Active Treatment of Chronic Neck Pain: A Prospective Randomized Intervention
Active Treatment of Chronic Neck Pain: A Prospective Randomized Intervention
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慢性颈部疼痛的积极治疗：前瞻性随机干预
DOI：
10.1097/00007632-200004150-00018
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发表时间：
2000
期刊：
影响因子：
3
通讯作者：
Sirkka Parviainen
中科院分区：
文献类型：
--
作者：
S. Taimela;E. Takala;Tom Asklöf;Kitty Seppälä;Sirkka Parviainen
研究设计.一项单盲结局评估的随机比较研究。目标.比较强调本体感觉训练（ACTIVE）的多模式治疗与激活的家庭锻炼（HOME）和推荐锻炼（CONTROL）在非特异性慢性颈痛患者中的疗效。背景数据总结。在过去的几项研究中，主动运动和被动物理疗法对颈部疾病的疗效有些令人失望。方法. 76例慢性非特异性颈部疼痛患者（22例男性，54例女性）参加了研究。62例患者参加了1年随访。在基线、3个月和12个月时测量主观疼痛和残疾、颈部活动范围和肩部的压痛阈值。ACTIVE治疗包括24次本体感受练习、放松和行为支持。HOME养生法包括一次颈部讲座和两次家庭练习的实践训练，以及保持进展日记的指导。对照治疗包括关于颈部护理的讲座，并建议进行锻炼。结果ACTIVE组的平均自我体验总益处最高，而HOME组的评分高于CONTROL组（P < 0.001）。在颈部症状的减轻、一般健康状况和自我体验工作能力的改善方面，记录了有利于ACTIVE治疗的组间差异（P < 0.01-0.03）。活动度和压力疼痛阈值的变化很小。结论.关于自我体验的益处，多模式治疗比激活的家庭锻炼更有效，激活的家庭锻炼明显比仅仅建议更有效。两组之间颈椎功能的客观测量结果没有显著差异，但这些评估在慢性颈部疾病中的内容有效性值得怀疑。
Study Design. A randomized comparative study with single-blind outcome assessments. Objectives. To compare the efficacy of a multimodal treatment emphasizing proprioceptive training (ACTIVE) with activated home exercises (HOME) and recommendation of exercise (CONTROL) in patients with nonspecific chronic neck pain. Summary of Background Data. The efficacy of active exercises and passive physiotherapy for neck trouble has been somewhat disappointing in the previous few studies. Methods. Seventy-six patients (22 men, 54 women) with chronic, nonspecific neck pain participated. Sixty-two participated the 1-year follow-up. Subjective pain and disability, cervical ranges of motion, and pressure pain threshold in the shoulder region were measured at baseline, at 3 months, and at 12 months. The ACTIVE treatment consisted of 24 sessions of proprioceptive exercises, relaxation, and behavioral support. The HOME regimen included a neck lecture and two sessions of practical training for home exercises and instructions for maintaining a diary of progress. The CONTROL treatment included a lecture regarding care of the neck with a recommendation to exercise. Results. The average self-experienced total benefit was highest in the ACTIVE group, and the HOME group rated over the CONTROL group (P < 0.001). Differences between the groups in favor of the ACTIVE treatment were recorded in reduction of neck symptoms and improvements in general health and self-experienced working ability (P < 0.01–0.03). Changes in measures of mobility and pressure pain threshold were minor. Conclusions. Regarding self-experienced benefit, the multimodal treatment was more efficacious than activated home exercises that were clearly more efficacious than just advising. No major differences were noted in objective measurements of cervical function between the groups, but the content validity of these assessments in chronic neck trouble can be questioned.