Effekte physiotherapeutischer Gruppenbehandlung mit Schmerzmanagement und gezielter Aktivierung bei chronischem Nackenschmerz

Zusammenfassung

Hintergrund: Chronische Nackenschmerzen sind weitverbreitet. Um diese Gesundheitsbelastung zu reduzieren, werden effektive, ökonomische Behandlungsformen benötigt.

Ziel: Nachweis der Effekte eines schmerzspezifischen Gruppen-Physiotherapieprogramms.

Methode: Retrospektive Datenauswertung. Die Gruppen-Physiotherapie bestand aus 10 60-minütigen Einheiten mit „Graded Activity“ und Edukation über 5 Wochen + 1 Einheit nach 4 Wochen zur Förderung des Selbstmanagements. Beim 1., 10. und 11. Termin wurden der Neck Disability Index (NDI), der Marburger Fragebogen zum habituellen Wohlbefinden (MFHW) und die Schmerzempfindungsskala (SES) erhoben. 59 % der Gruppenteilnehmer nahmen auch das Angebot instrumentierter Kraft- und Beweglichkeitsmessungen wahr. Unterschiede zwischen Termin 1, 10 und 11 wurden mithilfe der Analysis of Variance (ANOVA) für Messwiederholungen analysiert. Messwerte am individuell ersten und letzten Termin wurden mit t-Tests verglichen.

Ergebnisse: Die Daten von 34 Teilnehmern (26 Frauen, 18 Männer) im Alter von 54 (Standardabweichung [SD]: 16) Jahren zeigten eine Verbesserung des NDI um 33 % (P < 0,0001) und des Wohlbefindens um 63 % (P < 0,01). Die affektive Schmerzwahrnehmung verminderte sich um 27 % (P < 0,05), der somatosensorische Schmerz um 16 % (P < 0,05). Die instrumentierten Kraft- und Beweglichkeitsmessungen bei 20 Teilnehmern (15 Frauen, Alter 55 [SD: 19] Jahre) erzielten signifikante Verbesserungen.

Schlussfolgerung: Die vorgestellte Gruppen-Physiotherapie für Patienten mit Nackenschmerz unterschiedlicher Diagnose erwies sich als effektive Intervention.

Abstract

Background: Chronic neck pain is a widespread health problem. Effective, economic interventions are needed to alleviate this health burden.

Objective: Documentation of the effects of a pain-specific physiotherapy group program.

Methods: Retrospective data evaluation; the physiotherapy group consisted of 10 sessions (each 60 min) of graded activity and education over 5 weeks, + 1 session 4 weeks later to enhance self-management. At the 1st, the 10th and the 11th session, patients filled the Neck Disability Index (NDI), the Marburger Fragebogen zum habituellen Wohlbefinden (MFHW) and the Schmerzempfindungsskala (SES). 59 % of the participants took also part in the offered instrumented measurements of neck range of motion and strength. Differences between the 1st, the 10th and the 11th session were analysed using repeated measures ANOVA. Measurement differences between the individually first and last sessions were estimated with t-tests.

Results: Data from 34 participants (26 women) aged 54 (SD 16) years indicated an improvement of the NDI by 33 %, P< 0.0001, and of wellbeing by 63 %, P< 0.01. Affective pain feeling reduced by 27 %, P< 0.05, somatosensory pain feeling by 16 %, P< 0.05. The instrumented motion and strength measurements of 20 participants (15 female, aged 55 (SD 19) indicated significant improvements.

Conclusion: The presented group physiotherapy for neck pain patients with inhomogeneous diagnoses was an effective intervention.

Schlüsselwörter

Nackenschmerz - Physiotherapie

Key words

neck pain - physiotherapy

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