The CONECSI trial: Results of a randomized controlled trial of a multidisciplinary cognitive behavioral program for coping with chronic neuropathic pain after spinal cord injury

被引:84
作者
Heutink, Matagne [1 ,2 ,3 ]
Post, Marcel W. M. [1 ,2 ,3 ]
Bongers-Janssen, Helma M. H. [4 ]
Dijkstra, Catja A. [3 ]
Snoek, Govert J. [5 ]
Spijkerman, Dorien C. M. [6 ]
Lindeman, Eline [1 ,2 ,3 ]
机构
[1] Univ Med Ctr Utrecht, Rudolf Magnus Inst Neurosci, NL-3508 AE Utrecht, Netherlands
[2] Univ Med Ctr Utrecht, Ctr Excellence Rehabil Med, NL-3508 AE Utrecht, Netherlands
[3] Rehabil Ctr De Hoogstraat, NL-3508 AE Utrecht, Netherlands
[4] Adelante Zorggrp, NL-6430 AB Hoensbroek, Netherlands
[5] Rehabil Ctr Roessingh, NL-7500 AH Enschede, Netherlands
[6] Rijndam Rehabil Ctr, NL-3001 KD Rotterdam, Netherlands
关键词
Behavioral therapy; Cognitive therapy; Intervention studies; Neuralgia; Psychological; Spinal cord injuries; LOW-BACK-PAIN; MANAGEMENT PROGRAM; LIFE SATISFACTION; REHABILITATION; DEPRESSION; STRATEGIES; OUTCOMES; THERAPY; ANXIETY; INTERVENTIONS;
D O I
10.1016/j.pain.2011.09.029
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Many people with spinal cord injury (SCI) rate chronic neuropathic pain as one of the most difficult problems to manage. The aim of the CONECSI (COping with NEuropathiC Spinal cord Injury pain) trial was to evaluate a multidisciplinary cognitive behavioral treatment program for persons with chronic neuropathic pain after SCI. The intervention consisted of educational, cognitive, and behavioral elements. A total of 61 people were randomized to either the intervention group or the waiting list control group in 4 Dutch rehabilitation centers. Primary outcomes were pain intensity and pain-related disability (Chronic Pain Grade questionnaire), and secondary outcomes were mood (Hospital Anxiety and Depression Scale), participation in activities (Utrecht Activities List), and life satisfaction (Life Satisfaction Questionnaire). Measurements were performed at baseline, and at 3, and 6 months follow-up. The primary statistical technique was random coefficient analysis. The analyses showed significant changes over time on both primary (t1-t2), and 2 out of 4 secondary outcomes (both t1-t2 and t1-t3). Significant intervention effects (Time * Group interactions) were found for anxiety and participation in activities, but not for the primary outcomes. Subsequent paired t tests showed significant changes in the intervention group that were not seen in the control group: decrease of pain intensity, pain-related disability, anxiety, and increase of participation in activities. This study implies that a multidisciplinary cognitive behavioral program might have beneficial effects on people with chronic neuropathic SCI pain. (C) 2011 International Association for the Study of Pain. Published by Elsevier B. V. All rights reserved.
引用
收藏
页码:120 / 128
页数:9
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