著者

重藤 隼人 田中 陽一 古賀 優之 大住 倫弘 森岡 周

出版者

日本疼痛学会

雑誌

PAIN RESEARCH (ISSN:09158588)

巻号頁・発行日

vol.35, no.3, pp.133-140, 2020-09-30 (Released:2020-09-30)

参考文献数

23

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Central sensitization (CS) and psychological factors are associated with pain intensity. However, it has remained unclear whether the effects of central sensitivity syndromes and cognitive ⁄ emotional factors differ depending on the severity of pain and the pain quality. Our purposes were to perform subgrouping based on central sensitivity syndromes and pain intensity, and to clarify the difference in central sensitization syndrome and pain intensity between subgroups.Fifty–nine patients with musculoskeletal pain were included in this cross–sectional study. Pain intensity and psychological problems were assessed with Central sensitization inventory (CSI–9), Short–Form McGill Pain Questionnaire 2 (SFMPQ2), Hospital Anxiety and Depression Scale (HADS), Pain Catastrophizing Scale (PCS–4). The cluster analysis with a ward method was used to divide patients into subgroups based on central sensitization syndrome and pain intensity. In addition, Kruskal–Wallis test, multiple comparison (Bonferroni method), and Fisher’s exact test were performed to compare clinical outcomes between subgroups. The level of significance was set at 5%.The cluster analysis classified into three subgroups. One subgroup of patients (n=11) was characterized by high level of central sensitivity syndromes, pain intensity and psychological problems. A second subgroup (n=19) was characterized by low level of central sensitivity syndromes, moderate level of pain intensity, high level of psychological problems. The third subgroup (n=29) was characterized by low level of central sensitivity syndromes, pain intensity and psychological problems. That is, one subgroup was mainly affected with central sensitivity syndromes, and another subgroup was affected psychological factors. These results indicated the differences in pain mechanism among subgroups.

著者

長倉 侑祐 尾川 達也 古賀 優之 竜江 哲培

出版者

一般社団法人 日本作業療法士協会

雑誌

作業療法 (ISSN:02894920)

巻号頁・発行日

vol.42, no.5, pp.687-694, 2023-10-15 (Released:2023-10-15)

参考文献数

13

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事故後の外傷性頸部症候群による慢性疼痛,重度の中枢性感作症候群,心的外傷を呈し,日常生活に支障をきたした事例を経験した.Aid for Decision-making in Occupation Choiceを用いて目標を設定し,Goal Attainment Scalingにて段階的作業療法プログラムを実施した.結果,VASとPCS,PSEQの改善は認められなかったものの,GASの達成度が向上し,目標と関係するPDASの「腰を使う活動」に改善を認め,行動変容に繋がった.本事例を通して,外傷性頸部症候群による慢性疼痛患者に対する目標に基づいた作業療法が行動変容の促進に繋がる可能性が示唆された.