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单侧外侧肘部肌腱病患者的致敏相关症状和神经病理性相关症状:一项探索性研究。

Sensitization-associated and neuropathic-associated symptoms in patients with unilateral lateral elbow tendinopathy: an exploratory study.

作者信息

Cancela-Cilleruelo Ignacio, Rodríguez-Jiménez Jorge, Fernández-de-Las-Peñas César, Arendt-Nielsen Lars, Arias-Buría José L

机构信息

Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, Móstoles, Spain.

Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain.

出版信息

Physiother Theory Pract. 2024 Nov;40(11):2522-2529. doi: 10.1080/09593985.2023.2264384. Epub 2023 Oct 5.

Abstract

OBJECTIVES

We evaluate the presence of sensitization-associated symptoms and neuropathic pain features and identify if there is an association between these symptoms and pressure pain sensitivity, pain, and related-disability in lateral elbow tendinopathy.

METHODS

Thirty-seven (43% women, age: 45.5 ± 9.5 years) patients with lateral elbow tendinopathy completed: demographic (i.e. age, height, and weight); clinical (i.e. pain history, pain intensity, and Disabilities of the Arm, Shoulder and Hand); and psychophysical (i.e. pressure pain thresholds at the elbow, cervical spine, hand, and leg) outcomes, and the Central Sensitization Inventory and Self-administered Leeds Assessment of Neuropathic Symptoms and Signs questionnaires. Step-wise multiple linear regression models were performed to identify predictors of sensitization- or neuropathic-associated symptoms.

RESULTS

Six (16%) patients exhibited sensitization-associated symptoms (mean: 46.5, SD: 6.1), whereas 13 (35%) patients showed neuropathic-associated symptoms (mean: 13.5; SD: 1.4). Sensitization-associated symptoms were positively associated with neuropathic-associated symptoms ( = 0.538,  = .001) and negatively associated with pressure pain thresholds at the leg ( = -0.378,  = .021). Neuropathic-associated symptoms were positively associated with related-disability ( = 0.479,  = .003) and negatively associated with pressure pain threshold at the elbow ( = -0.394,  = .017). Stepwise regression analyses revealed that neuropathic-like symptoms explained 26.8% of the variance of sensitization symptoms (r: 0.268), whereas pressure pain threshold at the elbow explained an additional 6.6% to neuropathic-like symptoms (r: 0.334).

CONCLUSION

This explorative study identified sensitization- and neuropathic-associated symptoms in 16% and 35% of the people with lateral elbow tendinopathy. Sensitization- and neuropathic-associated symptoms were associated. Pressure pain sensitivity at the elbow (peripheral sensitization) was associated with neuropathic -associated symptoms.

摘要

目的

我们评估致敏相关症状和神经性疼痛特征的存在情况,并确定这些症状与外侧肘肌腱病的压痛敏感性、疼痛及相关残疾之间是否存在关联。

方法

37名(43%为女性,年龄:45.5±9.5岁)外侧肘肌腱病患者完成了以下各项:人口统计学信息(即年龄、身高和体重);临床信息(即疼痛病史、疼痛强度以及手臂、肩部和手部功能障碍);以及心理物理学指标(即肘部、颈椎、手部和腿部的压痛阈值),并完成了中枢致敏量表以及自我管理的利兹神经病理性症状和体征问卷。进行逐步多元线性回归模型以确定致敏或神经病理性相关症状的预测因素。

结果

6名(16%)患者表现出致敏相关症状(平均值:46.5,标准差:6.1),而13名(35%)患者表现出神经病理性相关症状(平均值:13.5;标准差:1.4)。致敏相关症状与神经病理性相关症状呈正相关(r = 0.538,p = 0.001),与腿部的压痛阈值呈负相关(r = -0.378,p = 0.021)。神经病理性相关症状与相关残疾呈正相关(r = 0.479,p = 0.003),与肘部的压痛阈值呈负相关(r = -0.394,p = 0.017)。逐步回归分析显示,类神经病理性症状解释了致敏症状变异的26.8%(r:0.268),而肘部的压痛阈值对类神经病理性症状的解释力额外增加了6.6%(r:0.334)。

结论

这项探索性研究在16%的外侧肘肌腱病患者中发现了致敏相关症状,在35%的患者中发现了神经病理性相关症状。致敏相关症状和神经病理性相关症状有关联。肘部的压痛敏感性(外周致敏)与神经病理性相关症状有关。

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