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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Abnormal Pain Response After a Compensable Shoulder Injury
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Abnormal Pain Response After a Compensable Shoulder Injury

机译：可补偿的肩部受伤后疼痛反应异常

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Background: The role of psychosocial factors has been established in patients with shoulder abnormalities. However, the prevalence of exaggerated pain behaviors and their association with the characteristics of injured workers have not been well studied. Purpose: To examine the prevalence of abnormal pain responses (APRs) in workers with active workers’ compensation claims for a shoulder injury and to examine the differences between workers with APRs versus workers without APRs. Study Design: Cross-sectional study; Level of evidence, 3. Methods: An analysis of electronic data files of injured workers was completed. An APR was defined as an exaggerated pain response during a clinical examination, including facial grimacing, shaking, withdrawal, nonanatomic dermatome or myotome disturbances, increased tenderness, regional symptoms, and verbal utterances such as groaning, moaning, or gasping. To control for potential confounders, patients with positive APRs (APR group) were matched with injured workers without APRs (control group) seen in the same clinic and matched for sex, age, and surgical candidacy. Results: Data from 1000 workers who had sustained a shoulder injury at work and who were referred for an early assessment by an orthopaedic surgeon and a physical therapist were reviewed. A total of 86 (9%) injured workers (mean age, 47 ± 11 years; 55 [64%] female) demonstrated APRs and were matched with 86 injured workers without APRs. There were no statistically significant between-group differences in the wait time, mechanism of injury, coexisting comorbidity, type of abnormality, or medication consumption. The APR group reported higher levels of disability ( P < .0001) and psychological problems ( P < .0001), presented with more inconsistency in range of motion ( P = .04), and had more limitations at work ( P = .02). Conclusion: The presence of an APR after a compensable shoulder injury was associated with higher reports of disability and psychological problems. Patients with positive APRs were more likely to be off work and less likely to perform full duties.
机译：背景：心理社会因素在肩部异常患者中的作用已经确立。但是，尚未对夸张的疼痛行为的普遍性及其与受伤工人特征的关系进行研究。目的：研究主动伤害工人要求赔偿肩部受伤的工人中异常疼痛反应（APR）的患病率，并检查具有APR工人与没有APR工人之间的差异。研究设计：横断面研究;证据等级，3。方法：完成了对受伤工人的电子数据文件的分析。 APR被定义为在临床检查过程中出现的过度疼痛反应，包括面部做鬼脸，摇晃，停药，非解剖性皮肤刀或肌节紊乱，压痛增加，区域症状以及口头表达，例如gro吟，mo吟或喘气。为了控制潜在的混杂因素，将APR阳性的患者（APR组）与在同一诊所看到的无APR的受伤工人（对照组）进行配对，并按性别，年龄和手术候选者进行匹配。结果：回顾了1000名工人的数据，这些工人在工作中遭受了肩部受伤，并由骨科医生和物理治疗师转介以进行早期评估。共有86名（9％）受伤工人（平均年龄47±11岁; 55 [64％]女性）表现出APR，并与86名没有APR的受伤工人相匹配。两组之间的等待时间，损伤机制，合并症，异常类型或药物消耗之间无统计学差异。 APR组报告了更高水平的残疾（P <.0001）和心理问题（P <.0001），表现出运动范围上的更多不一致（P = .04），并且在工作中有更多的限制（P = .02 ）。结论：可补偿性肩部受伤后APR的存在与残疾和心理问题的报道增多有关。 APRs阳性的患者更有可能下​​班，而履行全职职责的可能性也较小。

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