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诊断信息的内容对患有跟腱中段肌腱病的人负重时的疼痛有直接影响:一项随机临床试验。

The content of diagnostic information has an immediate effect on pain with loading in people with midportion Achilles tendinopathy: a randomized clinical experiment.

作者信息

Travers Nigel J, Travers Mervyn J, Gibson William, Debenham James R, Hince Dana A, Wand Benedict M

机构信息

Star Physiotherapy, West Perth, WA, Australia; School of Health Sciences, The University of Notre Dame Australia, Fremantle, WA, Australia.

School of Health Sciences, The University of Notre Dame Australia, Fremantle, WA, Australia.

出版信息

Braz J Phys Ther. 2025 Jul 12;29(5):101244. doi: 10.1016/j.bjpt.2025.101244.


DOI:10.1016/j.bjpt.2025.101244
PMID:40652602
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12280333/
Abstract

BACKGROUND: Contemporary models of pain suggest the beliefs an individual holds regarding the cause of pain may influence pain intensity. Direct evidence supporting this idea is lacking in clinical populations. OBJECTIVE: Investigate if the content of diagnostic information about the cause of pain influences pain and function in people with Achilles tendinopathy. METHODS: Fifty recreational runners with Achilles tendinopathy participated in this randomised clinical experiment. Participants in the experimental group received an explanation of tendon pain that highlighted changes in muscle function as the primary problem, without reference to tendon pathology. Participants in the control group received an explanation of tendon pain that prioritised tendon pathology. The primary outcome measure was maximal pain intensity during a standardised hopping task measured on a 0-100 visual analogue scale. Secondary outcomes were lower limb stiffness while hopping and time in seconds for pain to ease upon completion of the hopping task. RESULTS: Pain intensity was lower in the experimental group post intervention (mean difference = 12.3 mm; 95 % CI: 3.2, 21.5). Lower limb stiffness was higher in the experimental group (mean difference = -1546 Nm; 95 % CI: -3296, 204) and time-to-ease was near identical (mean difference = 0 s; 95 % CI: -11, 11). CONCLUSION: The content of diagnostic information influenced pain intensity with loading in people with Achilles tendinopathy. The effect on lower limb stiffness was uncertain and there appears to be no effect on time-to-ease.

摘要

背景:当代疼痛模型表明,个体对疼痛原因的信念可能会影响疼痛强度。临床人群中缺乏支持这一观点的直接证据。 目的:研究关于疼痛原因的诊断信息内容是否会影响跟腱病患者的疼痛和功能。 方法:50名患有跟腱病的休闲跑步者参与了这项随机临床试验。实验组的参与者收到了一份关于肌腱疼痛的解释,该解释强调肌肉功能变化是主要问题,而未提及肌腱病理情况。对照组的参与者收到了一份优先考虑肌腱病理的肌腱疼痛解释。主要结局指标是在标准化单腿跳任务中,使用0-100视觉模拟量表测量的最大疼痛强度。次要结局指标是单腿跳时下肢的僵硬程度以及单腿跳任务完成后疼痛缓解的时间(以秒为单位)。 结果:干预后实验组的疼痛强度较低(平均差异=12.3毫米;95%置信区间:3.2,21.5)。实验组的下肢僵硬程度较高(平均差异=-1546牛米;95%置信区间:-3296,204),疼痛缓解时间几乎相同(平均差异=0秒;95%置信区间:-11,11)。 结论:诊断信息的内容影响了跟腱病患者负重时的疼痛强度。对下肢僵硬程度的影响尚不确定,且似乎对疼痛缓解时间没有影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4cef/12280333/3b8953ee9121/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4cef/12280333/3b8953ee9121/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4cef/12280333/3b8953ee9121/gr1.jpg

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本文引用的文献

[1]
Reconceptualizing pain-related behaviour: Introducing the concept of bodily doubt.

Eur J Pain. 2023-7

[2]
The Fit-for-Purpose Model: Conceptualizing and Managing Chronic Nonspecific Low Back Pain as an Information Problem.

Phys Ther. 2023-2-1

[3]
Diagnostic labels and advice for rotator cuff disease influence perceived need for shoulder surgery: an online randomised experiment.

J Physiother. 2022-10

[4]
Public and patient perceptions of diagnostic labels for non-specific low back pain: a content analysis.

Eur Spine J. 2022-12

[5]
Effect of diagnostic labelling on management intentions for non-specific low back pain: A randomized scenario-based experiment.

Eur J Pain. 2022-8

[6]
The clinical diagnosis of Achilles tendinopathy: a scoping review.

PeerJ. 2021-9-28

[7]
Psychological factors during rehabilitation of patients with Achilles or patellar tendinopathy: a cross-sectional study.

Phys Ther Sport. 2021-7

[8]
Diagnostic Labels for Rotator Cuff Disease Can Increase People's Perceived Need for Shoulder Surgery: An Online Randomized Controlled Trial.

J Orthop Sports Phys Ther. 2021-8

[9]
The catastrophization effects of an MRI report on the patient and surgeon and the benefits of 'clinical reporting': results from an RCT and blinded trials.

Eur Spine J. 2021-7

[10]
The strength of association between psychological factors and clinical outcome in tendinopathy: A systematic review.

PLoS One. 2020

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