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认知功能疗法与治疗性运动治疗慢性肩痛个体的比较:一项随机对照试验方案

Cognitive functional therapy versus therapeutic exercises for the treatment of individuals with chronic shoulder pain: A protocol for a randomized controlled trial.

作者信息

Gava Vander, da Silva Eugenio Jessica Mayara, Meziat-Filho Ney, Almeida Lucas Araújo, Maciel Daniel Germano, do Nascimento Jose Diego Sales, de Andrade Palloma Rodrigues, Santos Fonseca Romário Nóbrega, Medeiros Barbosa Germanna, de Oliveira Valéria Mayaly Alves, Kamonseki Danilo Harudy

机构信息

Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil.

Postgraduate Program in Physical Therapy, Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil.

出版信息

PLoS One. 2025 Apr 21;20(4):e0320025. doi: 10.1371/journal.pone.0320025. eCollection 2025.


DOI:10.1371/journal.pone.0320025
PMID:40258003
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12011251/
Abstract

INTRODUCTION: Shoulder pain is a debilitating musculoskeletal condition with functional, physical, and psychological impacts. Interventions for chronic shoulder pain should address the biopsychosocial model, with Cognitive Functional Therapy (CFT) emerging as a promising physiotherapy approach. CFT approaches the multidimensional nature of pain, integrating physical and cognitive aspects. To date, no study has assessed the effectiveness of CFT in individuals with chronic shoulder pain. Therefore, this randomized controlled trial aims to compare the effects of CFT to therapeutic exercises on pain intensity, disability, self-efficacy, sleep quality, biopsychosocial aspects, and central pain processing in individuals with chronic shoulder pain. METHODS: This will be a randomized controlled trial, single-blinded with two parallel groups. Seventy-two individuals with chronic shoulder pain will be randomly assigned to one of two groups: CFT or Therapeutic exercise. The interventions will last 8 weeks, with the CFT group receiving therapy once a week and the therapeutic exercise group receiving sessions twice a week. The primary outcomes will be pain intensity and disability, while the secondary outcomes will include function, self-efficacy, sleep quality, biopsychosocial factors, perception of improvement/deterioration, and central pain processing. The outcome measures will be assessed at baseline, 4th week, end of treatment (8th week), and 12th-week follow-up. CONCLUSION: The results of this study will contribute to understanding the effectiveness of CFT in treating individuals with chronic shoulder pain. Trial registration number: NCT06542666.

摘要

引言:肩部疼痛是一种使人衰弱的肌肉骨骼疾病,会对功能、身体和心理产生影响。慢性肩部疼痛的干预措施应遵循生物心理社会模型,认知功能疗法(CFT)已成为一种有前景的物理治疗方法。CFT针对疼痛的多维度性质,整合了身体和认知方面。迄今为止,尚无研究评估CFT对慢性肩部疼痛患者的有效性。因此,这项随机对照试验旨在比较CFT与治疗性锻炼对慢性肩部疼痛患者的疼痛强度、功能障碍、自我效能、睡眠质量、生物心理社会方面以及中枢性疼痛处理的影响。 方法:这将是一项随机对照试验,单盲,分为两个平行组。72名慢性肩部疼痛患者将被随机分配到两组之一:CFT组或治疗性锻炼组。干预措施将持续8周,CFT组每周接受一次治疗,治疗性锻炼组每周接受两次治疗。主要结局将是疼痛强度和功能障碍,次要结局将包括功能、自我效能、睡眠质量、生物心理社会因素、对改善/恶化的感知以及中枢性疼痛处理。结局指标将在基线、第4周、治疗结束时(第8周)和第12周随访时进行评估。 结论:本研究结果将有助于了解CFT治疗慢性肩部疼痛患者的有效性。试验注册号:NCT06542666。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0af/12011251/327ccd6534aa/pone.0320025.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0af/12011251/c2f09b621828/pone.0320025.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0af/12011251/327ccd6534aa/pone.0320025.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0af/12011251/c2f09b621828/pone.0320025.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0af/12011251/327ccd6534aa/pone.0320025.g002.jpg

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本文引用的文献

[1]
Cognitive Functional Therapy for Chronic Low Back Pain: A Systematic Review and Meta-Analysis.

Phys Ther. 2024-12-6

[2]
Exercise therapy and physical activity in the paradigm shift from a tissue- and disease-based pain management approach towards multimodal lifestyle interventions for chronic pain.

Braz J Phys Ther. 2024

[3]
Effectiveness of specific scapular therapeutic exercises in patients with shoulder pain: a systematic review with meta-analysis.

JSES Rev Rep Tech. 2024-1-19

[4]
The importance of sleep in the paradigm shift from a tissue- and disease-based pain management approach towards multimodal lifestyle interventions for chronic pain.

Braz J Phys Ther. 2024

[5]
Effectiveness of Cognitive Functional Therapy Versus Core Exercises and Manual Therapy in Patients With Chronic Low Back Pain After Spinal Surgery: Randomized Controlled Trial.

Phys Ther. 2024-1-1

[6]
Process of change for people with knee osteoarthritis undergoing cognitive functional therapy: a replicated single-case experimental design study.

Disabil Rehabil. 2024-6

[7]
Cognitive functional therapy with or without movement sensor biofeedback versus usual care for chronic, disabling low back pain (RESTORE): a randomised, controlled, three-arm, parallel group, phase 3, clinical trial.

Lancet. 2023-6-3

[8]
Are clinical outcomes associated with baseline sensory profiles in people with musculoskeletal shoulder pain? Protocol for a prospective longitudinal observational study.

Musculoskeletal Care. 2023-9

[9]
Effectiveness of Cognitive Functional Therapy for Reducing Pain and Disability in Chronic Low Back Pain: A Systematic Review and Meta-analysis.

J Orthop Sports Phys Ther. 2023-5

[10]
A systematic review of the global prevalence and incidence of shoulder pain.

BMC Musculoskelet Disord. 2022-12-8

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