目的:开发并内部验证预测急性或亚急性非特异性特发性新发作后慢性疼痛的预后模型,接受理疗初级护理的患者的非创伤性颈部疼痛,强调可修改的生物医学,心理和社会因素。
方法:一项前瞻性队列研究,在2020年1月至2023年3月之间进行6个月的随访。
方法:30个理疗初级护理实践。
方法:新出现非特异性特发性的患者,非创伤性颈部疼痛,发病后持续时间不超过12周。
■从参与者收集的候选预后变量包括年龄和性别,颈部疼痛症状,与工作相关的因素,一般因素,心理和行为因素以及其余因素:治疗关系和医疗保健提供者的态度。
方法:6周时的疼痛强度,纳入后3个月和6个月的数字疼痛评定量表(NPRS)。每个时间点的NPRS评分≥3用于定义慢性颈痛。
结果:603名参与者中有62名(10%)出现慢性颈部疼痛。最终模型中的预后因素是性别,疼痛强度,报告了身体不同部位的疼痛,自从颈部疼痛以来和之前的头痛,工作时的姿势,就业状况,关于疼痛身份和康复的疾病信念,治疗信念,痛苦和自我效能感。该模型显示出乐观校正的曲线下面积为0.83,校正的R2为0.24。校准被认为是可以接受的,如校准曲线所示。Hosmer-Lemeshow检验得出的p值为0.7167,表明模型拟合良好。
结论:该模型有可能在新的急性和亚急性非特异性特发性发作后获得慢性疼痛的有效预后,非创伤性颈部疼痛.它主要包括物理治疗实践的潜在可改变的因素。建议对该模型进行外部验证。
OBJECTIVE: To develop and internally validate a prognostic model to predict chronic pain after a new episode of acute or subacute non-specific idiopathic, non-traumatic neck pain in patients presenting to physiotherapy primary care, emphasising modifiable biomedical, psychological and social factors.
METHODS: A prospective cohort study with a 6-month follow-up between January 2020 and March 2023.
METHODS: 30 physiotherapy primary care practices.
METHODS: Patients with a new presentation of non-specific idiopathic, non-traumatic neck pain, with a duration lasting no longer than 12 weeks from onset.
UNASSIGNED: Candidate prognostic variables collected from participants included age and sex, neck pain symptoms, work-related factors, general factors, psychological and behavioural factors and the remaining factors: therapeutic relation and healthcare provider attitude.
METHODS: Pain intensity at 6 weeks, 3 months and 6 months on a Numeric Pain Rating Scale (NPRS) after inclusion. An NPRS score of ≥3 at each time point was used to define chronic neck pain.
RESULTS: 62 (10%) of the 603 participants developed chronic neck pain. The prognostic factors in the final model were sex, pain intensity, reported pain in different body regions, headache since and before the neck pain, posture during work, employment status, illness beliefs about pain identity and recovery, treatment beliefs, distress and self-efficacy. The model demonstrated an optimism-corrected area under the curve of 0.83 and a corrected R2 of 0.24. Calibration was deemed acceptable to good, as indicated by the calibration curve. The Hosmer-Lemeshow test yielded a p-value of 0.7167, indicating a good model fit.
CONCLUSIONS: This model has the potential to obtain a valid prognosis for developing chronic pain after a new episode of acute and subacute non-specific idiopathic, non-traumatic neck pain. It includes mostly potentially modifiable factors for physiotherapy practice. External validation of this model is recommended.