), referred to as Pain Informed Movement in people with knee Osteoarthritis (KOA). This program has the potential to improve our understanding of intrinsic pain modulation and its role in the management of chronic pain.

METHODS

This was a single-arm feasibility trial with a nested qualitative component. Primary outcome: complete follow-up. Inclusion criteria: age ≥40 years, KOA clinical diagnosis or meeting KOA NICE criteria, and pain intensity ≥3/10. The program consisted of 8-week in-person and at-home exercise sessions. PNE and mind-body techniques were provided as videos and integrated into the exercise sessions. Participants completed questionnaires and physical assessments including blood draws at baseline and program completion. Secondary feasibility outcomes: acceptability of the intervention, burden, rates of recruitment, compliance and adherence, and adverse events. success criteria were identified. Participants were invited to an online focus group.

RESULTS

19 participants were enrolled, with a complete follow-up rate of 74% (mean age 63.3 years (SD 10.5), 73% female), indicating modifications were necessary to proceed. All other success criteria were met. The focus groups revealed that the video content pertaining to the mind-body techniques would benefit from on screen demonstrations.

CONCLUSION

The Pain Informed Movement program is deemed feasible, with minor modifications needed to proceed. A pilot two-arm RCT will be conducted to establish the feasibility and explore potential effects of Pain Informed Movement compared to conventional neuromuscular exercise and standard OA education.

摘要

目的

确定一种由神经肌肉锻炼、身心技巧和疼痛神经科学教育(PNE)组成的干预措施(在膝骨关节炎(KOA)患者中称为疼痛知情运动)的可行性。该计划有可能增进我们对内在疼痛调节及其在慢性疼痛管理中作用的理解。

方法

这是一项带有嵌套定性成分的单臂可行性试验。主要结果:完成随访。纳入标准:年龄≥40岁,KOA临床诊断或符合KOA英国国家卫生与临床优化研究所(NICE)标准,且疼痛强度≥3/10。该计划包括为期8周的面对面和家庭锻炼课程。PNE和身心技巧以视频形式提供并融入锻炼课程。参与者在基线和课程结束时完成问卷调查和身体评估,包括抽血。次要可行性结果:干预措施的可接受性、负担、招募率、依从性和坚持性以及不良事件。确定了成功标准。邀请参与者参加在线焦点小组。

结果

招募了19名参与者,完全随访率为74%(平均年龄63.3岁(标准差10.5),73%为女性),表明需要进行修改才能继续。所有其他成功标准均已满足。焦点小组显示,与身心技巧相关的视频内容将受益于屏幕演示。

结论

疼痛知情运动计划被认为是可行的,只需进行一些小的修改即可继续。将进行一项试点双臂随机对照试验,以确定疼痛知情运动与传统神经肌肉锻炼和标准骨关节炎教育相比的可行性并探索其潜在效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/258b/10474231/20fac95d4e78/gr1.jpg

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