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疼痛神经科学教育和治疗性运动治疗乳腺癌幸存者慢性疼痛后遗症:一项初步研究。

Pain neuroscience education and therapeutic exercise for the treatment of sequelae in breast cancer survivors living with chronic pain: A pilot study.

机构信息

Posgrado Institucional en Ciencias de la Salud, Universidad Autónoma de Yucatán (UADY), Mexico.

Facultad de Enfermería, Universidad Autónoma de Yucatán (UADY), Mexico.

出版信息

J Bodyw Mov Ther. 2024 Oct;40:1744-1751. doi: 10.1016/j.jbmt.2024.10.025. Epub 2024 Oct 15.

DOI:10.1016/j.jbmt.2024.10.025
PMID:39593518
Abstract

BACKGROUND

Breast cancer represents the most common type of malignant neoplasm worldwide. Advances in diagnosis and treatment have increased the life expectancy of patients. However, the sequelae associated with the treatment of the disease such as chronic pain, kinesiophobia and loss of physical function in breast cancer survivors (BCS) are a long-term health problem. Therapeutic strategies are required for the treatment of chronic sequelae in this population.

OBJECTIVES

To evaluate the effectiveness of a pain neuroscience education (PNE) and therapeutic exercise (TE) for the treatment of chronic sequelae in BCS.

METHODS

Quasi-experimental repeated measures study. The intervention lasted 9 weeks, with 3 educational and 24 exercise sessions. Pain frequency and intensity (VAS scale), neuropathic pain (DN4), kinesiophobia level (TSK-11V), central sensitization (CSI-Sp), functionality of the affected arm (ULFI-Sp) and active joint range (ROM) with goniometry were measured at baseline, 3rd, 6th and 9th week. Statistical analysis included Friedman's test and ANOVA according to normality criteria.

RESULTS

A total sample of 26 BCS participate in the study. Significant statistical changes were found from the 3rd week of treatment in the frequency and intensity of pain, kinesiophobia and neuropathic pain (p < 0.05). All variables had significant changes at the 9th week (p = 0.001).

CONCLUSION

The results of the present investigation suggest that the combination of PNE and TE are effective in treating sequelae at short term in BCS with chronic pain.

摘要

背景

乳腺癌是全球最常见的恶性肿瘤类型。诊断和治疗的进步提高了患者的预期寿命。然而,与疾病治疗相关的后遗症,如慢性疼痛、运动恐惧症和乳腺癌幸存者(BCS)的身体功能丧失,是一个长期的健康问题。需要针对该人群的慢性后遗症制定治疗策略。

目的

评估疼痛神经科学教育(PNE)和治疗性运动(TE)治疗 BCS 慢性后遗症的效果。

方法

准实验性重复测量研究。干预持续 9 周,包括 3 次教育和 24 次运动。在基线、第 3、6 和第 9 周测量疼痛频率和强度(VAS 量表)、神经病理性疼痛(DN4)、运动恐惧症水平(TSK-11V)、中枢敏化(CSI-Sp)、患侧手臂功能(ULFI-Sp)和关节活动度(ROM)用测角器。统计分析包括 Friedman 检验和根据正态性标准的 ANOVA。

结果

共有 26 名 BCS 参与了这项研究。从治疗的第 3 周开始,疼痛频率和强度、运动恐惧症和神经病理性疼痛均发现有显著的统计学变化(p<0.05)。所有变量在第 9 周均有显著变化(p=0.001)。

结论

本研究结果表明,PNE 和 TE 的联合治疗在短期内对慢性疼痛的 BCS 后遗症有效。

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