基于互联网的颈部运动训练对神经根型颈椎病患者疼痛和功能障碍的影响

Effects of internet-based neck-specific training programs on pain and disability in patients with cervical spondylotic radiculopathy

目的 探究基于互联网的远程康复项目是否可以减轻神经根型颈椎病(cervical spondylotic radiculopathy, CSR)参与者疼痛和功能障碍。方法 选取2022年3月—9月在四川大学华西医院就诊的CSR患者。采用随机数字表法将纳入患者分为远程康复组和传统治疗组。主要结局指标包括颈部视觉模拟评分法评分、颈部功能障碍指数、患者可接受度。次要结局指标包括欧洲五维健康量表评分、恐惧-回避信念问卷评分、医院焦虑抑郁量表评分、田中靖久20分症状量表评分。在基线、首次干预后的第12周和第24周收集定量结局指标结果,在首次干预后的第24周收集定性结局指标结果。结果 共纳入患者90例,每组各45例。两组患者的年龄、性别等人口学特征与一般资料比较,差异均无统计学意义(P>0.05)。除田中靖久20分症状量表不存在交互效应(组别×时间)外(P>0.05),其他定量结局指标的交互效应均有统计学意义(P<0.05)。各定量结局指标的时间效应均有统计学意义(P<0.001)。各定量结局指标的组别效应均无统计学意义(P>0.05)。两组不同时间点定量结局指标组内两两比较,差异均有统计学意义(P<0.001)。各定性结局指标两组组间比较,差异均无统计学意义(P>0.05)。结论 经过为期12周的基于互联网的颈部运动训练项目或传统治疗,CSR患者的疼痛和和功能障碍都得到减轻,且长期疗效显著,两种治疗的疗效无明显差异。

Objective To investigate whether an internet-based neck-specific training program can alleviate pain and disability in participants with cervical spondylotic radiculopathy(CSR).Methods Patients diagnosed with CSR at West China Hospital of Sichuan University between March 2022 and September 2022 were randomly allocated to either an telehabilitation group or a traditional treatment group.The primary outcome measures included Visual Analogue Scale,Neck Disability Index,and patient satisfaction.Secondary outcome measures included the Euroqol group's 5-Domain questionnaire,Fear-Avoidance Beliefs Questionnaire,Hospital Anxiety and Depression Scale,Tanaka Jingjiu cervical spondylosis symptom scale(20 points)and satisfaction.Quantitative outcome measures were collected at baseline,12th and 24th weeks after the first intervention,while qualitative outcome measures were collected at 24th weeks after the first intervention.ResultsA total of 90 patients were included,with 45 in each group.There was no statistically significant difference between the two groups in terms of age,gender and other demography characteristics and general data(P>0.05).There is no interaction effect(group×time)for the Tanaka Jingjiu cervical spondylosis symptom scale(20 points)(P>0.05),the interaction effects(group×time)for other quantitative outcome measures were statistically significant(P<0.05).The time effect showed significant statistical differences across all quantitative outcome measures(P<0.001),while the group effect did not exhibit any significant statistical differences(P>0.05).The comparison results within the group showed that at different time points,the differences between the two groups were statistically significant(P<0.001).There were no significant statistical differences between the two groups in terms ofqualitative outcomemeasures(P>0.05).ConclusionssAn internet-based neck-specific training program or traditional treatment for 12 weeks can effectively reduce pain and disability among CSR patients,with significant longterm effects.There was no significant difference in treatment effectiveness between the two groups.