Bisson Leslie J, Weiss-Laxer Nomi S, Katz Jeffrey N, Haider Mohammad N, Flikkema Kyle B, Lackner Jeffrey M
Department of Orthopaedics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, USA.
Department of Orthopaedic Surgery and Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Orthop J Sports Med. 2024 Oct 28;12(10):23259671241285431. doi: 10.1177/23259671241285431. eCollection 2024 Oct.
The role of nonspecific factors, such as treatment credibility, treatment expectancy, and symptom expectancy, may shape the outcomes of the nonoperative treatment of degenerative meniscal tears (DMTs).
PURPOSE/HYPOTHESIS: The purpose of this study was to characterize treatment credibility and expectancy, symptom expectancy, and patient and clinical correlates of these factors among participants before undergoing 4 nonoperative treatment programs for DMTs. It was hypothesized that (1) treatment credibility scores would be similar across patient and baseline clinical subgroups and (2) treatment expectancy and symptom expectancy scores would be lower in older patients and among those reporting a longer pain duration or greater pain intensity.
Cohort study; Level of evidence, 3.
In 126 participants, validated scales were administered before treatment to assess the credibility of the assigned treatment (possible score of 1-9) as well as the expectations of treatment outcomes (0-100) and symptom improvement (1-5). Patient and clinical characteristics associated with these variables were examined.
On average, participants (mean age, 58 years [range, 45-75 years]; 51% female; 94% White) expected the treatment to improve their symptoms by a mean of 68% and expected their symptoms to be "very likely" to improve. Participants with a body mass index (BMI) ≥30 kg/m had lower mean treatment credibility (6.09 ± 1.81) and treatment expectancy (64.53 ± 25.16) scores on bivariate analyses than those with a BMI <30 kg/m (6.73 ± 1.69 [ = .045] and 72.86 ± 19.20 [ = .039], respectively). Participants reporting a pain duration ≥3 months also had lower mean treatment expectancy (63.85 ± 23.83) and symptom expectancy (3.70 ± 0.85) scores compared to those reporting a pain duration <3 months (75.52 ± 18.93 [ = .003] and 4.16 ± 0.67 [ = .001], respectively).
Most patients about to undergo physical therapy for DMTs considered it to be between "somewhat" and "very" credible and believed that their symptoms, on average, were "very likely" to improve. Although not supported by most evidence, patients with a BMI ≥30 kg/m believed physical therapy to be less credible and had lower treatment and symptom expectations, and those with symptoms present for ≥3 months had lower treatment and symptom expectations as well. Whether these nonspecific factors influence outcomes should be considered for further research.
非特异性因素，如治疗可信度、治疗期望和症状期望，可能会影响退行性半月板撕裂（DMT）非手术治疗的结果。
目的/假设：本研究的目的是在参与者接受4种DMT非手术治疗方案之前，对治疗可信度、治疗期望、症状期望以及这些因素的患者和临床相关性进行特征描述。研究假设为：（1）不同患者和基线临床亚组的治疗可信度评分相似；（2）老年患者以及报告疼痛持续时间较长或疼痛强度较大的患者的治疗期望和症状期望评分较低。
队列研究；证据等级为3级。
对126名参与者在治疗前使用经过验证的量表，以评估所分配治疗的可信度（可能得分为1 - 9）以及对治疗结果（0 - 100）和症状改善（1 - 5）的期望。检查与这些变量相关的患者和临床特征。
平均而言，参与者（平均年龄58岁[范围45 - 75岁]；51%为女性；94%为白人）预计治疗能使症状平均改善68%，并认为症状“非常可能”改善。在双变量分析中，体重指数（BMI）≥30 kg/m²的参与者的平均治疗可信度（6.09 ± 1.81）和治疗期望（64.53 ± 25.16）得分低于BMI < 30 kg/m²的参与者（分别为6.73 ± 1.69 [P = 0.045]和72.86 ± 19.20 [P = 0.039]）。与报告疼痛持续时间<3个月的参与者相比，报告疼痛持续时间≥3个月的参与者的平均治疗期望（63.85 ± 23.83）和症状期望（3.70 ± 0.85）得分也较低（分别为75.52 ± 18.93 [P = 0.003]和4.16 ± 0.67 [P = 0.001]）。
大多数即将接受DMT物理治疗的患者认为其可信度在“有点”到“非常”之间，并相信他们的症状平均“非常可能”改善。尽管大多数证据不支持，但BMI≥30 kg/m²的患者认为物理治疗的可信度较低，治疗和症状期望也较低，症状出现≥3个月的患者的治疗和症状期望同样较低。这些非特异性因素是否会影响治疗结果值得进一步研究。
