Reduction of Pain-Related Fear and Disability in Post-Traumatic Neck Pain: A Replicated Single-Case Experimental Study of Exposure In Vivo

JOURNAL OF PAIN

卷:9

Article

de Jong, Jeroen R.^1,2  Vangronsveld, Karoline²  Peters, Madelon L.²  Goossens, Marielle E. J. B.²  Onghena, Patrick³  Bulte, Isis³  Vlaeyen, Johan W. S.^2,4 

[1] Univ Hosp Maastricht, Dept Rehabil, NL-6202 AZ Maastricht, Netherlands

[2] Maastricht Univ, Dept Clin Psychol Sci, Maastricht, Netherlands

[3] Katholieke Univ Leuven, Dept Educ Sci, Louvain, Belgium

[4] Katholieke Univ Leuven, Dept Psychol, Louvain, Belgium

关键词: Pain-related fear;    graded exposure in vivo;    graded activity;    post-traumatic neck pain disability;   

DOI  :  10.1016/j.jpain.2008.06.015

来源: Elsevier

【 摘 要 】

For patients with acute post-traumatic neck pain (PTNP), pain-related fear has been identified as a potential predictor of chronic disability. If such is the case, fear reduction should enhance the prevention of further pain disability and distress after traumatic neck pain disability. However, exposure-based treatments have not been tested in patients with PTNP. Using a replicated single-case crossover phase design with multiple measurements, this study examined whether the validity of a graded exposure in vivo, as compared with usual graded activity, extends to PTNP. Eight patients who reported substantial pain-related fear were included in the study. Daily changes in pain intensity, pain-related fear, pain catastrophizing, and activity goal achievement were assessed. Before and after each intervention, and at 6-month follow-up, standardized questionnaires of pain-related fear and pain disability were administered, and, to quantify daily physical activity level, patients carried an ambulatory activity monitor. The results showed decreasing levels of self-reported pain-related fear, pain intensity, disability, and improvements in physical activity level only when graded exposure in vivo was introduced, and not in the graded activity condition. The results are discussed in the context of the search for customized treatments for PTNP. Perspective: This is the first study showing that the effects of graded exposure in vivo generalize to patients with chronic PTNP reporting elevated levels of pain-related fear. This could help clinicians to customize treatments for PTNP. (C) 2008 by the American Pain Society

【 授权许可】

Free