Musculoskeletal Science and Practice最新文献_第6页

Contents and delivery methods of pain neuroscience education in pediatrics: A scoping review 儿科疼痛神经科学教育的内容和授课方法：范围综述

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2024-09-13 DOI: 10.1016/j.msksp.2024.103182

Juliana Rezende , Louise Acalantis , Leandro Calazans Nogueira , Ney Meziat-Filho , Kelly Ickmans , Felipe J.J. Reis

Background

Pain is prevalent among children and adolescents. The development and implementation of Pain Neuroscience Education (PNE) strategies tailored to this population remains overlooked in contrast to the adult population.

Objective

This study sought to identify the content, delivery methods, and dosage of PNE for children and adolescents available in the literature.

Method

We systematically searched PubMed, EMBASE, Physiotherapy Evidence Database, Scopus, Web of Science, Cochrane Library, PsycINFO, and clinical trial registration databases. Inclusion criteria consisted of studies that involved children submitted to a PNE program in community, school, clinics, hospitals or child development centers. We considered studies that included children with and without pain who received PNE strategies associated or not with self-motivational interventions. Studies focusing on psychological interventions were excluded. We extracted data on authors, publication year, country, sample characteristics, health condition, PNE content, study design, context, outcomes, duration, follow-up, main results, dropout, and adverse effects. Data extracted were qualitatively organized.

Results

A total of 805 studies were initially reviewed. The final sample comprised 17 studies. Common PNE topics included pain neurophysiology, biopsychosocial influences, pain concepts, self-management, and coping strategies. Delivery methods ranged from slideshows and videos to booklets, with sessions lasting 8–60 min. Schools were the most common setting for these interventions.

Conclusion

Our review demonstrates the diversity in PNE content, delivery methods, and intervention dosages among the included studies. Most studies occurred in school settings, potentially limiting its generalizability for clinical contexts.

背景疼痛在儿童和青少年中普遍存在。本研究旨在确定文献中针对儿童和青少年的疼痛神经科学教育（PNE）的内容、实施方法和剂量。方法我们系统地检索了 PubMed、EMBASE、物理治疗证据数据库、Scopus、Web of Science、Cochrane Library、PsycINFO 和临床试验注册数据库。纳入标准包括涉及在社区、学校、诊所、医院或儿童发展中心接受新生儿及儿童营养教育项目的儿童的研究。我们考虑的研究包括有疼痛和无疼痛的儿童，他们接受了与自我激励干预相关或不相关的 PNE 策略。以心理干预为主的研究除外。我们提取了有关作者、发表年份、国家、样本特征、健康状况、PNE 内容、研究设计、背景、结果、持续时间、随访、主要结果、辍学和不良反应的数据。对提取的数据进行了定性整理。最终样本包括 17 项研究。常见的 PNE 主题包括疼痛神经生理学、生物心理社会影响、疼痛概念、自我管理和应对策略。授课方式从幻灯片、视频到小册子不等，授课时间为 8-60 分钟。结论我们的综述表明，纳入研究的 PNE 内容、授课方法和干预剂量多种多样。大多数研究都是在学校环境中进行的，这可能会限制其在临床环境中的推广性。

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引用次数: 0

Machine learning methods in physical therapy: A scoping review of applications in clinical context 物理治疗中的机器学习方法：临床应用范围综述

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2024-09-13 DOI: 10.1016/j.msksp.2024.103184

Felipe J.J. Reis , Matheus Bartholazzi Lugão de Carvalho , Gabriela de Assis Neves , Leandro Calazans Nogueira , Ney Meziat-Filho

Background

Machine learning (ML) efficiently processes large datasets, showing promise in enhancing clinical practice within physical therapy.

Objective

The aim of this scoping review is to provide an overview of studies using ML approaches in clinical settings of physical therapy.

Data sources

A scoping review was performed in PubMed, EMBASE, PEDro, Cochrane, Web of Science, and Scopus.

Selection criteria

We included studies utilizing ML methods. ML was defined as the utilization of computational systems to encode patterns and relationships, enabling predictions or classifications with minimal human interference.

Data extraction and data synthesis

Data were extracted regarding methods, data types, performance metrics, and model availability.

Results

Forty-two studies were included. The majority were published after 2020 (n = 25). Fourteen studies (33.3%) were in the musculoskeletal physical therapy field, nine (21.4%) in neurological, and eight (19%) in sports physical therapy. We identified 44 different ML models, with random forest being the most used. Three studies reported on model availability. We identified several clinical applications for ML-based tools, including diagnosis (n = 14), prognosis (n = 7), treatment outcomes prediction (n = 7), clinical decision support (n = 5), movement analysis (n = 4), patient monitoring (n = 3), and personalized care plan (n = 2).

Limitation

Model performance metrics, costs, model interpretability, and explainability were not reported.

Conclusion

This scope review mapped the emerging landscape of machine learning applications in physical therapy. Despite the growing interest, the field still lacks high-quality studies on validation, model availability, and acceptability to advance from research to clinical practice.

背景机器学习（ML）可高效处理大型数据集，在提高物理治疗的临床实践方面大有可为。目的本范围综述旨在概述在物理治疗的临床环境中使用 ML 方法的研究。ML 被定义为利用计算系统对模式和关系进行编码，从而在最少人为干预的情况下进行预测或分类。数据提取和数据综合提取了有关方法、数据类型、性能指标和模型可用性的数据。大多数研究发表于 2020 年之后（n = 25）。14项研究（33.3%）涉及肌肉骨骼理疗领域，9项（21.4%）涉及神经理疗领域，8项（19%）涉及运动理疗领域。我们发现了 44 种不同的 ML 模型，其中使用最多的是随机森林模型。三项研究报告了模型的可用性。我们确定了基于 ML 工具的几种临床应用，包括诊断（14 例）、预后（7 例）、治疗结果预测（7 例）、临床决策支持（5 例）、运动分析（4 例）、患者监控（3 例）和个性化护理计划（2 例）。尽管人们对机器学习的兴趣与日俱增，但该领域仍然缺乏关于验证、模型可用性和可接受性的高质量研究，因此无法从研究推进到临床实践。

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引用次数: 0

Patient acceptance of care of a novel care pathway for those at risk of poor outcomes from musculoskeletal pain: A mixed methods study 患者对针对肌肉骨骼疼痛不良后果高危人群的新型护理路径的接受程度：混合方法研究

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2024-09-12 DOI: 10.1016/j.msksp.2024.103178

Darren Beales , Eileen Boyle , Robyn Fary , Anton Mikhailov , Benjamin Saunders , Sonia Coates , Kerrie Evans , Milena Simic , Michele Sterling , Kim Bennell , Trudy Rebbeck

Objective

Investigate people's acceptance of specialist musculoskeletal care within a new care pathway for common musculoskeletal conditions (low back pain, neck pain/whiplash, knee osteoarthritis).

Design

Convergent parallel mixed methods design referencing the Theoretical Framework of Acceptability. The study included a subset of participants (n = 29) at-risk of poor outcomes from the intervention arm of the PAthway of CarE for common musculoskeletal conditions (PACE-MSK) trial. In the PACE-MSK arm, participants received specialist physiotherapist care as an adjunct to the care provided by their primary healthcare professional(s). One-to-one semi-structured interviews were conducted around 3-months after commencing in the trial. Quantitative data were collected at baseline and 3-month follow-up (health-related quality of life, pain self-efficacy, global perceived change, satisfaction).

Results

Five themes were identified (Expectations and beliefs shaped patient experience; Clinical expertise and competence influence acceptance; Person-centred care; Mechanisms facilitating beneficial responses to care; Gaps in care pathway implementation). There were positive individual changes in physical quality of life for 17/29 (59%) participants, mental health quality of life for 12/29 (41%), pain self-efficacy for 8/29 (28%) and global perceived change for 19/29 (66%). Management met expectations with the majority reporting high levels of satisfaction. Integrating the qualitative and quantitative data with the Theoretical Framework of Acceptability, there were complementary meta-inferences in the constructs of ‘ethicality’, ‘intervention coherence’, ‘self-efficacy’ and ‘affective attitude’. Divergence was identified in ‘perceived effectiveness’.

Discussion

In general, there was positive acceptance of the care pathway by participants. Specialist physiotherapists’ care was perceived as a positive addition to usual care.

目标：调查人们对常见肌肉骨骼疾病（腰背痛、颈部疼痛/颈椎病、膝关节骨性关节炎）新护理路径中肌肉骨骼专科护理的接受程度。设计：参照可接受性理论框架，采用收敛平行混合方法设计。该研究纳入了常见肌肉骨骼疾病的PACE-MSK（PAthway of CarE for common musculoskeletal conditions）试验干预组中有不良后果风险的参与者子集（n = 29）。在PACE-MSK干预组中，参与者接受专业物理治疗师的护理，作为其初级医疗保健专业人员提供的护理的补充。试验开始 3 个月后，我们对参与者进行了一对一的半结构化访谈。结果确定了五个主题（期望和信念影响患者体验；临床专业知识和能力影响接受程度；以人为本的护理；促进对护理产生有益反应的机制；护理路径实施中的不足）。17/29（59%）名参与者的身体生活质量、12/29（41%）名参与者的心理健康生活质量、8/29（28%）名参与者的疼痛自我效能以及 19/29（66%）名参与者的整体感知变化均出现了积极的个人变化。管理达到了预期目标，大多数人表示非常满意。将定性和定量数据与 "可接受性理论框架 "相结合，在 "道德性"、"干预一致性"、"自我效能 "和 "情感态度 "等方面形成了互补的元推论。讨论总体而言，参与者对护理路径的接受度较高。专业物理治疗师的护理被认为是对常规护理的积极补充。

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引用次数: 0

Effects of therapeutic exercise on pain processing in people with chronic non-specific neck pain - A systematic review and meta-analysis 治疗性运动对慢性非特异性颈痛患者疼痛处理的影响--系统回顾与荟萃分析

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2024-09-11 DOI: 10.1016/j.msksp.2024.103183

Adriane Aguayo-Alves , Giovanna Laura Neves Antônio Gaban , Marcos Amaral de Noronha , Luiz Fernando Approbato Selistre

Background

Emerging evidence suggests that individuals with chronic non-specific neck pain may experience altered sensory processing, potentially contributing to the modest response to therapeutic exercise treatments.

Objective

This systematic review aims to explore the effect of therapeutic exercise on pain processing among patients with chronic non-specific neck pain.

Methods

A systematic search was conducted in multiple databases (PubMed, EMBASE, CINAHL, PEDro, SportDiscus, and Cochrane CENTRAL) from inception to June 2023. Inclusion criteria included randomized controlled trials (RCT) comparing therapeutic exercise to non-exercise treatments or no treatment. The screening and data extraction was conducted by two reviewers. The methodological quality was evaluated using the PEDro scale and the certainty of evidence using GRADE. The primary outcomes assessed were pressure pain threshold (PPT), temporal summation, and conditioned pain modulation.

Results

Thirteen trials included a total of 948 participants, with 586 in the exercise therapy group and 362 in the non-exercise group. The therapeutic exercise was not superior to non-exercise treatments for both local and PPT in the immediate (MD = 0.13, 95%CI = −0.18 to 0.43), and short-term follow-up (MD = 0.17, 95%CI = −0.27 to 0.61). In the medium term, therapeutic exercise demonstrated a small effect size in increasing local PPT (Kg/cm2) (MD = 0.64, 95%CI = 0.08 to 1.19) compared to non-exercise interventions. The certainty of evidence for these outcomes was very low.

Conclusions

There is very low certainty of evidence that therapeutic exercise is not superior than non-exercise treatment on pain processing in patients with chronic non-specific neck pain.

背景越来越多的证据表明，慢性非特异性颈部疼痛患者的感觉处理可能会发生改变，这可能是导致治疗性运动疗法反应不大的原因之一。目的本系统综述旨在探讨治疗性运动对慢性非特异性颈部疼痛患者疼痛处理的影响。方法从开始到 2023 年 6 月，在多个数据库（PubMed、EMBASE、CINAHL、PEDro、SportDiscus 和 Cochrane CENTRAL）中进行了系统检索。纳入标准包括比较治疗性运动与非运动疗法或无疗法的随机对照试验（RCT）。筛选和数据提取由两名审稿人进行。方法学质量采用PEDro量表进行评估，证据的确定性采用GRADE进行评估。结果13项试验共纳入948名参与者，其中运动疗法组586人，非运动疗法组362人。在近期（MD = 0.13，95%CI = -0.18 至 0.43）和短期随访（MD = 0.17，95%CI = -0.27 至 0.61）中，治疗性运动在局部和 PPT 方面均不优于非运动疗法。从中期来看，与非运动干预相比，治疗性运动在提高局部 PPT（Kg/cm2）（MD = 0.64，95%CI = 0.08 至 1.19）方面的效果较小。这些结果的证据确定性很低。结论对于慢性非特异性颈部疼痛患者的疼痛处理，治疗性运动并不比非运动疗法更有优势，这一证据的确定性很低。

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引用次数: 0

Online education and manual skill acquisition 在线教育和手工技能学习

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2024-09-10 DOI: 10.1016/j.msksp.2024.103181

Professor Emerita Gwendolen Jull AO (Co-EditorMusculoskeletal Science and Practice), Professor Emerita Ann P. Moore CBE (Editor in ChiefMusculoskeletal Science and Practice)

引用次数: 0

Cross-cultural Adaptation of the Avoidance of Daily Activities Photo Scale for Turkish patients with shoulder pain: Reliability and validity assessment according to the COSMIN guideline 针对土耳其肩痛患者的 "避免日常活动照片量表 "的跨文化改编：根据 COSMIN 指南进行可靠性和有效性评估

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2024-09-10 DOI: 10.1016/j.msksp.2024.103180

Pinar Kuyulu Haksal , Kubra Caylan Gurses , Birgul Dingirdan , Busra Pakoz , Irem Duzgun , Anamaria Siriani de Oliveira , Elif Turgut

Context

People with chronic or long-term pain may develop various psychosocial symptoms such as fear and avoidance of behavior due to pain. Reliable and valid quality of life tools must be available in Turkish to specifically assess avoidance of behavior in people with shoulder pain.

Objectives

This study aimed to translate and culturally adapt the Avoidance of Daily Activities Photo Scale for Patients with Shoulder Pain and to evaluate the psychometric properties of its Turkish version (ADAP-Tr) in patients with shoulder pain.

Methods

Translation, adaptation, and validation were performed according to the COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) guidelines. The internal consistency, reliability, construct validity, and discriminant validity of the ADAP-Tr were tested. The Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia (TSK), and Shoulder Pain and Disability Index (SPADI) were applied for validation purposes.

Results

The study included a total of 162 participants with shoulder pain. The internal consistency of the ADAP-Tr showed excellent reliability with a Cronbach's α of 0.94 and a test-retest assessment of 0.88 ICC (95% CI, 0.83-0.91). The standard error of measurement was 1.85 points, and the minimal detectable change was determined 5.12 points. There was a low to high correlation among the ADAP-Tr and PCS (r = 0.481, p < .001), TSK (r = 0.448, p < .001), and SPADI (r = 0.826, p < .001) scores.

Conclusions

The ADAP-Tr was shown to be a valid and strong reliability tool to use in clinical and research settings as a shoulder-specific measurement tool.

背景慢性或长期疼痛患者可能会出现各种社会心理症状，如因疼痛而产生恐惧和行为回避。本研究旨在翻译肩痛患者避免日常活动照片量表并对其进行文化适应性调整，同时评估其土耳其语版本（ADAP-Tr）在肩痛患者中的心理测量特性。对 ADAP-Tr 的内部一致性、可靠性、结构效度和判别效度进行了测试。研究还采用了疼痛灾难化量表（PCS）、坦帕运动恐惧量表（TSK）和肩痛与残疾指数（SPADI）进行验证。ADAP-Tr的内部一致性极佳，Cronbach's α为0.94，测试-再测评估ICC为0.88（95% CI，0.83-0.91）。测量的标准误差为 1.85 分，可检测到的最小变化为 5.12 分。ADAP-Tr与PCS（r = 0.481，p <.001）、TSK（r = 0.448，p <.001）和SPADI（r = 0.826，p <.001）得分之间存在低到高的相关性。

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引用次数: 0

Corrigendum to “Conference abstracts from IFOMPT 24, the 12th world conference of musculoskeletal and manual physical therapy. Celebrating 50 years. Basel, Switzerland 4th–6th July” [Muscoskel. Sci. Pract. 72 (2024) 103127] 第 12 届世界肌肉骨骼和手法理疗大会 IFOMPT 24 会议摘要》的更正。庆祝 50 周年。瑞士巴塞尔，7 月 4-6 日" [Muscoskel.

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2024-09-07 DOI: 10.1016/j.msksp.2024.103159

引用次数: 0

Can assessment of human assumed central sensitisation improve the predictive accuracy of the STarT Back screening tool in acute low back pain? 对人体假定中枢敏感性的评估能否提高 STarT Back 筛选工具对急性腰背痛的预测准确性？

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2024-09-07 DOI: 10.1016/j.msksp.2024.103177

Wei-Ju Chang , Peter Humburg , Luke C. Jenkins , Valentina Buscemi , M.E. Gonzalez-Alvarez , James H. McAuley , Matthew B. Liston , Siobhan M. Schabrun

Background

The STarT Back Screening Tool (SBT) is recommended to provide risk-stratified care in low back pain (LBP), yet its predictive value is moderate for disability and low for pain severity. Assessment of human assumed central sensitisation (HACS) in conjunction with the SBT may improve its predictive accuracy.

Objectives

To examine whether assessment of HACS in acute LBP improves the predictive accuracy of the SBT for LBP recovery at six months in people with acute non-specific LBP.

Design

A prospective longitudinal study.

Method

Data were drawn from the UPWaRD study. One hundred and twenty people with acute non-specific LBP were recruited from the community. Baseline measures included SBT risk status, nociceptive flexor withdrawal reflex, pressure and heat pain thresholds and conditioned pain modulation. Primary outcome was the presence of LBP (pain numeric rating scale ≥1 and Roland Morris Disability Questionnaire score ≥3) at six-month follow-up. Regression coefficients were penalised using the least absolute shrinkage and selection operator technique to select predictor variables. Internal validation was performed using ten-fold cross-validation.

Results/findings

SBT risk status alone did not predict the presence of LBP at six months (area under receiver operating characteristic curve [AUC] = 0.58). Adding measures of HACS to the SBT did not improve discrimination for whether LBP was present at six months (AUC = 0.59).

Conclusions

This study confirmed the suboptimal predictive accuracy of the SBT, administered during acute LBP, for LBP recovery at six months. Assessment of HACS in acute LBP does not improve the predictive accuracy of the SBT.

背景STarT背部筛查工具（SBT）被推荐用于为腰背痛（LBP）患者提供风险分级护理，但它对残疾的预测价值一般，对疼痛严重程度的预测价值较低。目标研究对急性腰背痛患者进行 HACS 评估是否能提高 SBT 对急性非特异性腰背痛患者六个月后腰背痛恢复情况的预测准确性。方法数据来自 UPWaRD 研究。从社区招募了120名急性非特异性腰痛患者。基线测量包括SBT风险状态、痛觉屈肌退缩反射、压力和热痛阈值以及条件性疼痛调节。主要结果是随访六个月时是否存在枸杞痛（疼痛数字评分量表≥1，罗兰-莫里斯残疾问卷评分≥3）。使用最小绝对收缩和选择算子技术对回归系数进行惩罚，以选择预测变量。采用十倍交叉验证法进行内部验证。结果/发现仅凭SBT风险状况并不能预测6个月后是否出现LBP（接收器操作特征曲线下面积[AUC] = 0.58）。结论这项研究证实，在急性 LBP 时进行的 SBT 对 6 个月后 LBP 恢复的预测准确性并不理想。对急性枸杞痛进行 HACS 评估并不能提高 SBT 的预测准确性。

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引用次数: 0

The effect of visual cues at different heights on sit-to-stand movements in people with and without low back pain 不同高度的视觉提示对腰痛患者和无腰痛患者从坐到站动作的影响

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2024-09-07 DOI: 10.1016/j.msksp.2024.103179

Cathrine H. Feier, Stephen H.M. Brown

Background

Investigating movement strategies that can be utilized to avoid pain-provocation could enhance the management of low back pain episodes.

Objective

To assess the effect of visual cues at different heights on the kinematics of sit-to-stand movements, as well as perceived difficulty and pain levels.

Design

Cross-over design comparing individuals with low back pain to healthy controls.

Methods

26 asymptomatic controls and 15 individuals with chronic, recurrent low back pain performed 5 sets of 5 sit-to-stand movements. High, middle, and low visual cues were used during sets 2–4. Spinal sagittal plane range of motion, peak spinal flexion and extension angles, and trunk centre of mass velocity were obtained from kinematic data.

Results

The low cue led to significantly more head and lumbar spine flexion, while the high cue led to significantly more head and thoracic spine extension and increased thoracic spine range of motion. The low back pain group demonstrated a significantly lower vertical trunk centre of mass velocity than the control group during the high cue trials. There was a significant association between higher perceived difficulty scores and lower trunk centre of mass velocity for the low back pain group. Pain scores were not significantly different between cue conditions.

Conclusion

Visual cues can be used to temporarily change the spinal kinematics of sit-to-stand movements in people with and without low back pain. This could be helpful in clinical practice to encourage more, or less, movement in specific spinal regions, and avoid pain provocation to facilitate functional rehabilitation.

背景研究可用于避免疼痛诱发的运动策略可加强对腰背痛发作的管理。目的评估不同高度的视觉提示对坐立运动的运动学以及感知难度和疼痛程度的影响。方法26名无症状对照组和15名慢性复发性腰背痛患者进行了5组5次坐立运动。在第 2-4 组中使用了高、中、低视觉提示。从运动学数据中获得了脊柱矢状面运动范围、脊柱屈伸角度峰值和躯干质心速度。结果低视线提示使头部和腰椎屈曲明显增加，而高视线提示使头部和胸椎伸展明显增加，胸椎运动范围增大。腰痛组在高提示试验中的躯干垂直质心速度明显低于对照组。腰痛组的难度感知评分较高，而躯干质量中心速度较低，两者之间存在明显关联。结论视觉提示可用于暂时改变腰背痛患者和非腰背痛患者从坐到站运动的脊柱运动学。这在临床实践中可能会有所帮助，以鼓励在特定脊柱区域进行更多或更少的运动，并避免引发疼痛，从而促进功能康复。

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引用次数: 0

Pain neuroscience education is not superior to spinal physiology and ergonomics education within a short multidisciplinary rehabilitation program: A randomized controlled trial 在短期多学科康复计划中，疼痛神经科学教育并不优于脊柱生理学和人体工程学教育：随机对照试验

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice

Pub Date : 2024-09-05 DOI: 10.1016/j.msksp.2024.103176

Nicolas Adenis , Valérie Wieczorek , Sophie Corbinau , Léa Mortain , André Thevenon

Introduction

There is little evidence to suggest that one educational intervention is superior to another when associated with a rehabilitation program in the management of persistent low back pain. The objective of the present study was to compare pain neuroscience education with spine physiology and ergonomics education as part of a one-week multidisciplinary rehabilitation program.

Method

We conducted a randomized, controlled trial among patients having experienced persistent low back pain for at least 1 year. The patients participated in a one-week multidisciplinary rehabilitation program with an educational component. The members of the experimental and control groups received pain neuroscience education and spine physiology and ergonomics education, respectively. Outcomes were assessed before the program (day 0), immediately afterwards (day 5), and on day 90 after the start of the program. The primary outcome measure was functional disability on day 90.

Results

A total of 88 patients were randomized. On day 90, a statistically significant mean [95% confidence interval] decrease in the level of disability was observed in the experimental (PNE) group (−3.4 [-5.0 to −1.8]). The mean [95%CI] difference versus the control group (−1.7 [-4.0 to 0.5]) was not statistically significant (p = 0.12). There were no statistically significant intergroup differences in the secondary outcome measures.

Conclusion

There appears to be no advantage in replacing a conventional, non-neuroscientific educational program (based on spinal physiology and ergonomics) with a pain neuroscience education program as part of a one-week multidisciplinary rehabilitation program. Further research is needed to identify patients who will respond better to a pain neuroscience education module as part of a personalized care program.

引言在治疗顽固性腰背痛的康复计划中，几乎没有证据表明一种教育干预措施优于另一种。本研究的目的是比较疼痛神经科学教育与脊柱生理学和人体工程学教育，作为为期一周的多学科康复计划的一部分。这些患者参加了为期一周的多学科康复计划，其中包含教育内容。实验组和对照组的成员分别接受了疼痛神经科学教育、脊柱生理学和人体工程学教育。结果分别在项目开始前（第0天）、项目结束后（第5天）和项目开始后第90天进行评估。主要结果是第 90 天的功能障碍。在第 90 天，实验组（PNE）的残疾程度平均[95% 置信区间]显著下降（-3.4 [-5.0 至-1.8]）。与对照组（-1.7 [-4.0 to 0.5]）相比，平均[95%置信区间]差异无统计学意义（P = 0.12）。结论在为期一周的多学科康复计划中，用疼痛神经科学教育计划取代传统的非神经科学教育计划（基于脊柱生理学和人体工程学）似乎没有优势。还需要进一步研究，以确定哪些患者对作为个性化护理计划一部分的疼痛神经科学教育模块反应更好。

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引用次数: 0