Spence Susan H, Sharpe Louise, Newton-John Toby, Champion David
Department of Psychology, University of Queensland, Brisbane, QLD4072 Australia Department of Clinical Psychology, Hounslow and Spelthorne Community Mental Health, Hounslow UK Department of Clinical Health Psychology, St. Mary's Hospital, London UK St. Vincent's Hospital, Sydney Australia.
Pain. 1995 Nov;63(2):199-206. doi: 10.1016/0304-3959(95)00047-V.
This study examined the relative effectiveness of EMG biofeedback, applied relaxation training and a combined procedure in the management of chronic, upper extremity cumulative trauma disorder. Forty-eight patients with a history of about 5-6 years of upper extremity pain were randomly assigned to 1 of 4 treatment conditions, namely applied relaxation training, EMG biofeedback, a combined approach or a wait-list control. Treatments were conducted on an individual basis, twice per week for 4 weeks. Patients in all 3 treatment conditions showed significant short-term reductions in pain and psychopathology in comparison to the wait-list group who showed minimal change. Six-month follow-up data were obtained for patients in the treatment conditions, but not the wait-list group. There was some evidence of relapse on measures of depression, anxiety and pain beliefs for treated patients during the 6-month follow-up period, although measures remained significantly below pre-treatment levels for most outcome indices. Self-monitored pain continued to decrease for the treatment groups through follow-up. Contrary to predictions, however, the strongest short-term treatment benefits were shown by patients receiving applied relaxation training on measures of pain, distress, interference in daily living, depression and anxiety. By 6-month follow-up, differences between treatment groups were no longer evident.
本研究考察了肌电图生物反馈、应用放松训练以及一种联合治疗方法在慢性上肢累积性创伤障碍管理中的相对有效性。48名有大约5至6年上肢疼痛病史的患者被随机分配到4种治疗条件中的一种，即应用放松训练、肌电图生物反馈、联合治疗方法或等待名单对照组。治疗以个体为基础进行，每周两次，共4周。与几乎没有变化的等待名单组相比，所有3种治疗条件下的患者在疼痛和精神病理学方面均显示出显著的短期减轻。对接受治疗的患者获取了6个月的随访数据，但未对等待名单组进行随访。在6个月的随访期内，有证据表明接受治疗的患者在抑郁、焦虑和疼痛信念测量方面出现了复发，尽管大多数结果指标仍显著低于治疗前水平。治疗组自我监测的疼痛在随访期间持续下降。然而，与预测相反的是，在疼痛、痛苦、日常生活干扰、抑郁和焦虑测量方面，接受应用放松训练的患者显示出最强的短期治疗效果。到6个月随访时，治疗组之间的差异不再明显。
