Norwood Stephen M, Han David, Gupta Ashim
, Austin, TX, 78738, USA.
Department of Management Science and Statistics, University of Texas at San Antonio, San Antonio, TX, 78249, USA.
Pain Ther. 2024 Feb;13(1):113-126. doi: 10.1007/s40122-023-00570-6. Epub 2024 Jan 5.
Chronic low back pain (cLBP) is a problem globally, creating a tremendous economic burden. Since conventional treatments often fail, various forms of electrical stimulation have been proposed to improve function and decrease pain. Patient-reported outcome measures (PROMs) have not been adequately reported in the electrical stimulation literature.
A retrospective independent statistical analysis was conducted on PROMs data for users of H-Wave device stimulation (HWDS) collected by the device manufacturer over a period of 4 years. Final surveys for 34,192 pain management patients were filtered for pain chronicity limited to 3-24 months and device use of 22-365 days, resulting in 11,503 patients with "all diagnoses"; this number was then reduced to 2711 patients with nonspecific cLBP, sprain, or strain.
Reported pain was reduced by 3.12 points (0-10 pain scale), with significant (≥ 20%) relief in 85.28%. Function/activities of daily living (ADL) improved in 96.36%, while improved work performance was reported in 81.61%. Medication use decreased or stopped in 64.41% and sleep improved in 59.76%. Over 96% reported having expectations met or exceeded, service satisfaction, and confidence in device use, while no adverse events were reported. Subgroup analyses found positive associations with longer duration of device use, home exercise participation, and working, whereas older age and longer pain chronicity resulted in reduced benefit. Similar analysis of the larger all-diagnoses cohort demonstrated near-equivalent positive outcomes.
Treatment outcomes directly reported by cLBP HWDS patients demonstrated profound positive effects on function and ADL, robust improvement in pain perception, and additional benefits like decreased medication use, better sleep, and improved work performance, representing compelling new evidence of treatment efficacy.
慢性下腰痛(cLBP)是一个全球性问题,造成了巨大的经济负担。由于传统治疗常常失败,人们提出了各种形式的电刺激来改善功能和减轻疼痛。患者报告结局指标(PROMs)在电刺激文献中尚未得到充分报道。
对设备制造商在4年期间收集的H-Wave设备刺激(HWDS)使用者的PROMs数据进行回顾性独立统计分析。对34192名疼痛管理患者的最终调查进行筛选,将疼痛慢性期限制在3 - 24个月,设备使用时间为22 - 365天,结果有11503名患者“所有诊断”;然后这个数字减少到2711名患有非特异性cLBP、扭伤或拉伤的患者。
报告的疼痛减轻了3.12分(0 - 10分疼痛量表),85.28%的患者有显著(≥20%)缓解。96.36%的患者日常生活功能/活动(ADL)得到改善,81.61%的患者报告工作表现有所改善。64.41%的患者药物使用减少或停止,59.76%的患者睡眠改善。超过96%的患者报告期望得到满足或超出、服务满意度以及对设备使用的信心,同时未报告不良事件。亚组分析发现,与更长的设备使用时间、家庭锻炼参与度和工作呈正相关,而年龄较大和疼痛慢性期较长则获益减少。对更大的所有诊断队列的类似分析显示了近乎等同的积极结果。
cLBP HWDS患者直接报告的治疗结果显示,对功能和ADL有深远的积极影响,疼痛感知有显著改善,以及药物使用减少、睡眠更好和工作表现改善等额外益处,代表了治疗效果的令人信服的新证据。