在一项随机对照试验中评估恐动症和灾难化患者报告结局：电容电阻单极射频联合肌筋膜技术与假射频治疗慢性盆腔疼痛综合征的疗效——一项二次分析
Assessing Kinesiophobia and Catastrophizing Patient-Reported Outcomes in a Randomized Controlled Trial: Efficacy of Capacitive-Resistive Monopolar Radiofrequency Combined with Myofascial Techniques vs. Sham Radiofrequency in Chronic Pelvic Pain Syndrome-A Secondary Analysis.
作者信息
Carralero-Martínez Andrea, Naranjo-Ortiz Cristina, Blanco-Ratto Laia, Kauffmann Stéphanie, Ramírez-García Inés
机构信息
RAPbarcelona Physiotherapy Clinical Center, Barcelona, Spain.
Yale School of Medicine, Yale Cancer Center, 300 George St., Ste. 123, New Haven, CT06520-8028, USA.
出版信息
Int Urogynecol J. 2025 Apr;36(4):799-811. doi: 10.1007/s00192-025-06052-x. Epub 2025 Jan 28.
INTRODUCTION AND HYPOTHESIS
Chronic Pelvic Pain Syndrome causes psychological distress, worsened by kinesiophobia and pain catastrophizing. This study assesses whether combining capacitive-resistive monopolar radiofrequency with myofascial techniques is more effective than myofascial techniques alone for improving psychological outcomes such as kinesiophobia and catastrophizing.
METHODS
This double-blind, randomized controlled trial enrolled 81 chronic pelvic pain syndrome patients (67.9% female, mean age 43.6 years) from March 2019 to April 2021. Participants were assigned to either an activated (intervention) or deactivated (control) capacitive-resistive monopolar radiofrequency group, with both groups receiving physiotherapy and pain education over 10 weeks. Outcomes on kinesiophobia and catastrophizing were assessed at weeks 5 and 10, using the Spanish versions of the Tampa Scale (TSK-11) and Pain Catastrophizing Scale (PCS).
RESULTS
At treatment's end, the intervention group showed greater improvement in kinesiophobia (3 points) compared to controls, though nonsignificant (p = .099). The intervention also significantly reduced catastrophizing scores by 8 points versus control (p = .042). No major adverse effects occurred, and adherence was high (86.4%), with no differences between groups.
CONCLUSION
This study shows that combining capacitive-resistive monopolar radiofrequency with myofascial techniques can improve kinesiophobia and catastrophizing in chronic pelvic pain syndrome patients, such as fear movement and catastrophic thinking related to pain. This marks a potential breakthrough in chronic pain management. Future research should focus on larger, multicenter RCTs with extended follow-up periods to better assess long-term effects.
REGISTRATION
Clinical trial registration (NCT03797911).
引言与假设
慢性盆腔疼痛综合征会导致心理困扰，运动恐惧和疼痛灾难化会使其加重。本研究评估了电容电阻单极射频联合肌筋膜技术在改善运动恐惧和灾难化等心理结果方面是否比单纯的肌筋膜技术更有效。
方法
这项双盲、随机对照试验于2019年3月至2021年4月招募了81名慢性盆腔疼痛综合征患者（67.9%为女性，平均年龄43.6岁）。参与者被分配到激活（干预）或未激活（对照）的电容电阻单极射频组，两组均接受为期10周的物理治疗和疼痛教育。在第5周和第10周，使用西班牙语版的坦帕运动恐惧量表（TSK - 11）和疼痛灾难化量表（PCS）评估运动恐惧和灾难化的结果。
结果
在治疗结束时，干预组在运动恐惧方面的改善（3分）比对照组更大，尽管不显著（p = 0.099）。与对照组相比，干预还显著降低了灾难化得分8分（p = 0.042）。未发生重大不良反应，依从性高（86.4%），两组之间无差异。
结论
本研究表明，电容电阻单极射频联合肌筋膜技术可改善慢性盆腔疼痛综合征患者的运动恐惧和灾难化，如与疼痛相关的运动恐惧和灾难性思维。这标志着慢性疼痛管理方面的一个潜在突破。未来的研究应侧重于更大规模、多中心的随机对照试验，并延长随访期，以更好地评估长期效果。
注册
临床试验注册（NCT03797911）
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