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Quirk DA, Johnson ME, Anderson DE, Smuck M, Sun R, Matthew R, Bailey J, Marras WS, Bell KM, Darwin J, Bowden AE. Biomechanical Phenotyping of Chronic Low Back Pain: Protocol for BACPAC. PAIN MEDICINE (MALDEN, MASS.) 2023; 24:S48-S60. [PMID: 36315101 PMCID: PMC10403313 DOI: 10.1093/pm/pnac163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/12/2022] [Accepted: 10/21/2022] [Indexed: 04/27/2023]
Abstract
OBJECTIVE Biomechanics represents the common final output through which all biopsychosocial constructs of back pain must pass, making it a rich target for phenotyping. To exploit this feature, several sites within the NIH Back Pain Consortium (BACPAC) have developed biomechanics measurement and phenotyping tools. The overall aims of this article were to: 1) provide a narrative review of biomechanics as a phenotyping tool; 2) describe the diverse array of tools and outcome measures that exist within BACPAC; and 3) highlight how leveraging these technologies with the other data collected within BACPAC could elucidate the relationship between biomechanics and other metrics used to characterize low back pain (LBP). METHODS The narrative review highlights how biomechanical outcomes can discriminate between those with and without LBP, as well as among levels of severity of LBP. It also addresses how biomechanical outcomes track with functional improvements in LBP. Additionally, we present the clinical use case for biomechanical outcome measures that can be met via emerging technologies. RESULTS To answer the need for measuring biomechanical performance, our "Results" section describes the spectrum of technologies that have been developed and are being used within BACPAC. CONCLUSION AND FUTURE DIRECTIONS The outcome measures collected by these technologies will be an integral part of longitudinal and cross-sectional studies conducted in BACPAC. Linking these measures with other biopsychosocial data collected within BACPAC increases our potential to use biomechanics as a tool for understanding the mechanisms of LBP, phenotyping unique LBP subgroups, and matching these individuals with an appropriate treatment paradigm.
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Affiliation(s)
- D Adam Quirk
- Harvard School of Engineering and Applied Science, Harvard University, Cambridge, Massachusetts
| | - Marit E Johnson
- Department of Orthopaedic Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Dennis E Anderson
- Center for Orthopaedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Matthew Smuck
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California
| | - Ruopeng Sun
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California
| | - Robert Matthew
- Department of Physical Therapy and Rehabilitation Sciences, University of California, San Francisco, California
| | - Jeannie Bailey
- Department of Orthopaedic Surgery, University of California, San Francisco, California
| | - William S Marras
- Department of Integrated Systems Engineering, The Ohio State University, Columbus, Ohio
| | - Kevin M Bell
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jessa Darwin
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Anton E Bowden
- Department of Mechanical Engineering, Brigham Young University, Provo, Utah, USA
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Factors influencing kinesiophobia during the "blanking period" after radiofrequency catheter ablation in patients with atrial fibrillation by the fear-avoidance model. Int J Cardiol 2022; 363:49-55. [PMID: 35716943 DOI: 10.1016/j.ijcard.2022.06.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/31/2022] [Accepted: 06/10/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND The influencing factors of kinesiophobia (fear of movement) in patients with atrial fibrillation(AF)during the post-operative "Blanking Period" are not known. The aims were to investigate the status of kinesiophobia in patients with AF during the post-operative "Blanking Period", then further describe the occurrence and analyze the influencing factors of patients' kinesiophobia by the Fear-Avoidance Model. MATERIALS AND METHODS In total,400 patients diagnosed with atrial fibrillation, during the post-operative "Blanking Period" from the selected hospital were included in this study. The Tampa Scale for Kinesiophobia Heart (TSK-SV Heart), the Self-efficacy for Exercise (SEE) scale, and the Geriatric Locomotive Function Scale (GLFS) were used to assess kinesiophobia, exercise self-efficacy, and physical function. The study adopted a cross-sectional design. RESULTS The score of kinesiophobia during the "Blanking Period" after operation in patients with atrial fibrillation was (44.06 ± 10.77), and the rate of high kinesiophobia was 71.61%.Logistic regression results showed that age, education, household monthly income, resting heart rate, EHRA symptom classification, exercise self-efficacy, and physical function influenced the kinesiophobia of patients during the post-operative "Blanking Period"(p<0.05, p<0.01). CONCLUSIONS Kinesiophobia is common in patients with atrial fibrillation during the postoperative "Blanking Period", and the fear of movement is related to age, education, household monthly income, resting heart rate, EHRA symptom classification, exercise self-efficacy, and physical function. Clinical and nursing staff should pay close attention to the psychological problems in the post-operation "Blanking Period" of exercise rehabilitation in patients with atrial fibrillation, make timely interventions to reduce patients' fear of movement, and improve patients' compliance with exercise rehabilitation.
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Burrus C, Vuistiner P, Léger B, Luthi F. Determination of Perceived Levels of Physical Work Demand Thresholds, and Reliability and Responsiveness of the Modified-Spinal Function Sort Questionnaire in a Multidisciplinary Occupational Rehabilitation Setting. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:822-830. [PMID: 33761082 DOI: 10.1007/s10926-021-09968-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE To determine the levels of perceived work demand capacity corresponding to the Modified Spinal Function Sort (M-SFS) score and precise reliability validity and responsiveness. METHODS This prospective validation study included patients with chronic musculoskeletal impairments who underwent multidisciplinary occupational rehabilitation. After determining the percentiles of the work demand thresholds corresponding to the spinal function sort (SFS), the percentiles were transposed to the M-SFS. Reliability was assessed using the intraclass correlation coefficient and limits of agreement. Correlations with other questionnaires and a lifting task were measured to assess validity. Responsiveness was determined using anchor- and distribution-based approaches. RESULTS 288 patients were included. The following thresholds were obtained for the M-SFS: 0-43 points, minimal; 44-50, very light; 51-58, light; 59-64, light to medium; 65-70, medium; 71-76, heavy; and 77-80, very heavy. Reliability was confirmed. The correlation between the M-SFS and SFS scores was good at 0.89 (95% CI, 0.86-0.91) and moderate according to the PILE-test result of 0.60 (95% CI, 0.50-0.67). We could not calculate a valid anchor-based minimal clinically important difference. The standard error of measurement was 3.9 points, and the smallest detectable change was 10.8 points. CONCLUSIONS On the basis of the comparison of the M-SFS and SFS scores, the M-SFS score can be interpreted in relation to the levels of work demand. This study confirms the good reliability and validity of the M-SFS questionnaire in assessing perceived physical capacity. Further studies are needed to determine its responsiveness.
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Affiliation(s)
- Cyrille Burrus
- Department for Musculoskeletal Rehabilitation, Clinique Romande de Réadaptation, Avenue Grand-Champsec 90, 1950, Sion, Switzerland.
- Institute for Research in Rehabilitation, Clinique Romande de Réadaptation, Avenue Grand-Champsec 90, 1950, Sion, Switzerland.
| | - Philippe Vuistiner
- Institute for Research in Rehabilitation, Clinique Romande de Réadaptation, Avenue Grand-Champsec 90, 1950, Sion, Switzerland
| | - Bertrand Léger
- Institute for Research in Rehabilitation, Clinique Romande de Réadaptation, Avenue Grand-Champsec 90, 1950, Sion, Switzerland
| | - François Luthi
- Department for Musculoskeletal Rehabilitation, Clinique Romande de Réadaptation, Avenue Grand-Champsec 90, 1950, Sion, Switzerland
- Institute for Research in Rehabilitation, Clinique Romande de Réadaptation, Avenue Grand-Champsec 90, 1950, Sion, Switzerland
- Department of Physical Medicine and Rehabilitation, Orthopaedic Hospital, Lausanne University Hospital, Rue du Bugnon 21, 1011, Lausanne, Switzerland
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Lv H, Yang N. Clinical effect of application of nursing concept of rehabilitation surgery for improvement of quality of postoperative recovery in orthopedics. J Orthop Surg Res 2021; 16:471. [PMID: 34330306 PMCID: PMC8323299 DOI: 10.1186/s13018-021-02610-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 07/12/2021] [Indexed: 11/10/2022] Open
Abstract
Objective To analyze the application of concept nursing of accelerated rehabilitation surgery in orthopedic postoperative recovery. Methods A total of 120 patients who received orthopedic surgery were divided into the control group undergoing routine orthopedic nursing and the observation group undergoing the concept of accelerated rehabilitation surgery nursing. Results Patients in the observation group had shorter in-bed activity time and out-of-bed activity time, average time of hospital stay, and lower total treatment costs. The incidence of incision infection, respiratory system infection, digestive tract infection, urinary tract infection, deep vein thrombosis, and other complications in the observation group was much lower. The recovery scores of joint function in the observation group at 1, 3, 6, and 12 months after the operation were all better, and the recovery rate of joint function within 1 year after the operation was higher. Conclusion Following the concept of accelerated rehabilitation surgery nursing during the perioperative period can improve the quality of postoperative orthopedic recovery.
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Affiliation(s)
- Hong Lv
- Inner Mongolia Sports Hospital, No.2 South Tongdao Road, Huimin District, Hohhot, 010030, Inner Mongolia Autonomous Region, China.
| | - Ning Yang
- Inner Mongolia Sports Hospital, No.2 South Tongdao Road, Huimin District, Hohhot, 010030, Inner Mongolia Autonomous Region, China
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Bieleman HJ, Rijken NHM, Reneman MF, Oosterveld FGJ, Soer R. Changes in kinematics and work physiology during progressive lifting in healthy adults. APPLIED ERGONOMICS 2021; 94:103396. [PMID: 33667899 DOI: 10.1016/j.apergo.2021.103396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE To analyze progression of changes in kinematics and work physiology during progressive lifting in healthy adults. METHODS Healthy participants were recruited. A standardized lifting test from the WorkWell Functional Capacity Evaluation (FCE) was administered, with five progressive lifting low series of five repetitions. The criteria of the WorkWell observation protocol were studied: changes in muscle use (EMG), heart rate (heart rate monitor), base of support, posture and movement pattern (motion capture system). Repeated measures ANOVA's were used to analyze changes during progressive workloads. RESULTS 18 healthy young adults participated (8 men, 10 women; mean age 22 years). Mean maximum weight lifted was 66 (±3.2) and 44 (±7.4) kg for men and women, respectively. With progressive loads, statistically significant (p < 0.01) differences were observed: increase in secondary muscle use at moderate lifting, increase of heart rate, increase of base of support and movement pattern changes were observed; differences in posture were not significant. CONCLUSIONS Changes in 4 out of 5 kinematic and work physiology parameters were objectively quantified using lab technology during progressive lifting in healthy adults. These changes appear in line with existing observation criteria.
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Affiliation(s)
- Hendrik J Bieleman
- Saxion University of Applied Sciences, Faculty of Health and Movement, Enschede, the Netherlands.
| | - Noortje H M Rijken
- Saxion University of Applied Sciences, Faculty of Health and Movement, Enschede, the Netherlands
| | - Michiel F Reneman
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands
| | - Frits G J Oosterveld
- Saxion University of Applied Sciences, Faculty of Health and Movement, Enschede, the Netherlands
| | - Remko Soer
- Saxion University of Applied Sciences, Faculty of Health and Movement, Enschede, the Netherlands; University of Groningen, University Medical Center Groningen, Pain Center, Groningen, the Netherlands
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Edelaar MJA, Oesch PR, Gross DP, James CL, Reneman MF. Functional Capacity Evaluation Research: Report from the Fourth International Functional Capacity Evaluation Research Meeting. JOURNAL OF OCCUPATIONAL REHABILITATION 2020; 30:475-479. [PMID: 32034571 DOI: 10.1007/s10926-020-09876-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose To summarize progress of functional capacity evaluation (FCE) research based on the proceedings of the Fourth International FCE Research Conference held in Switzerland on September 21 and 22, 2018. Methods A scientific committee identified key issues in FCE research and developed the program including key note presentations, a call for abstracts, and round table discussions over 2 days. Highlights of the presentations and discussions are summarized in this article. Results Seventy-nine participants from 11 countries attended the conference where 10 keynote lectures and 21 abstracts were presented. There was also an open discussion regarding the need for an International FCE clinical practice guideline (CPG), methods for developing such a guideline, and practical next steps. Full program details and abstracts from this Fourth International FCE Research Conference are available from https://www.sar-reha.ch/interessengemeinschaften/ig-ergonomie.html . Conclusions Researchers and clinicians continue to increase the body of knowledge in the FCE field. A major finding of this conference is the diversity across the different FCE protocols and research groups as well as of the different uses of FCE across cultural and social economic systems. Next steps will include exploring the development of an international, interdisciplinary, evidence-based FCE clinical practice guideline by a committee formed at the conference.
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Affiliation(s)
- M J A Edelaar
- Rehabilitation Center Heliomare, Wijk aan zee, The Netherlands.
| | - P R Oesch
- Work Rehabilitation, Rehabilitation Centre Valens, Valens, Switzerland
| | - D P Gross
- Department of Physical Therapy, University of Alberta, Edmonton, AB, Canada
| | - C L James
- School of Health Sciences, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - M F Reneman
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Burrus C, Vuistiner P, Léger B, Stiefel F, Rivier G, Luthi F. The self-assessment INTERMED predicts healthcare and social costs of orthopaedic trauma patients with persistent impairments. Clin Rehabil 2020; 35:135-144. [PMID: 32851861 PMCID: PMC7814092 DOI: 10.1177/0269215520949170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Objective: To use the self-assessment INTERMED questionnaire to determine the relationship between biopsychosocial complexity and healthcare and social costs of patients after orthopaedic trauma. Design: Secondary prospective analysis based on the validation study cohort of the self-assessment INTERMED questionnaire. Setting: Inpatients orthopaedic rehabilitation with vocational aspects. Subjects: In total, 136 patients with chronic pain and impairments were included in this study: mean (SD) age, 42.6 (10.7) years; 116 men, with moderate pain intensity (51/100); suffering from upper (n = 55), lower-limb (n = 51) or spine (n = 30) pain after orthopaedic trauma; with minor or moderate injury severity (severe injury for 25). Main measures: Biopsychosocial complexity, assessed with the self-assessment INTERMED questionnaire, and other confounding variables collected prospectively during rehabilitation. Outcome measures (healthcare costs, loss of wage costs and time for fitness-to-work) were collected through insurance files after case settlements. Linear multiple regression models adjusted for age, gender, pain, trauma severity, education and employment contract were performed to measure the influence of biopsychosocial complexity on the three outcome variables. Results: High-cost patients were older (+3.6 years) and more anxious (9.0 vs 7.3 points at HADS-A), came later to rehabilitation (+105 days), and showed higher biopsychosocial complexity (+3.2 points). After adjustment, biopsychosocial complexity was significantly associated with healthcare (ß = 0.02; P = 0.003; expß = 1.02) and social costs (ß = 0.03; P = 0.006, expß = 1.03) and duration before fitness-to-work (ß = 0.04; P < 0.001, expß = 1.04). Conclusion: Biopsychosocial complexity assessed with the self-assessment INTERMED questionnaire is associated with higher healthcare and social costs.
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Affiliation(s)
- Cyrille Burrus
- Department for Musculoskeletal Rehabilitation, Clinique Romande de Réadaptation Suva, Sion, Switzerland.,Institute for Research in Rehabilitation, Clinique Romande de Réadaptation Suva, Sion, Switzerland
| | - Philippe Vuistiner
- Institute for Research in Rehabilitation, Clinique Romande de Réadaptation Suva, Sion, Switzerland
| | - Bertrand Léger
- Institute for Research in Rehabilitation, Clinique Romande de Réadaptation Suva, Sion, Switzerland
| | - Friedrich Stiefel
- Service of liaison psychiatry, Lausanne University and Lausanne University Hospital, Lausanne, VD, Switzerland
| | - Gilles Rivier
- Department for Musculoskeletal Rehabilitation, Clinique Romande de Réadaptation Suva, Sion, Switzerland
| | - François Luthi
- Department for Musculoskeletal Rehabilitation, Clinique Romande de Réadaptation Suva, Sion, Switzerland.,Institute for Research in Rehabilitation, Clinique Romande de Réadaptation Suva, Sion, Switzerland.,Department of Physical Medicine and Rehabilitation, Orthopaedic Hospital, Lausanne University Hospital, Lausanne, Switzerland
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Task-Contingent Persistence is Related to Better Performance-Based Measures in Patients with Chronic Musculoskeletal Pain. Pain Res Manag 2020; 2020:1765456. [PMID: 32655723 PMCID: PMC7317324 DOI: 10.1155/2020/1765456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 05/20/2020] [Indexed: 11/17/2022]
Abstract
Purpose Pacing, avoidance, and overdoing are considered the three main behavioral strategies, also labeled activity patterns. Their relationship with functioning of patients with chronic pain is debated. The purpose of this study was to measure the influence of activity patterns on lifting tasks commonly used in daily life. Method We performed a monocentric observational study and included patients performing Functional Capacity Evaluation (FCE). Avoidance, pacing, and persistence were assessed with using the Patterns of Activity Measures-Pain (POAM-P). Maximal safe performance was measured for floor-to-waist, waist-to-overhead, horizontal lift, and carrying with dominant-hand tests according to the FCE guidelines. Descriptive statistics, associations of POAM-P subscales with various sociodemographic variables, and correlations are presented. Standard multiple linear regression models were applied to measure the associations between FCE tests and POAM-P subscales, adjusting for the following potential confounders: age, gender, body mass index (BMI), pain severity, trauma severity, localization of injury, and education. Results Persistence was significantly positively associated with performance on the 4 FCE tests: floor-to-waist (coefficient = 0.20; p=0.001), waist-to-overhead (coefficient = 0.13; p=0.004), horizontal lift (coefficient = 0.31; p ≤ 0.001), and dominant-handed lifting (coefficient = 0.19; p=0.001). Pacing was found to have a negative influence on the carrying dominant-hand test (coefficient = -0.14; p=0.034), and avoidance was not found to have an influence on the 4 FCE tests. Conclusion This study shows that task-persistence pattern is positively associated with physical performance in FCE, whereas pacing can have a negative influence on some tests.
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Paoloni-Giacobino A, Luthi F, Stenz L, Le Carré J, Vuistiner P, Léger B. Altered BDNF Methylation in Patients with Chronic Musculoskeletal Pain and High Biopsychosocial Complexity. J Pain Res 2020; 13:1289-1296. [PMID: 32581570 PMCID: PMC7276326 DOI: 10.2147/jpr.s251782] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 05/07/2020] [Indexed: 12/22/2022] Open
Abstract
Purpose The INTERMED instrument, which was developed to measure patient's biopsychosocial (BPS) complexity, represents a powerful diagnostic and therapeutic tool. Epigenetic changes are the interface between signals from the environment and genetic modifications, affecting gene expression, in particular, by DNA methylation of CpG dinucleotides in promotor regions of the corresponding genes. The brain-derived neurotrophic factor (BDNF) gene plays a crucial role in the central sensitization (CS) of pain. In this study, we hypothesized that chronic pain modifies the methylation levels of the BDNF gene in a manner that is interconnected with the BPS status. Patients and Methods Fifty-eight chronic musculoskeletal pain patients (CMSP) were enrolled in the study. DNA was extracted from blood samples, the methylation levels of 13 CpG sites in the BDNF promoter were measured by pyrosequencing, and association studies with various patient parameters and the INTERMED scores were performed. Results Interestingly, a negative correlation (-0.40) was found between the total INTERMED scores and the average CpG methylation values of the BDNF gene, but no correlation was observed with the severity of pain, degree of anxiety, depression, or kinesiophobia and catastrophism. Moreover, the association was independent of age, sex and level of comorbidities. Conclusion This result shows that CMSP, in association with its biopsychosocial context, epigenetically decreases the degree of methylation of the BDNF promoter and should therefore increase the level of BDNF transcription. It also suggests a role of the INTERMED tool to detect a relationship between the BPS complexity and the epigenetic control of a target gene. The possible upregulation of BDNF expression might be, at least in part, the signal for chronic pain-induced central sensitization (CS). This could partly explain why patients with a higher level of complexity feel more pain than those with lower complexity.
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Affiliation(s)
- Ariane Paoloni-Giacobino
- Medicine Faculty, Department of Genetic Medicine and Development, Geneva University, Geneva, Switzerland
| | - François Luthi
- Institute for Research in Rehabilitation, Clinique romande de réadaptation, Sion, Switzerland.,Department of Musculoskeletal Rehabilitation, Clinique romande de réadaptation, Sion, Switzerland.,Department of Physical Medicine and Rehabilitation, Orthopaedic Hospital, Lausanne University Hospital, Lausanne, Switzerland
| | - Ludwig Stenz
- Medicine Faculty, Department of Genetic Medicine and Development, Geneva University, Geneva, Switzerland
| | - Joane Le Carré
- Institute for Research in Rehabilitation, Clinique romande de réadaptation, Sion, Switzerland.,Department of Medical Research, Clinique romande de réadaptation, Sion, Switzerland
| | - Philippe Vuistiner
- Institute for Research in Rehabilitation, Clinique romande de réadaptation, Sion, Switzerland.,Department of Medical Research, Clinique romande de réadaptation, Sion, Switzerland
| | - Bertrand Léger
- Institute for Research in Rehabilitation, Clinique romande de réadaptation, Sion, Switzerland.,Department of Medical Research, Clinique romande de réadaptation, Sion, Switzerland
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Swift MC, Townsend R, Edwards D, Loudon JK. Testing to Identify Submaximal Effort: Lifting to a Perceived 50% Effort vs. an Assigned Submaximal Load. J Strength Cond Res 2020; 36:2115-2120. [PMID: 32282531 DOI: 10.1519/jsc.0000000000003586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Swift, MC, Townsend, R, Edwards, D, and Loudon, J. Testing to identify submaximal effort: Lifting to a perceived 50% effort vs. an assigned submaximal load. J Strength Cond Res XX(X): 000-000, 2020-The ability to accurately measure effort during postinjury functional testing allows for the validation of displayed physical limitations by injured workers. The Cross-Reference Testing System (XRTS) has been developed to identify submaximal efforts through distraction-based dynamic material handling testing. The XRTS material handling assessment compares dynamic lifts of weights in a crate and lifts using a lever arm device. The purpose of this study was to determine whether subjects lifting an assigned submaximal load influence test results compared with subjects lifting to but not exceeding a 50% perceived effort. Subjects in group A (n = 35) were assigned the condition to attempt to lift to but not exceed a randomly assigned weight value for both the crate lift and XRTS at 3 lifting heights. Subjects in group B (n = 32) were asked to lift to but not exceed 37.5 lb from the same 3 lifting heights. The reproducibility of effort was measured with current validity criteria for distraction-based material handling testing. Using the percent difference values, a 2 × 3 (group, lifting height) analysis of variance (ANOVA) was performed to test the hypothesis. The alpha level was set at 0.05. The mean percent change between comparative lifts was 31.13%, 95% CI (22.51-39.75) for group A and 29.26% 95% CI (21.91-36.61) for group B. The 2 × 3 ANOVA demonstrated no significant difference (p = 0.751) between groups. The results indicate attempting to lift to a perceived 50% effort was not significantly different from attempting to lift to but not exceed an assigned submaximal load.
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Affiliation(s)
- Marcie C Swift
- Department of Physical Therapy, Rockhurst University, Kansas City, Missouri
| | | | | | - Janice K Loudon
- Department of Physical Therapy, Rockhurst University, Kansas City, Missouri
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Predictive validity of a customized functional capacity evaluation in patients with musculoskeletal disorders. Int Arch Occup Environ Health 2020; 93:635-643. [DOI: 10.1007/s00420-020-01518-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 01/07/2020] [Indexed: 10/25/2022]
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Luthi F, Vuistiner P, Favre C, Hilfiker R, Léger B. Avoidance, pacing, or persistence in multidisciplinary functional rehabilitation for chronic musculoskeletal pain: An observational study with cross-sectional and longitudinal analyses. PLoS One 2018; 13:e0203329. [PMID: 30180195 PMCID: PMC6122830 DOI: 10.1371/journal.pone.0203329] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 08/17/2018] [Indexed: 01/05/2023] Open
Abstract
Background Three main activity patterns have been distinguished in describing chronic pain (avoidance, pacing and persistence). However, their influence on patient outcomes remains a question of debate. This observational study aimed to measure the associations between the avoidance, pacing, and persistence (labelled overdoing) scales of the Patterns of Activity Measure–Pain (POAM-P), self-reported outcomes (pain-interference, depression, functional ability), and observational outcomes (walking, lifting test, physical fitness). Methods We conducted an observational study with cross-sectional and longitudinal analyses. The data were collected prospectively before and after treatment, which was a 5-week functional rehabilitation including vocational aspects. In addition to self-reported and observational outcomes, patients were asked if they thought they would be able to return to work at 6 months. Analyses were conducted with treatment effect sizes, correlations, and multiple regression models. Results In this sample (891 patients), we found on average small to moderate improvements for pain-interference and observational outcomes (Cohen’s d: 0.37 to 0.64). According to the multivariable models, overdoing was associated with most of the beneficial psychosocial and observational outcomes (β -0.13 to 0.17; all p<0.01). Avoidance was related to negative psychosocial outcomes before treatment (β -0.09 to 0.17; all p<0.015). Pacing, which had moderate correlation with avoidance (r = 0.46), was not associated with most of the outcomes. The feeling that the goal of returning to work was attainable was associated with lower avoidance scores (adjusted OR 0.97; p = 0.024). Conclusions The overdoing POAM-P scale probably measures a task-contingent persistence, which appears appropriate in the setting of this study. Persistent behavior was indeed related to small or moderate positive biopsychosocial outcomes, before and after treatment. Moreover feeling able to return to work was related to lower avoidance. Further studies should test the efficacy of motivational strategies that may promote functional task-contingent persistence and reduce avoidance of painful tasks.
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Affiliation(s)
- François Luthi
- Department for Musculoskeletal Rehabilitation, Clinique Romande de Réadaptation suva, Sion, Switzerland
- Institute for Research in Rehabilitation, Clinique Romande de Réadaptation suva, Sion, Switzerland
- Department of Physical Medicine and Rehabilitation, Orthopedic Hospital, Lausanne University Hospital, Lausanne, Switzerland
- * E-mail:
| | - Philippe Vuistiner
- Institute for Research in Rehabilitation, Clinique Romande de Réadaptation suva, Sion, Switzerland
| | - Christine Favre
- Unit of Psychosomatic Medicine, Clinique Romande de Réadaptation suva, Sion, Switzerland
| | - Roger Hilfiker
- Institute for Research in Rehabilitation, Clinique Romande de Réadaptation suva, Sion, Switzerland
- School of Health Science, University of Applied Sciences and Arts Western Switzerland Valais (HES-SO Valais-Wallis), Sion, Switzerland
| | - Bertrand Léger
- Institute for Research in Rehabilitation, Clinique Romande de Réadaptation suva, Sion, Switzerland
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