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在多模式治疗方案中添加电镇痛方法是否能改善慢性非特异性颈部疼痛患者的临床疗效?一项随机对照试验。

Does Adding Electroanalgesic Modalities to a Multimodal Therapeutic Program Improve Clinical Outcomes in Individuals With Chronic Nonspecific Neck Pain? A Randomised Controlled Trial.

作者信息

de Santana Gabriela Nascimento, da Silva Aron Charles Barbosa, Dos Santos Patrícia Gabrielle, Girasol Carlos Eduardo, de Oliveira Adriano Rodrigues, Dibai-Filho Almir Vieira, de Paula Gomes Cid André Fidelis

机构信息

Postgraduate Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil.

Department of Physics, Faculty of Philosophy, Sciences and Letters, University of São Paulo, São Paulo, Brazil.

出版信息

Eur J Pain. 2025 Oct;29(9):e70121. doi: 10.1002/ejp.70121.

Abstract

BACKGROUND

Chronic nonspecific neck pain (CNSNP) is a prevalent and complex condition. Although many studies have evaluated the effectiveness of transcutaneous electrical nerve stimulation (TENS), interferential current (IFC), therapeutic exercise (TE), and manual therapy (MT) individually, this study aimed to determine whether adding IFC and/or TENS to a Multimodal Therapeutic Intervention Program (MTIP) would produce better outcomes than the MTIP alone concerning functional capacity, pain intensity, pain catastrophising, kinesiophobia and overall perceived effect in individuals with CNSNP.

METHODS

Seventy-five individuals with CNSNP were randomly assigned to one of three groups: MTIP, MTIP + IFC, or MTIP + TENS. Interventions were conducted over 8 weeks. Outcomes were assessed at baseline, post-intervention, and at a 1-month follow-up. The primary outcome was the Neck Disability Index (NDI). Secondary outcomes included the Numeric Pain Rating Scale (NPRS) at rest and during movement, the Pain-Related Catastrophizing Thoughts Scale (PRCTS), the Tampa Scale for Kinesiophobia (TSK), the Copenhagen Neck Functional Disability Scale (CNFDS), the WHO Disability Assessment Schedule (WHODAS 2.0), and the Global Perceived Effect Scale (GPES).

RESULTS

No significant differences were observed between groups for the primary outcome. For secondary outcomes, the MTIP group showed improved results for NPRS-m and CNFDS. Additionally, MTIP was superior to MTIP + IFC for NPRS-r post-intervention, while MTIP + TENS outperformed both groups at follow-up. No significant differences were found for GPES, and none of the differences reached clinical significance.

CONCLUSIONS

The addition of IFC and/or TENS to an MTIP did not enhance clinical outcomes in individuals with CNSNP.

SIGNIFICANCE

The results of this study assist clinicians in making informed decisions regarding the selection of therapeutic resources for managing chronic nonspecific neck pain. They also support researchers in refining and conducting new studies focused on improving the implementation of multimodal intervention protocols. Additionally, these findings help individuals with chronic nonspecific neck pain better understand which interventions may be most appropriate to include in their rehabilitation process.

TRIAL REGISTRATION

NCT05400486.

摘要

背景

慢性非特异性颈部疼痛(CNSNP)是一种常见且复杂的病症。尽管许多研究已分别评估了经皮电刺激神经疗法(TENS)、干扰电疗法(IFC)、治疗性运动(TE)和手法治疗(MT)的有效性,但本研究旨在确定在多模式治疗干预方案(MTIP)中加入IFC和/或TENS,相较于单独使用MTIP,在CNSNP患者的功能能力、疼痛强度、疼痛灾难化、运动恐惧和总体感知效果方面是否会产生更好的结果。

方法

75名CNSNP患者被随机分配到三组中的一组:MTIP组、MTIP + IFC组或MTIP + TENS组。干预为期8周。在基线、干预后和1个月随访时评估结果。主要结局指标是颈部功能障碍指数(NDI)。次要结局指标包括静息和运动时的数字疼痛评分量表(NPRS)、疼痛相关灾难化思维量表(PRCTS)、坦帕运动恐惧量表(TSK)、哥本哈根颈部功能障碍量表(CNFDS)、世界卫生组织残疾评定量表(WHODAS 2.0)和总体感知效果量表(GPES)。

结果

三组在主要结局指标上未观察到显著差异。对于次要结局指标,MTIP组在NPRS - m和CNFDS方面显示出改善结果。此外,干预后MTIP组在NPRS - r方面优于MTIP + IFC组,而在随访时MTIP + TENS组的表现优于其他两组。在GPES方面未发现显著差异,且所有差异均未达到临床意义。

结论

在MTIP中加入IFC和/或TENS并未改善CNSNP患者的临床结局。

意义

本研究结果有助于临床医生在选择治疗慢性非特异性颈部疼痛的治疗资源时做出明智决策。它们还支持研究人员完善并开展新的研究,重点在于改进多模式干预方案的实施。此外,这些发现有助于慢性非特异性颈部疼痛患者更好地了解在其康复过程中哪些干预措施可能最为合适。

试验注册

NCT05400486。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2d0/12412195/cb9ce4c14002/EJP-29-0-g001.jpg

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