Departamento de Ciencias de la Salud y Biomédicas, Universidad Loyola de Andalucía, Seville, Spain.
CTS 1110, UMSS Research Group, Andalusia, Seville, Spain.
Support Care Cancer. 2024 Oct 7;32(10):705. doi: 10.1007/s00520-024-08887-4.
To evaluate the effectiveness, compared with usual care, of an interactive online group programme combining pain neuroscience education (PNE) and graded exposure to movement (GEM) for improving quality of life and pain experience in breast cancer survivors with chronic pain.
This single-blind randomised controlled trial included a sample of 49 breast cancer survivors who were randomly assigned to two groups (experimental: n = 22 and control: n = 27). The experimental group received a 12-week person-centred online programme based on pain neuroscience education and therapeutic yoga as gradual exposure to movement, while the control group continued with their usual care. The primary outcome was quality of life (FACT-B + 4); the secondary outcomes were related to the experience of chronic pain (pain intensity, pain interference, catastrophizing, pain self-efficacy, kinesiophobia, and fear avoidance behaviours). All variables were assessed at four time points (T0, baseline; T1, after PNE sessions; T2, after yoga sessions; T3, at 3-month follow-up). For data analysis, ANOVA (2 × 4) analysis of variance (95% CI) was used when outcomes were normally distributed. If not, within-group and between-group comparisons were calculated.
Thirty-six participants were included in the analysis (control group, 22; experimental group, 14). A significant time * group effect was observed in favour of the experimental group regarding the global quality of life score (p = 0.010, η = 0.124). Significant differences in favour of the experimental group were observed for pain intensity, pain interference, catastrophizing, and pain self-efficacy. These differences persisted at follow-up.
An online intervention based on PNE and GEM appears to be more effective than usual care for improving quality of life in breast cancer survivors with chronic pain, as a time per group interaction was reported. In addition, the intervention also significantly improved the participants' experience of chronic pain. However, due to the study limitations further research is needed. Trial record: NCT04965909 (26/06/2021).
评估结合疼痛神经科学教育（PNE）和运动分级暴露（GEM）的互动式在线团体方案与常规护理相比，在改善慢性疼痛乳腺癌幸存者的生活质量和疼痛体验方面的有效性。
本单盲随机对照试验纳入了 49 名乳腺癌幸存者，他们被随机分配到两组（实验组：n=22；对照组：n=27）。实验组接受为期 12 周的以疼痛神经科学教育和治疗瑜伽为基础的个体化在线方案，作为运动的逐渐暴露，而对照组则继续接受常规护理。主要结局是生活质量（FACT-B+4）；次要结局与慢性疼痛体验相关（疼痛强度、疼痛干扰、灾难化、疼痛自我效能感、运动恐惧和回避行为）。所有变量在四个时间点（T0，基线；T1，PNE 课程后；T2，瑜伽课程后；T3，3 个月随访）进行评估。对于数据分析，如果结果呈正态分布，则使用方差分析（2×4）。如果不是，则计算组内和组间比较。
36 名参与者纳入分析（对照组，22 名；实验组，14 名）。结果显示，实验组在整体生活质量评分方面明显优于对照组（p=0.010，η=0.124）。实验组在疼痛强度、疼痛干扰、灾难化和疼痛自我效能感方面也表现出显著的优势。这些差异在随访时仍然存在。
基于 PNE 和 GEM 的在线干预似乎比常规护理更能有效改善慢性疼痛乳腺癌幸存者的生活质量，因为报告了时间与组间的相互作用。此外，该干预还显著改善了参与者的慢性疼痛体验。但是，由于研究的局限性，需要进一步的研究。试验记录：NCT04965909（2021 年 6 月 26 日）。
