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首页> 外文期刊>BMC Musculoskeletal Disorders >Effects of tailored neck-shoulder pain treatment based on a decision model guided by clinical assessments and standardized functional tests. A study protocol of a randomized controlled trial
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Effects of tailored neck-shoulder pain treatment based on a decision model guided by clinical assessments and standardized functional tests. A study protocol of a randomized controlled trial

机译：基于临床评估和标准化功能测试指导的决策模型，量身定制的肩甲疼痛治疗的效果。随机对照试验的研究方案

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Background A major problem with rehabilitation interventions for neck pain is that the condition may have multiple causes, thus a single treatment approach is seldom efficient. The present study protocol outlines a single blinded randomised controlled trial evaluating the effect of tailored treatment for neck-shoulder pain. The treatment is based on a decision model guided by standardized clinical assessment and functional tests with cut-off values. Our main hypothesis is that the tailored treatment has better short, intermediate and long-term effects than either non-tailored treatment or treatment-as-usual (TAU) on pain and function. We sub-sequentially hypothesize that tailored and non-tailored treatment both have better effect than TAU. Methods/Design 120 working women with minimum six weeks of nonspecific neck-shoulder pain aged 20–65, are allocated by minimisation with the factors age, duration of pain, pain intensity and disability in to the groups tailored treatment (T), non-tailored treatment (NT) or treatment-as-usual (TAU). Treatment is given to the groups T and NT for 11?weeks (27 sessions evenly distributed). An extensive presentation of the tests and treatment decision model is provided. The main treatment components are manual therapy, cranio-cervical flexion exercise and strength training, EMG-biofeedback training, treatment for cervicogenic headache, neck motor control training. A decision algorithm based on the baseline assessment determines the treatment components given to each participant of T- and NT-groups. Primary outcome measures are physical functioning (Neck Disability Index) and average pain intensity last week (Numeric Rating Scale). Secondary outcomes are general improvement (Patient Global Impression of Change scale), symptoms (Profile Fitness Mapping neck questionnaire), capacity to work in the last 6?weeks (quality and quantity) and pressure pain threshold of m. trapezius. Primary and secondary outcomes will be reported for each group with effect size and its precision. Discussion We have chosen not to include women with psychological ill-health and focus on biomedical aspects of neck pain. Future studies should aim at including psychosocial aspects in a widened treatment decision model. No important adverse events or side-effects are expected. Trial registration Current Controlled Trials registration ISRCTN49348025.
机译：背景技术针对颈部疼痛的康复干预的主要问题是该病症可能有多种原因，因此单一治疗方法很少有效。本研究方案概述了一项单盲的随机对照试验，该试验评估了量身定制的治疗方式对颈部肩痛的治疗效果。该治疗基于决策模型，该决策模型以标准化的临床评估和具有临界值的功能测试为指导。我们的主要假设是，针对疼痛和功能的情况，量身定制的治疗方法比非量身定制的治疗方法或常规治疗（TAU）更好的短期，中期和长期效果。我们随后假设，量身定制和非量身定制的治疗均比TAU疗效更好。方法/设计通过最小化因素，将年龄，疼痛持续时间，疼痛强度和残疾等因素分配给120名职业女性，这些女性至少有20周年龄在20-65岁之间的非特异性颈肩痛，这些人群是针对性治疗量身定制的治疗（NT）或常规治疗（TAU）。 T组和NT组进行了11周的治疗（平均分配27个疗程）。提供了测试和治疗决策模型的详尽介绍。主要治疗成分是手动疗法，颅颈屈肌锻炼和力量训练，EMG生物反馈训练，宫颈源性头痛的治疗，颈部运动控制训练。基于基线评估的决策算法确定给予T组和NT组每个参与者的治疗成分。主要结局指标是身体机能（颈部残疾指数）和上周平均疼痛强度（数字评分量表）。次要结果是总体改善（患者总体变化印象量表），症状（适应性健康状况调查问卷），最近6周的工作能力（质量和数量）以及m的压力痛阈值。斜方肌。将报告每个组的主要和次要结局，包括效应大小及其准确性。讨论我们选择不包括患有心理疾病的女性，而专注于颈部疼痛的生物医学方面。未来的研究应旨在将社会心理方面纳入扩大的治疗决策模型中。预计不会发生重大不良事件或副作用。试用注册当前控制的试用注册ISRCTN49348025。

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