Archives of physical medicine and rehabilitation · 2026
Community-based Exercise for Chronic Pain in People With Spinal Cord Injury: A Pragmatic Randomized Controlled Trial.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Martin Ginis Kathleen A, Gee Cameron, Hoekstra Femke, Blitz Sandra, Baumgart Julia K, Davis Jennifer C, Karim Mohammad Ehsanul, Little Jonathan Peter, Singer Joel, Todd Kendra R, Townson Andrea, West Christopher R, Kramer John L K
Аннотация
OBJECTIVE: To test the hypothesis that home- and community-based exercise, prescribed according to the spinal cord injury (SCI) exercise guidelines, reduces chronic pain.
DESIGN: Single-blinded, pragmatic randomized controlled trial with 2 arms (exercise intervention, waitlist control) and assessments at baseline, 3 months, and 6 months.
SETTING: Testing at 2 university-based laboratories located on separate campuses within the same institution. Exercise in participants' preferred locations.
PARTICIPANTS: Forty-six adults with SCI (76% men/male; 59% paraplegic; Mage=50.6±14.1; Myears since injury=16.5±12.8) and chronic neuropathic or musculoskeletal pain, who did not routinely achieve the SCI exercise guidelines.
INTERVENTION: Intervention participants (n=25) received an individualized exercise prescription for aerobic and strength training. Fitness trainers and exercise counselors supported implementation. Control participants (n=21) continued their usual activities.
MAIN OUTCOME MEASURES: The primary outcome was the SF-36 Pain score at 6 months. Secondary outcomes were International SCI Pain Basic Dataset version 2.0 (ISCIPBDS) pain-intensity and interference scores, and standardized measures of pain coping, well-being, conditioned pain modulation, and proinflammatory cytokines.
RESULTS: In intent-to-treat analyses, the estimated treatment effect (95% CI) on SF-36 Pain was 7.9 (-1.9 to 17.7; P=.11) at 6 months. Tipping-point analyses suggested that these effects may have been significant if the target sample size had been achieved. Treatment effects for ISCIPBDS pain intensity were -1.8 (-3.4, -0.1; P=.04) at 6 months. Relative to controls, participants in the intervention condition reported significant reductions in pain interference at 3 months and reduced use of pain-coping strategies at 6 months (Ps<0.05). No other effects were significant.
CONCLUSIONS: Intervention effects on SF-36 Pain were inconclusive. Analyses of secondary outcomes (ISCIPBDS) suggest exercise prescribed according to the SCI exercise guidelines, and implemented in real-world settings, can reduce pain intensity. Meeting the aerobic-exercise guideline may be especially important. Further replication in pragmatic trials is required.
DESIGN: Single-blinded, pragmatic randomized controlled trial with 2 arms (exercise intervention, waitlist control) and assessments at baseline, 3 months, and 6 months.
SETTING: Testing at 2 university-based laboratories located on separate campuses within the same institution. Exercise in participants' preferred locations.
PARTICIPANTS: Forty-six adults with SCI (76% men/male; 59% paraplegic; Mage=50.6±14.1; Myears since injury=16.5±12.8) and chronic neuropathic or musculoskeletal pain, who did not routinely achieve the SCI exercise guidelines.
INTERVENTION: Intervention participants (n=25) received an individualized exercise prescription for aerobic and strength training. Fitness trainers and exercise counselors supported implementation. Control participants (n=21) continued their usual activities.
MAIN OUTCOME MEASURES: The primary outcome was the SF-36 Pain score at 6 months. Secondary outcomes were International SCI Pain Basic Dataset version 2.0 (ISCIPBDS) pain-intensity and interference scores, and standardized measures of pain coping, well-being, conditioned pain modulation, and proinflammatory cytokines.
RESULTS: In intent-to-treat analyses, the estimated treatment effect (95% CI) on SF-36 Pain was 7.9 (-1.9 to 17.7; P=.11) at 6 months. Tipping-point analyses suggested that these effects may have been significant if the target sample size had been achieved. Treatment effects for ISCIPBDS pain intensity were -1.8 (-3.4, -0.1; P=.04) at 6 months. Relative to controls, participants in the intervention condition reported significant reductions in pain interference at 3 months and reduced use of pain-coping strategies at 6 months (Ps<0.05). No other effects were significant.
CONCLUSIONS: Intervention effects on SF-36 Pain were inconclusive. Analyses of secondary outcomes (ISCIPBDS) suggest exercise prescribed according to the SCI exercise guidelines, and implemented in real-world settings, can reduce pain intensity. Meeting the aerobic-exercise guideline may be especially important. Further replication in pragmatic trials is required.