Alʹmanah Kliničeskoj Mediciny (Mar 2020)
Assessment of anxiety and pain in patients with lumbosacral radiculopathy at the early stage of rehabilitation with various rehabilitation programs after microdiscectomy
Abstract
Rationale: The role of the psychogenic component in chronic pain and delayed rehabilitation in patients with lumbosacral radiculopathy (LSR) has been extensively studied. However, there is a paucity of studies evaluating anxiety and pain in LSR patients early after microdiscectomy. Only a few studies have performed a differentiated assessment of state (SA) and trait (TA) anxiety. The effects of repetitive peripheral magnetic stimulation (rPMS) on the TA level in the Russian LSR patients have not been investigated. Aim: To assess changes in anxiety and pain over time in LSR patients with various rehabilitation programs at the early stage after microdiscectomy. Materials and methods: The study included 71 patients with LSR after microdiscectomy (mean age 46.8 ± 10.5 years). At Day 7 after surgery, the patients were randomized into two groups. The patients in the 1st group (n = 35) received a rPMS course in addition to conventional rehabilitation, whereas the patients in the 2nd group (n = 36) were rehabilitated only conventionally. Pain was assessed by a visual analogue scale (VAS), and anxiety levels by Spielberger StateTrait Anxiety Inventory (validated Russian version). Results: There was a significant decrease of SA and TA levels in the patients of both groups at Day 21 of rehabilitation, compared to those at Day 7 (p < 0.001). At Day 21, there was a significant inter-group difference (p = 0.036) in the leg pain VAS score and the TA frequency distribution (p = 0.042, Fisher test). Conclusion: Better improvement of pain and trait anxiety in the patients treated with rPMS indicates that it would be reasonable to include an rPMS course into the comprehensive rehabilitation program after microdiscectomy.
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