与腰痛和慢性广泛性疼痛相比，跨学科疼痛管理计划对复杂性区域疼痛综合征的疗效：一项观察性研究。

The efficacy of an interdisciplinary pain management program for complex regional pain syndrome compared to low back pain and chronic widespread pain: an observational study.

作者信息

Bean Debbie J, Tuck Natalie L, Magni Nico, Aamir Tipu, Pollard Catherine, Lewis Gwyn N

机构信息

The Centre for Person Centred Research, Auckland University of Technology, Auckland 0627, New Zealand.

The Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland 0627, New Zealand.

出版信息

Pain Med. 2025 Apr 1;26(4):180-188. doi: 10.1093/pm/pnae126.

DOI:10.1093/pm/pnae126

PMID:39666956

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11967180/

Abstract

BACKGROUND

Little research has assessed the efficacy of interdisciplinary pain management programs (IPMPs) for complex regional pain syndrome (CRPS), whereas evidence shows that IPMPs are effective for low back pain (LBP) and chronic widespread pain (CWP). This study aimed to determine whether outcomes following an IPMP differ for people with CRPS compared to LBP and CWP. In addition, we determined whether it is possible to predict IPMP outcomes using baseline characteristics.

METHODS

People with CRPS (N = 66) who had completed a 3-week IPMP were compared with age- and gender- matched controls with LBP (N = 66) and CWP (N = 66). Measures of pain intensity, pain interference and psychological factors were extracted for pre- and post-program, and at 1, 6, and 12 months. Latent class analysis identified recovery trajectories for pain intensity and pain interference, and χ2 analyses assessed differences between diagnostic groups in recovery trajectories. Machine learning models were implemented to predict recovery trajectories from baseline scores.

RESULTS

Two recovery trajectories for each dependent variable (pain interference and for pain intensity) were identified: Good responders and poorer responders. Following IPMPs, 37% of people belonged to a good responder recovery trajectory for pain interference, and 11% belonged to a good responder recovery trajectory for pain intensity. Recovery trajectories were similar across the three diagnostic groups (CRPS, LBP, CWP) for pain interference (χ2 = 1.8, P = .4) and intensity (χ = 0.2, P = .9). Modeling to predict outcomes correctly classified 69% of cases for pain interference and 88% of cases for pain intensity recovery trajectories using baseline scores.

CONCLUSION

People with CRPS, LBP, and CWP experience similar benefits following an IPMP. This supports the use of IPMPs for people with CRPS.

摘要

背景

很少有研究评估跨学科疼痛管理项目（IPMP）对复杂性区域疼痛综合征（CRPS）的疗效，而有证据表明IPMP对腰痛（LBP）和慢性广泛性疼痛（CWP）有效。本研究旨在确定与LBP和CWP患者相比，CRPS患者接受IPMP后的结果是否不同。此外，我们还确定了是否可以使用基线特征来预测IPMP的结果。

方法

将完成3周IPMP的CRPS患者（N = 66）与年龄和性别匹配的LBP患者（N = 66）和CWP患者（N = 66）进行比较。在项目前后以及1、6和12个月时提取疼痛强度、疼痛干扰和心理因素的测量值。潜在类别分析确定了疼痛强度和疼痛干扰的恢复轨迹，χ2分析评估了诊断组之间在恢复轨迹上的差异。实施机器学习模型以根据基线分数预测恢复轨迹。

结果

确定了每个因变量（疼痛干扰和疼痛强度）的两种恢复轨迹：良好反应者和较差反应者。接受IPMP后，37%的人属于疼痛干扰的良好反应者恢复轨迹，11%的人属于疼痛强度的良好反应者恢复轨迹。在疼痛干扰（χ2 = 1.8，P = 0.4）和强度（χ = 0.2，P = 0.9）方面，三个诊断组（CRPS、LBP、CWP）的恢复轨迹相似。使用基线分数进行的预测结果建模正确分类了69%的疼痛干扰病例和88%的疼痛强度恢复轨迹病例。