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Shephard S, Dahlenburg K, Kilgour A. Drawing on lessons learnt in allied health & medicine: Exploring pain science in radiography practice. J Med Imaging Radiat Sci 2024; 55:101343. [PMID: 38016853 DOI: 10.1016/j.jmir.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 11/08/2023] [Indexed: 11/30/2023]
Affiliation(s)
- Sophie Shephard
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Wagga Wagga NSW 2678, Australia.
| | - Kate Dahlenburg
- Radiographer - Department of Medical Imaging, Logan Hospital, Meadowbrook, QLD 4131, Australia
| | - Andrew Kilgour
- Medical Radiations and Assistant Associate Dean, Medical Radiations, School of Health and Biomedical Sciences, RMIT University, PO Box 71, Bundoora VIC 3083, Australia
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Zhang X, Fang W, Zhang Y, Yang M, Wang M, Fan X. The relationship between fatigue, exercise self-efficacy, fear of movement, and quality of life in patients with heart failure: A moderated mediation model. J Health Psychol 2024:13591053241273655. [PMID: 39175156 DOI: 10.1177/13591053241273655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2024] Open
Abstract
This study was aimed to examine the moderated mediating effects of exercise self-efficacy and fear of movement on the relationship between fatigue and quality of life in patients with heart failure. A total of 305 patients with heart failure were enrolled in this cross-sectional study. The results showed that fear of movement significantly mediated the relationship between fatigue and quality of life, indicating that relieving fear of movement may be beneficial to improve quality of life. Furthermore, exercise self-efficacy negatively moderated the mediating effect of fear of movement on the relationship between fatigue and physical health-related quality of life. It is suggesting that improving exercise self-efficacy may provide opportunities to buffer the negative effect of fear of movement on physical health-related quality of life in patients with heart failure, especially for those with fatigue. The findings provide additional strategies to optimize quality of life management in patients with heart failure.
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Affiliation(s)
- Xiuting Zhang
- School of Nursing and Rehabilitation, Shandong University, P.R. China
| | - Wenjie Fang
- School of Nursing and Rehabilitation, Shandong University, P.R. China
| | - Yilin Zhang
- School of Nursing and Rehabilitation, Shandong University, P.R. China
| | - Mei Yang
- School of Nursing and Rehabilitation, Shandong University, P.R. China
| | - Mei Wang
- School of Nursing and Rehabilitation, Shandong University, P.R. China
| | - Xiuzhen Fan
- School of Nursing and Rehabilitation, Shandong University, P.R. China
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Qiu R, Bai X, Li Y, Shi X, Song D, Zhang Y. Factors Associated With Pain Catastrophizing in Patients With Chronic Neuropathic Pain: A Cross-Sectional Study. Pain Manag Nurs 2024; 25:e279-e286. [PMID: 38704246 DOI: 10.1016/j.pmn.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 03/24/2024] [Accepted: 04/06/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Pain catastrophizing is a significant factor in the recovery of patients with chronic pain. This topic has not received the warranted attention in clinical practice, while the outcomes of pain interventions have been suboptimal. This study explores the current situation of pain catastrophizing in patients with chronic neuropathic pain, its influencing factors, and further analyzes the complex relationship between these factors. METHODS A cross-sectional study design was used to select preoperative patients hospitalized in the pain and spine surgery departments of two tertiary hospitals in Shandong Province, China, between February and August 2022. The Pain Catastrophizing Scale, Toronto Alexithymia Scale, Connor-Davidson Resilience Scale-Short, Somatization Sub-Scale of Symptom Checklist 90, and a sociodemographic questionnaire were used to evaluate participants' pain catastrophizing, alexithymia, psychological resilience, somatization, and relevant sociodemographic variables, respectively. Descriptive statistics, correlation, univariate, and multivariate analyses were employed throughout this process. RESULTS Pain catastrophizing in patients with chronic neuropathic pain was affected by pain severity, disease type, alexithymia, psychological resilience, and somatization (p < .05). The mediating effect values of psychological resilience and somatization between alexithymia and pain catastrophizing were both 0.05, with 95% confidence intervals of (0.02, 0.09) and (0.02, 0.07), respectively. CONCLUSIONS Pain severity, disease type, alexithymia, psychological resilience, and somatization all had a significant effect on pain catastrophizing. Healthcare workers must provide timely and accurate assessments of patients' pain levels to help prevent the onset of pain catastrophizing. Adopting measures to improve alexithymia and somatization symptoms, and focusing on enhancing patients' psychological resilience can also help reduce the level of pain catastrophizing. Cognitive behavioral therapy may be an effective treatment method for pain catastrophizing.
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Affiliation(s)
- Ruirui Qiu
- Department of Pain Management, The Second Hospital of Shandong University, Jinan, Shandong, PR China; School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, PR China
| | - Xiaoliang Bai
- Department of Pain Management, The Second Hospital of Shandong University, Jinan, Shandong, PR China
| | - Yuli Li
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, PR China.
| | - Xinhua Shi
- The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, PR China
| | - Dongyu Song
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, PR China
| | - Yanyan Zhang
- The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, PR China
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Çatal SN, Aktaş YY. Pain Intensity After Cardiac Surgery and its Association With Kinesiophobia: A Descriptive Study. J Perianesth Nurs 2024:S1089-9472(24)00158-8. [PMID: 39093235 DOI: 10.1016/j.jopan.2024.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 04/16/2024] [Accepted: 04/22/2024] [Indexed: 08/04/2024]
Abstract
PURPOSE Severe pain and fear of pain may decrease physical activity and restrict movements after cardiac surgery. This study aimed to determine pain intensity after cardiac surgery and its association with kinesiophobia. DESIGN This was a descriptive and correlational study. METHODS The study was conducted with cardiac surgery patients (n = 170). The sample size was calculated by using the G*POWER 3.1 program. According to the power analysis, the sample size was calculated as 170, taking into account the dependent variable with the largest sample size (kinesiophobia) and 20% loss. The outcome measures were pain and kinesiophobia collected using the Visual Analog Scale and Tampa Kinesiophobia Scale. FINDINGS Married patients were at the greatest risk for kinesiophobia, higher than that for single patients (β = -3.765, β = -3.609; P < .05). Obese patients were at the greatest risk for kinesiophobia higher when compared to patients of normal weight (β = -2.907, P < .05). No statistically significant correlation was found between the pain intensity and kinesiophobia scores (P > 0.05). CONCLUSIONS Kinesiophobia was higher in patients after cardiac surgery. Married and obese patients were predictors of kinesiophobia; however, pain was not associated with kinesiophobia.
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Affiliation(s)
- Seda Nur Çatal
- Department of Intensive Care Unit, Hitit University Erol Olçok Training and Research Hospital, Çorum, Turkey
| | - Yeşim Yaman Aktaş
- Department of Surgical Nursing, Faculty of Health Sciences, Giresun University, Giresun, Turkey.
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Feinstein AB, Brown K, Dunn AL, Neville AJ, Sokol O, Poupore-King H, Sturgeon JA, Kwon AH, Griffin AT. Where do we start? Health care transition in adolescents and young adults with chronic primary pain. Pain 2024:00006396-990000000-00645. [PMID: 38981053 DOI: 10.1097/j.pain.0000000000003324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/27/2024] [Indexed: 07/11/2024]
Affiliation(s)
- Amanda B Feinstein
- Department of Anesthesiology, Children's Healthcare of Atlanta, Atlanta, GA, United States
| | - Kimberly Brown
- Department of Psychology, Palo Alto University, Palo Alto, CA, United States
| | - Ashley L Dunn
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
| | - Alexandra J Neville
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | | | - Heather Poupore-King
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - John A Sturgeon
- Department of Anesthesiology, University of Michigan School of Medicine, Ann Arbor, MI, United States
| | - Albert H Kwon
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Anya T Griffin
- Department of Pediatrics & Department of Psychiatry and Behavioral Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States
- Children's Hospital Los Angeles, Los Angeles, CA, United States
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Cuomo A, Parascandolo I. Role of Nutrition in the Management of Patients with Chronic Musculoskeletal Pain. J Pain Res 2024; 17:2223-2238. [PMID: 38947129 PMCID: PMC11214565 DOI: 10.2147/jpr.s456202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 05/13/2024] [Indexed: 07/02/2024] Open
Abstract
Chronic musculoskeletal pain (CMP), defined as persistent discomfort in musculoskeletal tissues persisting for over 3 months, afflicts an estimated 1.71 billion people globally, leading to significant functional impairments and psychological distress, thereby detrimentally affecting individuals' quality of life. The objective of this narrative review is to elucidate the complex relationship among dietary habits, sarcopenia, and gut microbiota composition, with an eye toward enhancing patient management and outcomes. Given the burgeoning interest in the influence of diet on CMP, a detailed examination of the current literature is warranted. Nutritional intake is a critical determinant of the gut microbiota profile, which, in turn, is linked to musculature integrity and performance, potentially leading to sarcopenia. The development of sarcopenia can aggravate CMP owing to diminished muscular strength and functionality. Additionally, disruptions in the gut microbiota may directly modulate nociception, intensifying CMP manifestations. Thus, nutritional optimization emerges as a viable approach to CMP management. Emphasizing a diet conducive to a healthy gut microbiome could forestall or mitigate sarcopenia, thereby attenuating CMP intensity. Nevertheless, the domain calls for further empirical exploration to unravel the nuances of these interactions and to forge efficacious dietary strategies for individuals with CMP. Beyond mere analgesia, comprehensive patient care for CMP requires acknowledgment of the complex and multifactorial nature of pain and its foundational elements. Embracing an integrative treatment model allows healthcare practitioners to promise better patient prognoses, enriched life quality, and a decrease in the sustained healthcare costs associated with CMP.
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Affiliation(s)
- Arturo Cuomo
- Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori, IRCCS - Fondazione G Pascale, Naples, Italy
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Kwon OB, Hwang DW, Kang DH, Yoo SJ, Lee DH, Kwon M, Jang SW, Cho HW, Kim SD, Park KS, Kim ES, Lee YJ, Kim D, Ha IH. Effectiveness of lumbar motion style acupuncture treatment on inpatients with acute low back pain: A pragmatic, randomized controlled trial. Complement Ther Med 2024; 82:103035. [PMID: 38513746 DOI: 10.1016/j.ctim.2024.103035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 03/07/2024] [Accepted: 03/18/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND AND PURPOSE This parallel, single-center, pragmatic, randomized controlled study aimed to investigate the effectiveness and safety of motion style acupuncture treatment (MSAT; a combination of acupuncture and Doin therapy) to reduce pain and improve the functional disability of patients with acute low back pain (aLBP) due to road traffic accidents. MATERIALS AND METHODS Ninety-six patients with aLBP admitted to the Haeundae Jaseng Hospital of Korean Medicine in South Korea due to traffic accidents were treated with integrative Korean medicine (IKM) with additional 3-day MSAT sessions during hospitalization (MSAT group, 48 patients) or without (control group, 48 patients), and followed up for 90 days. RESULTS The mean numeric rating scale (NRS) scores of low back pain (LBP) of the MSAT and control groups were both 6.7 (95% confidence interval [CI]: 6.3, 7.1) at baseline. After completing the third round of all applicable treatment sessions (the primary endpoint in this study), the mean NRS scores of the MSAT and control groups were 3.76 (95% CI: 3.54, 3.99) and 5.32 (95% CI: 5.09, 5.55), respectively. The difference in the mean NRS score between the two groups was 1.56 (95% CI: 1.25, 1.87). CONCLUSION IKM treatment combined with MSAT can reduce pain and improve the range of motion of patients with aLBP. TRIAL REGISTRATION This trial is registered at ClinicalTrial.gov (NCT04956458).
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Affiliation(s)
- Oh-Bin Kwon
- Department of Acupuncture & Moxibustion, Haeundae Jaseng Hospital of Korean Medicine, Busan 48102, Republic of Korea
| | - Dong Wook Hwang
- Department of Korean Medicine Rehabilitation, Haeundae Jaseng Hospital of Korean Medicine, Busan 48102, Republic of Korea
| | - Dong-Hyeob Kang
- Department of Korean Medicine Rehabilitation, Haeundae Jaseng Hospital of Korean Medicine, Busan 48102, Republic of Korea
| | - Sang-Joon Yoo
- Department of Korean Medicine Rehabilitation, Haeundae Jaseng Hospital of Korean Medicine, Busan 48102, Republic of Korea
| | - Do-Hoon Lee
- Department of Korean Medicine Rehabilitation, Haeundae Jaseng Hospital of Korean Medicine, Busan 48102, Republic of Korea
| | - Minjin Kwon
- Department of Internal Korean Medicine, Haeundae Jaseng Hospital of Korean Medicine, Busan 48102, Republic of Korea
| | - Seon-Woo Jang
- Department of Oriental Neuropsychiatry, Haeundae Jaseng Hospital of Korean Medicine, Busan 48102, Republic of Korea
| | - Hyun-Woo Cho
- Department of Korean Medicine Rehabilitation, Haeundae Jaseng Hospital of Korean Medicine, Busan 48102, Republic of Korea
| | - Sang Don Kim
- Department of Korean Medicine Rehabilitation, Haeundae Jaseng Hospital of Korean Medicine, Busan 48102, Republic of Korea
| | - Kyong Sun Park
- Department of Korean Medicine Obstetrics and Gynecology, Jaseng Hospital of Korean Medicine, Seoul 06110, Republic of Korea
| | - Eun-San Kim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 540, Gangnam-gu, Seoul 06110, Republic of Korea
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 540, Gangnam-gu, Seoul 06110, Republic of Korea
| | - Doori Kim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 540, Gangnam-gu, Seoul 06110, Republic of Korea.
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 540, Gangnam-gu, Seoul 06110, Republic of Korea.
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Lunde CE, Dudek MR, Talbert CA, Sieberg CB, Silva KE, Papadelis C, Ullrich NJ, Manley PE, Moulton EA. The long-term impact of cerebellar tumor resection on executive functioning, anxiety, and fear of pain: A mixed methodology pilot study. APPLIED NEUROPSYCHOLOGY. CHILD 2024:1-11. [PMID: 38604218 PMCID: PMC11467132 DOI: 10.1080/21622965.2024.2337208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
This pilot study investigated the long-term impact of a surgery-only treatment (no exposure to other treatments, such as chemotherapy and radiation) for pediatric cerebellar low-grade gliomas on executive function, anxiety, and fear of pain (FOP) beliefs. Twelve patients who underwent surgical glioma resection during childhood (surgery age was 4-16 years, study visit age was 10-28 years), and 12 pain-free controls matched for age, sex, race, and handedness were tested. The spatial extent of resection was precisely mapped using magnetic resonance imaging (MRI). Executive function, anxiety, and FOP were assessed using validated self-report age-appropriate questionnaires for children and adults. Structured clinical interviews at a post-surgery follow-up visit were completed (average: 89 months, range: 20-99). No significant differences in FOP (FOPQ-C t[14 = 1.81, p = 0.09; FOPQ-III t[4] = 0.29, p = 0.79), executive function scores (BRIEF t[20] = 0.30, p = 0.28), or anxiety scores (MASC t[16] = 0.19, p = 0.85; MAQ t[4] = 1.80, p = 0.15) were found in pediatric or adult patients compared to pain-free controls. Clinical interviews mainly categorized pediatric patients as not anxious. One participant reported mild/subclinical anxiety, and one had moderate clinical anxiety. Neither psychologists nor patients endorsed impairments to executive functioning, anxiety, or FOP. Our pilot results suggest that pediatric cerebellar tumor survivors treated with surgery-only have favorable long-term functioning related to these themes. While these results are promising, they will need to be replicated in a larger patient sample.
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Affiliation(s)
- Claire E Lunde
- Biobehavioral Pain Innovations Lab, Department of Psychiatry & Behavioral Sciences, Boston Children's Hospital, Boston, Massachusetts, USA
- Pain and Affective Neuroscience Center, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Nuffield Department of Women's and Reproductive Health, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Madison R Dudek
- Pain and Affective Neuroscience Center, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Brain and Eye Pain Imaging Lab, Department of Anesthesiology, Critical Care and Pain Medicine, Boston, Massachusetts, USA
| | - Cameron A Talbert
- Pain and Affective Neuroscience Center, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Brain and Eye Pain Imaging Lab, Department of Anesthesiology, Critical Care and Pain Medicine, Boston, Massachusetts, USA
| | - Christine B Sieberg
- Biobehavioral Pain Innovations Lab, Department of Psychiatry & Behavioral Sciences, Boston Children's Hospital, Boston, Massachusetts, USA
- Pain and Affective Neuroscience Center, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Center for Health Outcomes & Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
- Division of Adolescent & Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Katie E Silva
- Pain and Affective Neuroscience Center, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Brain and Eye Pain Imaging Lab, Department of Anesthesiology, Critical Care and Pain Medicine, Boston, Massachusetts, USA
| | - Christos Papadelis
- Jane and John Justin Neurosciences Center, Cook Children's Health Care System, Fort Worth, Texas, USA
- Division of Newborn Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Nicole J Ullrich
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Peter E Manley
- Department of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Eric A Moulton
- Pain and Affective Neuroscience Center, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Brain and Eye Pain Imaging Lab, Department of Anesthesiology, Critical Care and Pain Medicine, Boston, Massachusetts, USA
- Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Shim M, Gaydos M, Goldstein-Levitas N, Musalo N, Prakash N, Bradt J, Zhang F, Wenger S, Gonzalez A. Development and feasibility of a mindfulness-based dance/movement therapy intervention for chronic low back pain. FRONTIERS IN PAIN RESEARCH 2024; 5:1281085. [PMID: 38689886 PMCID: PMC11057879 DOI: 10.3389/fpain.2024.1281085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 03/20/2024] [Indexed: 05/02/2024] Open
Abstract
Introduction Responding to the need for innovative, multi-modal, non-pharmacological strategies in chronic low back pain (cLBP) care, this article presents the development and a mixed methods feasibility trial of a manualized Mindfulness-based Dance/Movement Therapy (M-DMT) program for cLBP. The 12-week program is designed as a group therapy, integrating mindfulness principles, creative/expressive dance and movement, and psychoeducational content focused on cLBP management. This holistic program seeks to cultivate nonjudgmental awareness of pain experiences, challenge maladaptive pain-related beliefs, enhance emotional well-being, foster social support, and promote effective coping strategies for the daily challenges associated with cLBP. Methods The 12-week M-DMT intervention was administered to individuals with non-specific cLBP (N = 18, aged 51.7 ± 13.9 years, 72% female, 55% Black and 39% White). We assessed feasibility and acceptability through monitoring enrollment and retention rates, attendance, and adverse events. Moreover, we measured the intervention's credibility/expectancy, participants' perception of changes, and overall satisfaction. Additionally, we collected qualitative data, capturing participants' perspectives on the intervention's usefulness and perceived benefits. Specific benchmarks were established to gauge the successful feasibility and acceptability of the program. Results The adherence rate stood at 80%, with a perfect retention rate of 100%. The study successfully met the benchmarks for treatment acceptability and satisfaction criteria, with 61% of participants reporting "feeling better" or a "great deal better" after the intervention. No adverse events were observed. Participants found the intervention enjoyable and reported that it provided effective tools for cLBP and related symptoms. Notably, participants reported a decrease in fear-avoidance behaviors, increased motivation for physical activity, and a boost in self-efficacy for pain management. Discussion These encouraging findings establish a strong basis for considering the M-DMT intervention as a promising approach for cLBP management, warranting further investigation in larger-scale studies.
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Affiliation(s)
- Minjung Shim
- Creative Arts Therapies, Drexel University, Philadelphia, PA, United States
| | - Monica Gaydos
- Creative Arts Therapies, Drexel University, Philadelphia, PA, United States
| | | | - Nicole Musalo
- Creative Arts Therapies, Drexel University, Philadelphia, PA, United States
| | - Nalini Prakash
- Creative Arts Therapies, Drexel University, Philadelphia, PA, United States
| | - Joke Bradt
- Creative Arts Therapies, Drexel University, Philadelphia, PA, United States
| | - Fengqing Zhang
- Psychology, Drexel University, Philadelphia, PA, United States
| | - Sarah Wenger
- Physical Therapy and Rehabilitation Science, Drexel University, Philadelphia, PA, United States
| | - Adam Gonzalez
- Psychiatry and Behavioral Health, Stony Brook University, Stony Brook, NY, United States
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Sturgeon JA, Pierce J, Trost Z. Initial validation of the 12-item Tampa Scale of Kinesiophobia in a retrospective sample of adults with chronic headache. PAIN MEDICINE (MALDEN, MASS.) 2024; 25:187-193. [PMID: 37930882 PMCID: PMC11032727 DOI: 10.1093/pm/pnad147] [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: 05/22/2023] [Revised: 10/22/2023] [Accepted: 10/28/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION An area of emerging interest in chronic pain populations concerns fear of pain and associated fear of movement (kinesiophobia)-a cognitive appraisal pattern that is well-validated in non-headache chronic pain. However, there is limited research on whether this construct can be measured in a similar manner in headache populations. METHODS The current project details a confirmatory factor analysis of the 12-Item Tampa Scale of Kinesiophobia (TSK-12) using a clinical data set from 210 adults with diverse headache diagnoses presenting for care at a multidisciplinary pain clinic. One item (concerning an "accident" that initiated the pain condition) was excluded from analysis. RESULTS Results of the confirmatory factor analysis for the remaining 12 items indicated adequate model fit for the previously established 2-factor structure (activity avoidance and bodily harm/somatic focus subscales). In line with previous literature, total TSK-12 scores showed moderate correlations with pain severity, pain-related interference, positive and negative affect, depressive and anxious symptoms, and pain catastrophizing. DISCUSSION The current study is the first to examine the factor structure of the TSK-12 in an adult headache population. The results support the relevance of pain-related fear to the functional and psychosocial status of adults with chronic headache, although model fit of the TSK-12 could be characterized as adequate rather than optimal. Limitations of the study include heterogeneity in headache diagnosis and rates of comorbid non-headache chronic pain in the sample. Future studies should replicate these findings in more homogenous headache groups (eg, chronic migraine) and examine associations with behavioral indices and treatment response.
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Affiliation(s)
- John A Sturgeon
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48105, United States
| | - Jennifer Pierce
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48105, United States
| | - Zina Trost
- Department of Psychology, Texas A&M University, College Station, TX 77840, United States
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Evans CB, Larimore LR, Grasmick VE. Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. Pain Manag Nurs 2024; 25:75-79. [PMID: 38129210 DOI: 10.1016/j.pmn.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/31/2023] [Accepted: 11/07/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Nurses include spirituality in holistic nursing care of persons in pain. However, there is a lack of awareness of spiritual suffering and the role of chaplains and spiritual care in pain management. AIM The purpose of this pilot is to report hospital chaplains' qualitative report of spirituality and pain management in an acute care setting. METHOD This qualitative inquiry pilot involved guided interviews of hospital chaplains on their role in pain management. A thematic analysis was performed. RESULTS Spiritual suffering in people in pain was the dominant theme. This included spiritual fear, and nurses suffering as a witness to pain. Chaplain interventions was a theme that involved spiritual support to persons in pain. CONCLUSIONS Spiritual suffering can occur in people in pain. An early consultation with hospital chaplains can augment pain management. A person in pain may experience spiritual suffering and a chaplain can provide the appropriate assessment and intervention.
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Affiliation(s)
- Cecile B Evans
- From St. Mary's Medical Center, Now Part of Intermountain Health, Grand Junction, Colorado.
| | - Lucinda R Larimore
- From St. Mary's Medical Center, Now Part of Intermountain Health, Grand Junction, Colorado
| | - Victoria E Grasmick
- From St. Mary's Medical Center, Now Part of Intermountain Health, Grand Junction, Colorado
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12
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Fang Y, Shi L, Qin F, Li T, Zhang X, Li M. Influence of Family-Learned Fear-of-Pain on Patients. Pain Manag Nurs 2024; 25:11-18. [PMID: 37183071 DOI: 10.1016/j.pmn.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 04/01/2023] [Accepted: 04/07/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Fear-of-pain is a common feeling of patients and their family who experience or witness severe or chronic pain. Fear-of-pain may disturb patient's recovery, and also influence family support to assist patients' recovery. AIM This study is to measure the level of family support for each patient; evaluate the extent of the supporting families' fear-of-pain; and identify possible interventions in family support and family fear-of-pain. METHODS This cross-sectional descriptive research involved 77 participants in the orthopedics department of a tertiary hospital by convenience sampling. The online questionnaire includes general information, and scales of fear-of-pain, pain anxiety, pain vigilance and awareness, pain catastrophizing, and family support. T-test, Pearson correlation analysis and Spearman correlation analysis were used to analyze data. RESULTS Most participants reported that they experienced a moderate-to-high level of fear-of-pain, pain anxiety, pain vigilance and awareness. A total of 15.6% of participants are at risk of pain catastrophizing. The family's pain vigilance and awareness, and fear-of-pain were often similar to those of the patient, and their levels of pain anxiety and catastrophizing were often higher than the patient's. Family support and families' fear-of-pain affect patients' feelings of pain and families' behavior in decision-making for patient recovery, necessitating the development of interventions for patients' families. CONCLUSIONS Family members can develop the fear-of-pain from witnessing painful experiences and may exhibit fear-avoidance behaviors in deciding on patients' rehabilitation plan. Family support, including the type of relationship with families, and length of time family spent with the patient, had an effect on patients' pain and fear-of-pain.
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Affiliation(s)
- Yaxuan Fang
- School of Nursing, Southern Medical University, Guangdong, China; Faculty of Nursing, Chiang Mai University, Chiangmai, Thiland
| | - Lei Shi
- School of Nursing, Southern Medical University, Guangdong, China.
| | - Fang Qin
- School of Nursing, Southern Medical University, Guangdong, China
| | - Ting Li
- School of Nursing, Southern Medical University, Guangdong, China
| | - Xishun Zhang
- Department of Orthopedics, Foshan First People's Hospital, Foshan, Guangdong, China
| | - Manman Li
- People's Hospital of Nanhai District, Foshan, Guangdong, China
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Ikwuanusi S, Tella A, Akinbo S, Nwaedozie O, Adje M. Determinants of outcomes for patients with chronic low back pain and fear-avoidance beliefs following treatment with specific stabilisation exercises. J Back Musculoskelet Rehabil 2024; 37:1059-1069. [PMID: 38217583 PMCID: PMC11307052 DOI: 10.3233/bmr-230312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/11/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND Specific stabilisation exercises (SSE) can combat the debilitating effects of chronic non-specific low back pain (CLBP), improve disability, pain and fear-avoidance beliefs (FAB). OBJECTIVE To elicit the determinants of outcome in patients with CLBP with associated FABs after treatment with SSE. METHOD Twenty-nine patients (20 females) with CLBP were classified using FAB questionnaire into high or low Work and Physical Activity (PA) subscales. After 4-week treatment, evaluations were done for pain, disability and lumbar spine active range of motion (AROM). Data was analysed exploratory-descriptively with a significance level set at p< 0.05. RESULTS Participants were aged 55.24 ± 11.91 years. They scored 19 (65.5%) and 5 (17.2%) respectively on Work and PA subscales. The post-intervention evaluation showed significant differences in all outcomes, but no significant difference between patients with high or low FAB scores for both subscales. PA scores correlated significantly with pain while work scores correlated significantly with disability. Participants' gender predicted disability, pain and AROM with moderate to large effect sizes. CONCLUSION SSE can potentially improve disability, pain and range of motion for patients with chronic low back pain regardless of FABQ status. Gender and baseline patient status are potential determinants of outcome of treatment using SSE.
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Affiliation(s)
- Stephanie Ikwuanusi
- Department of Physiotherapy, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Abidemi Tella
- Department of Physiotherapy, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Sunday Akinbo
- Department of Physiotherapy, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Obianuju Nwaedozie
- Department of Physiotherapy, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Mishael Adje
- LUNEX International University of Health, Exercise & Sports, Differdange, Luxembourg
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De Giorgio A, Angilletta S, Matteo B, Bonavolontà V, Bragazzi NL, Kuvačić G. Hatha yoga is more effective in improving kinesiophobia and subjective well-being when combined with self-compassion meditation in people with CLBP: a randomized control trial. Front Psychol 2023; 14:1272919. [PMID: 38054176 PMCID: PMC10694472 DOI: 10.3389/fpsyg.2023.1272919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/26/2023] [Indexed: 12/07/2023] Open
Abstract
Objective The present study aims to examine whether combining hatha yoga practice with self-compassion meditation could influence kinesiophobia, emotions, perceived stress, and perceived disability among individuals with chronic low back pain when compared with hatha yoga alone. Methods The randomized controlled study included 70 participants with chronic low back pain (CLBP) who were randomly assigned to a Hatha yoga group (HY; n = 35) or a Hatha yoga group plus self-compassion meditation (HYSCM; n = 35). Participants followed a protocol for 8 weeks, and the assessments were carried out before and after the intervention, with a follow-up evaluation conducted after one month. The participants completed the PANAS, PSS, TSK, and RMQ questionnaires. A Generalized Estimating Equation was used to explore the effect of interventions. Results Both HY and HYSCM groups improved kinesiophobia, perceived disability, and stress at the follow-up. However, the HYSCM group shown a more significant reduction in kinesiophobia compared to the HY group. Moreover, significant improvement in positive affect and a reduction in negative affect over time in the HYSCM group were observed. Conclusion Hatha yoga practice when combined with self-compassion meditation led to extra benefits by exhibiting a prolonged effect, especially on kinesiophobia positive and negative effects.
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Affiliation(s)
- Andrea De Giorgio
- Faculty of Psychology, eCampus University, Novedrate, Italy
- Klinikos Center for Psychodiagnostics and Psychotherapy, Rome, Italy
| | | | - Barbara Matteo
- Faculty of Psychology, eCampus University, Novedrate, Italy
| | - Valerio Bonavolontà
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, L’Aquila, Italy
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, Faculty of Science, York University, Toronto, ON, Canada
| | - Goran Kuvačić
- Faculty of Kinesiology, University of Split, Split, Croatia
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15
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de la Barra Ortiz HA, Parizotto N, Arias M, Liebano R. Effectiveness of high-intensity laser therapy in the treatment of patients with frozen shoulder: a systematic review and meta-analysis. Lasers Med Sci 2023; 38:266. [PMID: 37981583 DOI: 10.1007/s10103-023-03901-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 09/30/2023] [Indexed: 11/21/2023]
Abstract
The purpose of this study is to evaluate the effects of high-intensity laser therapy (HILT) in patients with frozen shoulder. PRISMA guidelines were adhered to, and a systematic search was conducted in the PubMed, Web of Science, Scopus, CINAHL, Science Direct, and PEDro databases (last update: September 4, 2023; search period: December 2022-September 2023). The inclusion criteria encompassed RCTs comparing HILT with other physical therapy interventions in frozen patients with frozen shoulders, with or without sham HILT, assessing pain intensity, shoulder ROM, and disability outcomes. The quality of the RCTs was assessed with the Cochrane Risk of Bias tool, and evidence was assessed using the GRADE approach. Five trials met the eligibility criteria and were included in the review and meta-analysis, which pooled results from the visual analog scale (VAS), goniometry, and the shoulder pain and disability index (SPADI). Mean differences (MDs) for pain intensity and disability show a pooled effect in favor of HILT both for VAS (MD = - 2.23 cm, 95% CI: - 3.25, - 1.22) and SPADI (MD = - 10.1% (95% CI = - 16.5, - 3.7), changes that are statistical (p < 0.01) and clinical. The MD for flexion (MD = 9.0°; 95% CI: - 2.36°, 20.3°; p = 0.12), abduction (MD = 3.4°; 95% CI: - 6.9°, 13.7°; p = 0.51), and external rotation (MD = - 0.95°; 95% CI: - 5.36°, 3.5°; p = 0.67) does not show statistical and clinical differences between groups after treatment. PI and disability changes were graded as important due to their clinical and statistical results. HILT into a physical therapy plan reduce pain and disability, but it does not outperform conventional physical therapy in improving shoulder ROM. It is suggested that future RCTs compare the effects of HILT and LLLT to assess their possible differences in their analgesic effects.
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Affiliation(s)
- Hernán Andrés de la Barra Ortiz
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, 7591538, Santiago, Chile.
- Physiotherapeutic Resources Research Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Paulo, Brazil.
| | - Nivaldo Parizotto
- Physiotherapeutic Resources Research Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Paulo, Brazil
| | - Mariana Arias
- Physiotherapeutic Resources Research Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Paulo, Brazil
| | - Richard Liebano
- Physiotherapeutic Resources Research Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Paulo, Brazil
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT, USA
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16
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Pester BD, Yamin JB, Cabrera MJ, Mehta S, Silverman J, Grossestreuer AV, Howard P, Edwards RR, Donnino MW. Change in Pain-Related Anxiety Mediates the Effects of Psychophysiologic Symptom Relief Therapy (PSRT) on Pain Disability for Chronic Back Pain: Secondary Results from a Randomized Controlled Trial. J Pain Res 2023; 16:3871-3880. [PMID: 38026456 PMCID: PMC10655606 DOI: 10.2147/jpr.s416305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 08/22/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose Widely used therapeutic approaches, such as cognitive-behavioral and mindfulness-based therapies, can improve pain and functioning in people with chronic back pain, but the magnitude and duration of their effects are limited. Our team developed a novel 12-week program, psychophysiologic symptom relief therapy (PSRT), to substantially reduce or eliminate pain and disability. This study examined whether PSRT helped more patients achieve large-magnitude (≥30%, ≥50%, ≥75%) reductions in back pain-related disability compared to mindfulness-based stress reduction (MBSR) and usual care (UC), and if the beneficial effects of PSRT were explained by reductions in pain-related anxiety following treatment. Patients and Methods Data from a three-armed randomized controlled trial were used (N=35 adults with chronic back pain). Change scores (baseline to 4-, 8-, 13-, and 26-weeks post-enrollment) were computed for back pain disability (RDQ) and pain-related anxiety (PASS-20). Fisher's exact tests and mediation analyses were conducted. Results Compared to MBSR and UC, PSRT helped significantly more patients achieve ≥75% reductions in back pain disability at all timepoints and in pain anxiety at all timepoints except 13-weeks. Change in pain anxiety significantly mediated the relationship between treatment group and change in back pain disability from baseline to 26-weeks. Conclusion PSRT helped more patients achieve substantial reductions in disability than an established treatment (MBSR) and usual care. Findings indicate reduced pain anxiety may be a mechanism by which PSRT confers long-term benefits on disability. Importantly, this work aims to move the field toward more precise and effective treatment for chronic back pain.
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Affiliation(s)
- Bethany D Pester
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jolin B Yamin
- Harvard Medical School, Boston, MA, USA
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Maria J Cabrera
- Harvard Medical School, Boston, MA, USA
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Shivani Mehta
- Harvard Medical School, Boston, MA, USA
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Jeremy Silverman
- Harvard Medical School, Boston, MA, USA
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Anne V Grossestreuer
- Harvard Medical School, Boston, MA, USA
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Patricia Howard
- Harvard Medical School, Boston, MA, USA
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Robert R Edwards
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Michael W Donnino
- Harvard Medical School, Boston, MA, USA
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
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Trøstrup J, Frost P, Dalbøge A, Mikkelsen LR, Høybye MT, Jørgensen LB, Casper SD, Klebe TM, Svendsen SW. Reducing Shoulder Complaints in Employees with High Occupational Shoulder Exposures: A Cluster-Randomised Controlled Study (The Shoulder-Café Study). JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:473-485. [PMID: 36512271 DOI: 10.1007/s10926-022-10086-z] [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: 11/15/2022] [Indexed: 06/17/2023]
Abstract
PURPOSE To evaluate if a group-based Shoulder-Café intervention could reduce shoulder complaints more effectively than an individual-based control intervention in employees with shoulder complaints and high occupational shoulder exposures. METHODS A cluster-randomised controlled study of 109 participants from 60 companies in Central Denmark Region. Companies were randomised and allocated to either Shoulder-Café or control intervention. Participants in both interventions received a pamphlet on home-based shoulder exercises and a pamphlet with general information on reducing occupational shoulder exposures. They also had their occupational shoulder exposures assessed. Shoulder-Café participants additionally received three café-meetings with casual discussion, clinical shoulder evaluation, education about shoulder anatomy and occupational shoulder exposures, supervised exercises, workplace-oriented counselling, and an optional workplace visit. The primary outcome measure was the Oxford Shoulder Score (OSS) at 6-month follow-up. Secondary outcome measures were the OSS at 12 months, Fear-Avoidance Beliefs Questionnaire - Physical Activity at 6 and 12 months, and Patients' Global Impression of Change at 6 months. The study also included seven supplementary outcome measures. RESULTS Both groups improved from baseline to 6 months with respect to the primary outcome (P < 0.01). No group differences were found for the primary outcome (mean difference (MD) [95% confidence interval]: 0.3 [- 1.6; 2.2]) or secondary outcomes. The supplementary outcomes "felt informed about handling shoulder complaints" and "felt informed about reducing occupational exposures" at 6 months, and "Patients' Global Impression of Change" and "overall satisfaction" at 12 months favoured the Shoulder-Café intervention. CONCLUSION The Shoulder-Café intervention did not reduce shoulder complaints more effectively than the control intervention. TRIAL REGISTRATION The trial was registered at Clinicaltrials.gov on 19 May 2017 (ID: NCT03159910).
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Affiliation(s)
- J Trøstrup
- Elective Surgery Centre, Silkeborg Regional Hospital, Falkevej 1-3, 8600, Silkeborg, Denmark.
| | - P Frost
- Centre for Social Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
- Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - A Dalbøge
- Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - L R Mikkelsen
- Elective Surgery Centre, Silkeborg Regional Hospital, Falkevej 1-3, 8600, Silkeborg, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - M T Høybye
- Elective Surgery Centre, Silkeborg Regional Hospital, Falkevej 1-3, 8600, Silkeborg, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - L B Jørgensen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Knowledge Centre for Neurorehabilitation of Western Denmark, Regional Hospital Central Jutland, Hammel, Denmark
| | | | - T M Klebe
- Elective Surgery Centre, Silkeborg Regional Hospital, Falkevej 1-3, 8600, Silkeborg, Denmark
| | - S W Svendsen
- Danish Ramazzini Centre, Department of Occupational Medicine, Gødstrup Hospital - University Research Clinic, Herning, Denmark
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González Aroca J, Díaz ÁP, Navarrete C, Albarnez L. Fear-Avoidance Beliefs Are Associated with Pain Intensity and Shoulder Disability in Adults with Chronic Shoulder Pain: A Cross-Sectional Study. J Clin Med 2023; 12:jcm12103376. [PMID: 37240482 DOI: 10.3390/jcm12103376] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/17/2023] [Accepted: 02/23/2023] [Indexed: 05/28/2023] Open
Abstract
Shoulder pain is one of the most common musculoskeletal conditions, and for people over 40 years old, it represents the musculoskeletal pain with the greatest impact on quality of life. Psychological factors, such as fear-avoidance beliefs, are associated with musculoskeletal pain, and several studies suggest that they can influence various treatment outcomes. Our objective was to explore the cross-sectional association between fear-avoidance beliefs and shoulder pain intensity and disability in subjects with chronic shoulder pain. A cross-sectional study was conducted, and 208 participants with chronic unilateral subacromial shoulder pain were recruited. The shoulder pain and disability index assessed pain intensity and disability. The Spanish fear-avoidance components scale assessed the presence of fear-avoidance beliefs. The association between fear-avoidance beliefs and pain intensity and disability was analyzed by means of multiple linear regression models and proportional odds models, reporting odds ratios and 95% confidence intervals. Shoulder and pain disability scores were significantly associated with fear-avoidance beliefs (p < 0.0001, adjusted R-square 0.93, multiple linear regression). There was no evidence of an association between sex and age in this study. The regression coefficient for shoulder pain intensity and disability score was 0.67446. The proportional odds model showed an odds ratio of 1.39 (1.29-1.50) for shoulder pain intensity and disability total score. This study suggests that greater levels of fear-avoidance beliefs are associated with greater levels of shoulder pain and disability in adults with chronic shoulder pain.
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Affiliation(s)
| | | | - Carlos Navarrete
- Department of Mathematics, Faculty of Science, University of La Serena, La Serena 1700000, Chile
| | - Loreto Albarnez
- School of Kinesiology, University of La Serena, La Serena 1700000, Chile
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Glogan E, Gatzounis R, Bennett MP, Holthausen K, Meulders A. Generalization of pain-related avoidance behavior based on de novo categorical knowledge. Pain 2023; 164:895-904. [PMID: 36149790 PMCID: PMC10026827 DOI: 10.1097/j.pain.0000000000002786] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 08/02/2022] [Accepted: 08/31/2022] [Indexed: 11/25/2022]
Abstract
ABSTRACT People with chronic pain often fear and avoid movements and activities that were never paired with pain. Safe movements may be avoided if they share some semantic relationship with an actual pain-associated movement. This study investigated whether pain-associated operant responses (movements) can become categorically associated with perceptually dissimilar responses, thus motivating avoidance of new classes of safe movements-a phenomenon known as category-based avoidance generalization. Using a robotic arm, 2 groups were trained to categorize arm movements in different ways. Subsequently, the groups learned through operant conditioning that an arm movement from one of the categories was paired with a high probability of pain, whereas the others were paired with either a medium probability of pain or no pain (acquisition phase). Self-reported pain-related fear and pain expectancy were collected as indices of fear learning. During a final generalization test phase, the movements categorically related to those from the acquisition phase were made available but in the absence of pain. Results showed that the generalization of outcome measures depended on the categorical connections between arm movements, ie, the groups avoided and feared the novel generalization movement categorically related to the pain-associated acquisition movement, depending on how they had previously learned to categorize the movements. This suggests that operant pain-related avoidance can generalize to safe behaviors, which are not perceptually, but categorically, similar to a pain-associated behavior. This form of pain-related avoidance generalization is problematic because category-based relations can be extremely wide reaching and idiosyncratic. Thus, category-based generalization of operant pain-related avoidance merits further investigation.
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Affiliation(s)
- Eveliina Glogan
- Centre for the Psychology of Learning and Experimental Psychopathology, KU Leuven, Leuven, Belgium
- Experimental Health Psychology, Maastricht University, Maastricht, the Netherlands
| | - Rena Gatzounis
- Experimental Health Psychology, Maastricht University, Maastricht, the Netherlands
| | - Marc Patrick Bennett
- Medical Research Council—Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - Katharina Holthausen
- Experimental Health Psychology, Maastricht University, Maastricht, the Netherlands
| | - Ann Meulders
- Centre for the Psychology of Learning and Experimental Psychopathology, KU Leuven, Leuven, Belgium
- Research Group Health Psychology, KU Leuven, Leuven, Belgium
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Smith NL, Smith MG, Gibson N, Imms C, Thornton AL, Harvey AR. Pain coping tools for children and young adults with a neurodevelopmental disability: A systematic review of measurement properties. Dev Med Child Neurol 2023; 65:318-328. [PMID: 36111806 PMCID: PMC10952855 DOI: 10.1111/dmcn.15410] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/22/2022] [Accepted: 08/16/2022] [Indexed: 11/28/2022]
Abstract
AIM To systematically identify and evaluate the measurement properties of patient-reported outcome measures (PROMs) and observer-reported outcome measures (parent proxy report) of pain coping tools that have been used with children and young adults (aged 0-24 years) with a neurodevelopmental disability. METHOD A two-stage search using MEDLINE, Embase, CINAHL, Web of Science, and PsycInfo was conducted. Search 1 in August 2021 identified pain coping tools used in neurodevelopmental disability and search 2 in September 2021 located additional studies evaluating the measurement properties of these tools. Methodological quality was assessed using the COnsensus-based Standards for the Selection of Health Measurement INstruments (COSMIN) guidelines (PROSPERO protocol registration no. CRD42021273031). RESULTS Sixteen studies identified seven pain coping tools, all PROMs and observer-reported outcome measures (parent proxy report) versions. The measurement properties of the seven tools were appraised in 44 studies. No tool had high-quality evidence for any measurement property or evidence for all nine measurement properties as outlined by COSMIN. Only one tool had content validity for individuals with neurodevelopmental disability: the Cerebral Palsy Quality of Life tool. INTERPRETATION Pain coping assessment tools with self-report and parent proxy versions are available; however, measurement invariance has not been tested in young adults with a neurodevelopmental disability. This is an area for future research.
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Affiliation(s)
- Nadine L. Smith
- Kids Rehab WAPerth Children's HospitalNedlandsWAAustralia
- Department of PhysiotherapyPerth Children's HospitalNedlandsWAAustralia
- Division of Paediatrics, Medical SchoolThe University of Western AustraliaWAAustralia
| | - Meredith G. Smith
- School of Allied Health Science and PracticeThe University of AdelaideSAAustralia
- Novita Disability ServicesAdelaideSAAustralia
| | - Noula Gibson
- Kids Rehab WAPerth Children's HospitalNedlandsWAAustralia
- Department of PhysiotherapyPerth Children's HospitalNedlandsWAAustralia
- Telethon Kids InstitutePerthWAAustralia
| | - Christine Imms
- Department of PaediatricsThe University of MelbourneVICAustralia
- Murdoch Children's Research InstituteMelbourneVICAustralia
| | - Ashleigh l. Thornton
- Kids Rehab WAPerth Children's HospitalNedlandsWAAustralia
- Division of Paediatrics, Medical SchoolThe University of Western AustraliaWAAustralia
- Telethon Kids InstitutePerthWAAustralia
| | - Adrienne R. Harvey
- Department of PaediatricsThe University of MelbourneVICAustralia
- Murdoch Children's Research InstituteMelbourneVICAustralia
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Diotaiuti P, Corrado S, Mancone S, Cavicchiolo E, Chirico A, Siqueira TC, Andrade A. A psychometric evaluation of the Italian short version of the Fear of Pain Questionnaire-III: Psychometric properties, measurement invariance across gender, convergent, and discriminant validity. Front Psychol 2023; 13:1087055. [PMID: 36726497 PMCID: PMC9886064 DOI: 10.3389/fpsyg.2022.1087055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/12/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction The Fear of Pain Questionnaire-III (FPQ-III) is a self-assessment instrument developed specifically to measure fear based on various pain stimuli converging on three factors: severe pain, medical pain, and minor pain. It actually remains the most studied and internationally used tool even in its short versions. The aim of this work was to propose a new validation study oriented to confirm the good psychometric properties of a short model of the FPQ-III for the Italian context. Methods A large sample of participants was recruited (n = 1,064) and Exploratory Factor Analysis (EFA) as well as Confirmatory Factor Analysis (CFA) were performed. Measurement invariance of the FPQ-III across gender was also evaluated. In order to examine convergent validity, a further convenient sample (n = 292) was used and variables related to the individual's pain experience, locus of control and coping orientations were assessed. A final discriminant assessment using experimental manipulation through fear eliciting videos was performed. Results The three factors structure of the 13-item version of the questionnaire was confirmed (χ2 = 148.092, CFI = 0.971, TLI = 0.962, RMSEA = 0.046, RMSEA 90% CI = 0.037-0.056) as well as the measurement invariance across gender. Item internal reliability was satisfactory. The results provided evidence of the good predictive validity of the FPQ-III and the discriminant assessment demonstrated that the instrument is suitable in detecting changes in fear of pain induced by specific situational conditions. Discussion The scale in this short version is suitable for quickly and efficiently gathering information about the perceived intensity of such anticipatory fears that might affect even the healthy person dysfunctionally.
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Affiliation(s)
- Pierluigi Diotaiuti
- Department of Human Sciences, Society and Health, University of Cassino and Lazio, Cassino, Italy,*Correspondence: Pierluigi Diotaiuti,
| | - Stefano Corrado
- Department of Human Sciences, Society and Health, University of Cassino and Lazio, Cassino, Italy
| | - Stefania Mancone
- Department of Human Sciences, Society and Health, University of Cassino and Lazio, Cassino, Italy
| | - Elisa Cavicchiolo
- Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Andrea Chirico
- Department of Psychology of Development and Socialization Processes, Sapienza University of Rome, Rome, Italy
| | - Thais Cristina Siqueira
- Health and Sports Science Center, Department of Physical Education, CEFID, Santa Catarina State University, Florianopolis, Santa Catarina, Brazil
| | - Alexandro Andrade
- Health and Sports Science Center, Department of Physical Education, CEFID, Santa Catarina State University, Florianopolis, Santa Catarina, Brazil
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Şentürk İA, Şentürk E, Üstün I, Gökçedağ A, Yıldırım NP, İçen NK. High-impact chronic pain: evaluation of risk factors and predictors. Korean J Pain 2023; 36:84-97. [PMID: 36581599 PMCID: PMC9812691 DOI: 10.3344/kjp.22357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/12/2022] [Accepted: 12/16/2022] [Indexed: 12/31/2022] Open
Abstract
Background The concept of high-impact chronic pain (HICP) has been proposed for patients with chronic pain who have significant limitations in work, social life, and personal care. Recognition of HICP and being able to distinguish patients with HICP from other chronic pain patients who do not have life interference allows the necessary measures to be taken in order to restore the physical and emotional functioning of the affected persons. The aim was to reveal the risk factors and predictors associated with HICP. Methods Patients with chronic pain without life interference (grade 1 and 2) and patients with HICP were compared. Significant data were evaluated with regression analysis to reveal the associated risk factors. Receiving operating characteristic (ROC) analysis was used to evaluate predictors and present cutoff scores. Results One thousand and six patients completed the study. From pain related cognitive processes, fear of pain (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.87-0.98; P = 0.007) and helplessness (OR, 1.06; 95% CI, 1.01-1.12; P = 0.018) were found to be risk factors associated with HICP. Predictors of HICP were evaluated by ROC analysis. The highest discrimination value was found for pain intensity (cut-off score > 6.5; 83.8% sensitive; 68.7% specific; area under the curve = 0.823; P < 0.001). Conclusions This is the first study in our geography to evaluate HICP with measurement tools that evaluate all dimensions of pain. Moreover, it is the first study in the literature to evaluate predictors and cut-off scores using ROC analysis for HICP.
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Affiliation(s)
- İlteriş Ahmet Şentürk
- Department of Pain Medicine, Bagcilar Education and Research Hospital, Istanbul, Turkiye
| | - Erman Şentürk
- Department of Psychiatry, Üsküdar University NP Feneryolu Medical Center, Istanbul, Turkiye,Correspondence: Erman Şentürk Department of Psychiatry, Üsküdar University NP Feneryolu Medical Center, Ahmet Mithat Efendi Cad. No:17 (Bağdat Cad. Sahil Yolu Kalamış Mevkii) - 34726 Fenerbahçe – Kadıköy, Istanbul, Turkiye, Tel: +902164181500, Fax: +902164181530, E-mail:
| | - Işıl Üstün
- Department of Physical Medicine and Rehabilitation, Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkiye
| | - Akın Gökçedağ
- Department of Neurosurgery, Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkiye
| | - Nilgün Pulur Yıldırım
- Department of Neurology, Bagcilar Education and Research Hospital, Istanbul, Turkiye
| | - Nilüfer Kale İçen
- Department of Neurology, Bagcilar Education and Research Hospital, Istanbul, Turkiye
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23
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Birkás B, Kiss B, Coelho CM, Zsidó AN. The role of self-reported fear and disgust in the activation of behavioral harm avoidance related to medical settings. Front Psychiatry 2023; 14:1074370. [PMID: 36761866 PMCID: PMC9902716 DOI: 10.3389/fpsyt.2023.1074370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 01/03/2023] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Although adaptive defense mechanisms are useful in helping us avoid getting injured, they are also triggered by medical interventions and procedures, when avoidance is harmful. A body of previous results showed that both fear and disgust play a pivotal role in medical avoidance. However, the underlying mechanisms are not fully understood. Thus, the aim of the current study was to examine the effects of experience, perceived control, and pain on medical avoidance with disgust and fear as mediating factors from an evolutionary perspective. METHODS We assessed participants' knowledge of and experience with medical procedures, former negative medical experiences, and health-related information; their life history strategy variation; pain-related fear and anxiety of medical procedures; perceived control over emotional reactions and extreme threats; disgust sensitivity; blood-injury-injection phobia and medical treatment avoidance. RESULTS We found that more knowledge, experience, and a slower life strategy were linked to a greater level of perceived control and attenuated emotional reactions. Further, better ability to control affective and stress reactions to negative experiences was linked to reduced disgust and fear of pain, and thus might mitigate the level of perceived threat, and diminish fear and disgust reactions. DISCUSSION More knowledge and experiences, better perceived control together with reduced disgust and fear of pain can decrease the probability of avoiding medical situations. Implications to treatment are discussed. Results support the importance of targeting these contextual factors in prevention to increase the likelihood of people attending regular screenings or seeking medical care when needed.
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Affiliation(s)
- Béla Birkás
- Department of Behavioural Sciences, Medical School, University of Pécs, Pécs, Hungary
| | - Botond Kiss
- Faculty of Human and Social Sciences, Institute of Psychology, University of Pécs, Pécs, Hungary
| | - Carlos M Coelho
- Department of Psychology, Faculty of Human and Social Sciences, Azores University, Ponta Delgada, Portugal.,Center for Psychology, Porto University, Porto, Portugal
| | - András N Zsidó
- Faculty of Human and Social Sciences, Institute of Psychology, University of Pécs, Pécs, Hungary.,Szentagothai Research Centre, University of Pécs, Pécs, Hungary
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24
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Altay H, Celenay ST. An investigation of the relationship between cutaneous allodynia and kinesiophobia, gastrointestinal system symptom severity, physical activity and disability in individuals with migraine. Korean J Pain 2023; 36:137-146. [PMID: 36581602 PMCID: PMC9812700 DOI: 10.3344/kjp.22327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 12/31/2022] Open
Abstract
Background To investigate the relationship between cutaneous allodynia (CA) and kinesiophobia, gastrointestinal system (GIS) symptom severity, physical activity, and disability, and to determine whether CA, pain, and disability were influencing factors for kinesiophobia, GIS symptoms, and physical activity in individuals with migraine. Methods The study included 144 individuals with migraine. CA, kinesiophobia, GIS symptoms, physical activity level, and migraine-related disability were evaluated with the Allodynia Symptom Checklist, the Tampa Kinesiophobia Scale (TKS), the Gastrointestinal Symptom Rating Scale (GSRS), the International Physical Activity Questionnaire-7, and the Migraine Disability Assessment Scale (MIDAS), respectively. Results The CA severity was only associated with TKS (r = 0.515; P < 0.001), GSRS-total (r = 0.336; P < 0.001), GSRS-abdominal pain (r = 0.323; P < 0.001), GSRS-indigestion (r = 0.257; P = 0.002), GSRS-constipation (r = 0.371; P < 0.001), and MIDAS scores (r = 0.178; P = 0.033). Attack frequency (P = 0.015), attack duration (P = 0.035) and presence of CA (P < 0.001) were risk factors for kinesiophobia. Attack frequency (P = 0.027) and presence of CA (P = 0.004) were risk factors for GIS symptoms. Conclusions There was a relationship between the CA and kinesiophobia, GIS symptoms, and disability. CA and attack frequency were found to be risk factors for kinesiophobia and GIS symptoms. Migraine patients with CA should be assessed in terms of kinesiophobia, GIS, and disability. Lifestyle changes such as exercise and dietary changes and/or pharmacological treatment options for CA may increase success in migraine management.
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Affiliation(s)
- Hafize Altay
- Physiotherapy and Rehabilitation Doctoral Program, Instute of Health Sciences, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Seyda Toprak Celenay
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Ankara Yildirim Beyazit University, Ankara, Turkey,Correspondence: Seyda Toprak Celenay Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Ankara Yildirim Beyazit University Esenboga Campus, Dumlupınar District, 06760 Cubuk/Ankara, Turkey, Tel: +903129061000, Fax: +903129062950, E-mail:
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25
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Özlü A, Akdeniz Leblebicier M. Does remission in rheumatoid arthritis bring kinesiophobia, quality of life, fatigue, and physical activity closer to normal? Arch Rheumatol 2022; 37:603-612. [PMID: 36879575 PMCID: PMC9985370 DOI: 10.46497/archrheumatol.2022.9552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 08/19/2022] [Indexed: 03/08/2023] Open
Abstract
Objectives This study aimed to compare kinesiophobia, fatigue, physical activity, and quality of life (QoL) between the patients with rheumatoid arthritis (RA) in remission and a healthy population. Patients and methods The prospective controlled study included 45 female patients (mean age: 54.22±8.2 year; range, 37 to 67 year) with a diagnosis of RA determined to be in remission according to the Disease Activity Score in 28 Joints (DAS28) being ≤2.6 between January 2022 and February 2022. As a control group, 45 female healthy volunteers (mean age: 52.2±8.2 year; range, 34 to 70 year) of similar age were evaluated. The QoL, disease activity, pain, kinesiophobia, fatigue severity, and physical activity were assessed using the Health Assessment Questionnaire, DAS28, Visual Analog Scale, Tampa Scale of Kinesiophobia, Fatigue Severity Scale, and International Physical Activity Questionnaire, respectively. Results There was no significant difference between the groups in demographic data. A statistically significant difference was found between the groups in terms of pain, C-reactive protein level, fatigue, kinesiophobia, QoL, and total, high, and moderate physical activity scores (p<0.001). Among the RA patients in remission, there was a significant correlation between kinesiophobia and moderate physical activity and QoL, as well as between fatigue and high physical activity (p<0.05). Conclusion Patient education and multidisciplinary approach strategies should be developed to increase the QoL and physical activity and reduce kinesiophobia in RA patients in remission since there may be a decrease in physical activity due to kinesiophobia, fatigue, and fear of movement in this patient group compared to the healthy population, impairing their QoL.
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Affiliation(s)
- Aysun Özlü
- Department of Physical Medicine and Rehabilitation, Kütahya Health Sciences University, Kütahya, Türkiye
| | - Merve Akdeniz Leblebicier
- Department of Physical Medicine and Rehabilitation, Kütahya Health Sciences University, Kütahya, Türkiye
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26
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Kunitake K, Ogura A, Iwata-Hatanaka M, Inagaki R, Furukawa S, Suzuki J, Nakai N, Nishida S, Katsuno M, Ito Y. Persistent brain damage in reversible cerebral vasoconstriction syndrome on 99mTc-ethyl cysteinate dimer single-photon emission computed tomography: A long-term observational study. J Neurol Sci 2022; 442:120441. [PMID: 36209569 DOI: 10.1016/j.jns.2022.120441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 08/24/2022] [Accepted: 09/25/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Blood-brain barrier (BBB) breakdown is considered a key step in the pathophysiology of reversible cerebral vasoconstriction syndrome (RCVS); however, its temporal course remains unclear. Based on the characteristics and dynamics of 99mTc-ethyl cysteinate dimer (99mTc-ECD) as a tracer, 99mTc-ECD single-photon emission computed tomography (SPECT) can detect not only hypoperfusion but also BBB breakdown and/or brain tissue damage. Therefore, this study aimed to investigate this course using 99mTc-ECD SPECT. METHODS Between 2011 and 2019, we enrolled seven patients (one male and six female patients) with RCVS without ischemic or hemorrhagic stroke or posterior reversible encephalopathy syndrome. 99mTc-ECD SPECT was performed repeatedly in each patient. SPECT data were statistically analyzed using an easy Z-score imaging system. RESULTS Thunderclap headache was the initial symptom in all the patients and was most commonly triggered by bathing (three patients). All the patients exhibited vasoconstriction and reduced cerebral uptake of 99mTc-ECD during the acute stage. Follow-up assessment from 3 to 16 months showed that reduced cerebral uptake persisted in all the patients, even after the vasoconstriction had resolved. CONCLUSION Reduced cerebral uptake of 99mTc-ECD persisted in the late stage of RCVS, even after vasoconstriction and headache subsided. BBB breakdown and/or brain tissue damage may underlie this phenomenon. 99mTc-ECD SPECT is an effective neuroimaging method to detect brain functional abnormalities, reflecting BBB breakdown or tissue damages, throughout the treatment course of RCVS.
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Affiliation(s)
- Katsuhiko Kunitake
- Department of Neurology, TOYOTA Memorial Hospital, Toyota, Aichi, Japan; Department of Molecular Therapy, National Institute of Neuroscience, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo, Japan; Department of NCNP Brain Physiology and Pathology, Graduate school of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo, Tokyo, Japan.
| | - Aya Ogura
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Mai Iwata-Hatanaka
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Ryosuke Inagaki
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Soma Furukawa
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Junichiro Suzuki
- Department of Neurology, TOYOTA Memorial Hospital, Toyota, Aichi, Japan
| | - Noriyoshi Nakai
- Department of Neurology, TOYOTA Memorial Hospital, Toyota, Aichi, Japan
| | - Suguru Nishida
- Department of Neurology, Nishichita General Hospital, Tokai, Aichi, Japan
| | - Masahisa Katsuno
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Yasuhiro Ito
- Department of Neurology, TOYOTA Memorial Hospital, Toyota, Aichi, Japan
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Andreu Y, Soto-Rubio A, Ramos-Campos M, Escriche-Saura A, Martínez M, Gavilá J. Impact of hormone therapy side effects on health-related quality of life, distress, and well-being of breast cancer survivors. Sci Rep 2022; 12:18673. [PMID: 36333362 PMCID: PMC9636256 DOI: 10.1038/s41598-022-22971-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
To explore the modulatory role of Adjuvant Hormone Therapy (AHT) on health-related quality of life (QoL), subjective well-being and distress prevalence in Breast Cancer (BC) survivors, considering the survival phase. Cross-sectional study with control group. 616 BC survivors participated. Examination of interaction effect between AHT and time since end of primary treatment showed that many of the positive changes observed through the survival phases were experienced exclusively by survivors without AHT. When AHT was not prescribed, longer time elapsed was associated with a decrease in distress prevalence and an improvement in subjective well-being and QoL. It seems there is a turning point around the fifth year after finalization of primary treatment, from which the survivors without AHT significantly improve in several areas and those with AHT do so to a lesser extent. It is expected that the improvement in QoL throughout the different survival phases will have a significant impact on the adherence and maintenance of AHT and, consequently, the likelihood of survival. Thus, AHT side-effects should be routinely assessed by health care providers to gain accurate knowledge that allows improving the QoL of BC survivors.
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Affiliation(s)
- Y Andreu
- Personality, Assessment and Psychological Treatments Department, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - A Soto-Rubio
- Personality, Assessment and Psychological Treatments Department, Faculty of Psychology, University of Valencia, Valencia, Spain.
| | - M Ramos-Campos
- Asociación Española Contra el Cáncer (AECC), Valencia, Spain
| | | | - M Martínez
- Department of Medical Oncology, Hospital Clínico Universitario de Valencia-Biomedical Research Institute INCLIVA, Valencia, Spain
| | - J Gavilá
- Medical Oncology Department, Fundación Instituto Valenciano de Oncología, Valencia, Spain
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28
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Heikkala E, Paananen M, Merikanto I, Karppinen J, Oura P. Eveningness intensifies the association between musculoskeletal pain and health-related quality of life: a Northern Finland Birth Cohort Study 1966. Pain 2022; 163:2154-2161. [PMID: 35135992 PMCID: PMC9578528 DOI: 10.1097/j.pain.0000000000002609] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/16/2022] [Accepted: 01/31/2022] [Indexed: 11/25/2022]
Abstract
ABSTRACT People with an evening (E)-type preference (ie, chronotype) experience musculoskeletal (MSK) pain and reduced health-related quality of life (HRQoL) more often than morning (M) types. Musculoskeletal pain is a well-established contributor to reduced HRQoL. This study aimed to evaluate whether eveningness amplifies the association between MSK pain and HRQoL in contrast to morningness. Questionnaire data on MSK pain dimensions (intensity, disability at work, number of pain sites [NPSs], and frequency), chronotype, covariates (sex, sufficiency of sleep duration, mental distress, and presence of coexisting diseases), and HRQoL (measured by 15D) were collected among 46-year-old individuals belonging to the Northern Finland Birth Cohort 1966 (N = 4257). Individuals without any MSK pain were excluded. General linear models were conducted to estimate the associations between chronotypes, MSK pain dimensions, and HRQoL. The interaction terms (chronotype × pain dimension) were tested in the models. There were 13% E-types and 43% M-types in the study sample. Each pain dimension and chronotype were related to HRQoL. In the sex-adjusted chronotype-specific models, the reduction in HRQoL in relation to pain appeared to be stronger among E-types than among M-types in respect to all pain dimensions. After adjustments, this was particularly seen in terms of NPS and pain frequency. Our findings suggest that eveningness intensifies the association between MSK pain and HRQoL, and, thus, they are indicative of E-types being more sensitive than M-types to the consequences of MSK pain. As such, MSK pain treatment and rehabilitation actions to improve HRQoL should be especially targeted at E-types.
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Affiliation(s)
- Eveliina Heikkala
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Finland
- Rovaniemi Health Center, Rovaniemi, Finland
| | - Markus Paananen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Finland
- Primary Health Care Services, City of Espoo, Espoo, Finland
| | - Ilona Merikanto
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
- Orton Orthopaedics Hospital, Helsinki, Finland
| | - Jaro Karppinen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Finland
- Rehabilitation Services of South Karelia Social and Health Care District, Lappeenranta, Finland
| | - Petteri Oura
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Finland
- Department of Forensic Medicine, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Forensic Medicine Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
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29
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Oh J, Lee MK. Shoulder pain, shoulder disability, and depression as serial mediators between stress and health-related quality of life among middle-aged women. Health Qual Life Outcomes 2022; 20:142. [PMID: 36224565 PMCID: PMC9558984 DOI: 10.1186/s12955-022-02054-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 10/05/2022] [Indexed: 11/16/2022] Open
Abstract
This study analyzed the mediating effects of shoulder pain, disability, and depression on the relationship between stress and health-related quality of life among middle-aged women using a serial mediation model. Methods. Data on stress, health-related quality of life, shoulder pain, shoulder disability, and depression were collected from 565 women aged 35–64 years living in Seoul, South Korea, from May 13 to 23, 2021, using a self-reported, structured survey. SPSS PROCESS macro (Model 6) and serial mediation analysis were used to analyze the relationship between stress and health-related quality of life among participants, with shoulder pain, shoulder disability, and depression as mediators. Results. The results indicate that stress had a statistically direct impact on health-related quality of life. In the serial mediation analysis, shoulder pain, disability, and depression were found to be statistically significant, thus affecting the relationship between stress and health-related quality of life, with an explanatory power of 33%. Therefore, the relationship between stress and health-related quality of life was partially mediated by these variables. Conclusions. Thus, this study suggests the need for healthcare workers to develop methods, such as exercise intervention programs based on various degrees and types of physical activity, to improve health-related quality of life and reduce stress caused by shoulder pain, shoulder disability, and depression among middle-aged women.
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Affiliation(s)
- Jihyun Oh
- Department of Nursing, College of Nursing and Health, Kongju National University, 32588, Kongju, South Korea
| | - Myung Kyung Lee
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, 41944, Daegu, South Korea.
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30
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Cetingok S, Seker O, Cetingok H. The relationship between fibromyalgia and depression, anxiety, anxiety sensitivity, fear avoidance beliefs, and quality of life in female patients. Medicine (Baltimore) 2022; 101:e30868. [PMID: 36181089 PMCID: PMC9524976 DOI: 10.1097/md.0000000000030868] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The study aims to determine whether there is a relationship between fibromyalgia (FM) disease and depression, anxiety, anxiety sensitivity, fear-avoidance beliefs, and quality of life in female patients with a diagnosis of fibromyalgia. 37 female patients followed up with FM diagnosis in pain medicine clinic and a control group consisting of 37 healthy women were included in the study. Sociodemographic and Clinical Characteristics Data Form, Quality of Life Form, fear-avoidance beliefs questionnaire, Anxiety Sensitivity Index-3, Beck Anxiety Inventory, Beck Depression Inventory, and Visual Analogue Scale was applied to the participants. When the patients in the FM group were compared to the control group; Statistically lower scores in all Quality of Life Form subscales except emotional role difficulty and social functionality scores; statistically higher scores in both physical and work activity subscales in fear-avoidance beliefs questionnaire; statistically higher scores in cognitive symptoms subscale in Anxiety Sensitivity Index-3, Beck Anxiety Inventory, Beck Depression Inventory, and Visual Analogue Scale scores were found. In FM patients, it has been determined that anxiety, depression and perceived pain severity reduce social functionality and quality of life in areas such as mental health, physical function, and emotional role difficulties. It was determined that the functionality and quality of life of patients diagnosed with FM decreased in daily life. An important contribution of the study to the literature is that it shows that the behavior of avoiding activity due to pain-induced fear exacerbates the pain and even contributes to its chronicity. These results, which show the effects of anxiety, depression, anxiety sensitivity, and fear-avoidance behavior on the prognosis of the disease in FM patients, indicate that psychiatric evaluation and treatment in FM patients is an important factor that determines the functionality and quality of life.
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Affiliation(s)
- Sera Cetingok
- Faculty of Health Science, Gerontology, Istanbul University – Cerrahpasa, Istanbul, Turkey
| | - Oznur Seker
- Limit Educational Institutions, Istanbul, Turkey
| | - Halil Cetingok
- Division of Pain Medicine, Department of Anesthesiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
- *Correspondence: Halil Cetingok, Division of Pain Medicine, Department of Anesthesiology, Istanbul Faculty of Medicine, Istanbul University, Turgut ozal Millet Street, 34093 Fatih, Istanbul, Turkey (e-mail: )
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31
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LaRowe LR, Williams DM. Activity-induced pain as a predictor of physical activity behavior among individuals with chronic pain: the role of physical activity enjoyment. J Behav Med 2022; 45:632-642. [PMID: 35501540 PMCID: PMC9308740 DOI: 10.1007/s10865-022-00318-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 03/30/2022] [Indexed: 10/18/2022]
Abstract
Nearly 70% of adults with chronic pain experience increased pain during activity, and this may reduce enjoyment of physical activity (PA), and subsequent PA intention/behavior. The goal of this study was to examine increased pain during activity as a predictor of PA, via its effects on PA enjoyment. Participants included 178 overweight/obese midlife adults with chronic pain who completed an online prospective survey. Results indicated that greater increases in pain during activity were associated with less PA enjoyment, and, in turn, lower intention to exercise over the next week (p < 0.05). Activity-induced pain also predicted lower total volume of PA at 1-week follow-up, and this relationship was mediated by PA enjoyment (p < 0.05). These findings have the potential to inform the refinement of PA promotion interventions for individuals with chronic pain.
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Affiliation(s)
- Lisa R LaRowe
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA.
| | - David M Williams
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA
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32
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Schneider MB, Manikowski A, Cohen L, Dampier C, Sil S. The distinct longitudinal impact of pain catastrophizing on pain interference among youth living with sickle cell disease and chronic pain. J Behav Med 2022; 45:622-631. [PMID: 35171440 PMCID: PMC9308676 DOI: 10.1007/s10865-021-00280-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 12/28/2021] [Indexed: 01/11/2023]
Abstract
Youth living with chronic sickle cell disease (SCD) pain are at risk for psychosocial distress and high levels of pain catastrophizing that contribute to functional impairment. This study aimed to identify the unique long-term impact of pain catastrophizing on pain impairment among youth with SCD. Youth with chronic SCD pain (N = 63, 10-18 years old, 58.3% female, 95.1% Black or African American) were recruited within comprehensive SCD clinics and completed a battery of measures at baseline and 4-months follow-up. A linear hierarchical regression examined baseline demographic and clinical characteristics (child SCD genotype, age, and average pain intensity), psychosocial functioning (anxiety, depression), and pain catastrophizing as predictors of pain interference at 4-months follow-up. Pain catastrophizing was the only unique predictor of pain interference at 4-months follow-up. Among youth with chronic SCD pain, pain catastrophizing warrants greater consideration as an important predictor that influences pain management and overall functioning.
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Affiliation(s)
- Mallory B Schneider
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, 515 N Crossville Rd, Roswell, GA, 30075, USA.
- Emory University School of Medicine, Atlanta, USA.
| | - Alison Manikowski
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, 515 N Crossville Rd, Roswell, GA, 30075, USA
- Emory University School of Medicine, Atlanta, USA
| | - Lindsey Cohen
- Emory University School of Medicine, Atlanta, USA
- Department of Psychology, Georgia State University, Atlanta, USA
| | - Carlton Dampier
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, 515 N Crossville Rd, Roswell, GA, 30075, USA
- Emory University School of Medicine, Atlanta, USA
| | - Soumitri Sil
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, 515 N Crossville Rd, Roswell, GA, 30075, USA
- Emory University School of Medicine, Atlanta, USA
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Increased shoulder pain across an exercise session and subsequent shoulder exercise: a prospective cohort study. BMC Musculoskelet Disord 2022; 23:726. [PMID: 35906579 PMCID: PMC9336042 DOI: 10.1186/s12891-022-05674-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 07/18/2022] [Indexed: 12/05/2022] Open
Abstract
Background Shoulder complaints are common and the recommended first-line treatment is exercise therapy. However, it remains unknown if increased shoulder pain after an exercise session is a barrier for subsequent exercise dose, particularly in people with high fear-avoidance beliefs. Such knowledge could indicate ways to optimise shoulder rehabilitation. The aim was to examine whether increased shoulder pain across an exercise session was associated with a lower subsequent exercise dose, and if high fear-avoidance beliefs exaggerated this association. Methods We conducted a prospective cohort study using data from a randomised controlled trial in Central Denmark Region 2017–2019. Participants were employees (n = 79) with shoulder complaints and high occupational shoulder exposures. The intervention was a home-based or partly supervised exercise programme lasting 2–3 months. Linear mixed models were used to examine the associations between change in shoulder pain and exercise dose (number of repetitions, progression level (1–3), resistance level (1–3), and time until next exercise session [days]). Results At baseline, the participants had a median pain intensity at rest of 2 on a numerical rating scale (0–10). For a 1-cm increase in pain on a visual analogue scale (0–10 cm) during an exercise session, the subsequent number of repetitions, progression level and resistance level were − 1.3 (95% confidence interval [CI] − 3.4 to 0.9), 0.0 (95% CI − 0.1 to 0.0) and − 0.0 (95% CI − 0.1 to 0.0), respectively. Likewise, the time until next exercise session was − 0.6 (95% CI − 2.4 to 1.3) days for a 1-cm increase. There were no interactions with fear-avoidance beliefs. Conclusion Increased pain across an exercise session was not associated with subsequent exercise dose, regardless of fear-avoidance beliefs, among employees with shoulder complaints and high occupational shoulder exposures. Trial registration The trial was registered at Clinicaltrials.gov 19/05/2017 (ID: NCT03159910). Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05674-2.
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Aho T, Sipilä R, Kalso E, Harno H. Temperament and character dimensions differ in chronic post-surgical neuropathic pain and cold pressure pain. Scand J Pain 2022; 22:515-525. [PMID: 35139264 DOI: 10.1515/sjpain-2021-0163] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 01/11/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Psychobiological temperament and cognitive-evaluative character link to coping with chronic pain. The aim was to study possible independent role of temperament and character dimensions both in chronic and experimental pain in chronic post-surgical pain patients. This is a substudy of a previously published larger cohort of patients with intercostobrachial nerve injury after breast cancer surgery. METHODS We recruited 241 women who had been treated for breast cancer 4-9 years before. They had a surgeon-verified intercostobrachial nerve injury with or without chronic post-surgical neuropathic pain (CPSNP). The patients filled in the Temperament and Character Inventory (TCI), Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), and Brief Pain Inventory (BPI), and underwent the cold pressor test (CPT). RESULTS 201 (83%) patients reported chronic pain and 135 (56%) met the criteria for CPSNP. Patients with CPSNP showed higher levels of Harm Avoidance (HA) temperament than non-CPSNP patients, which was associated with lower cold pain tolerance and greater increase of pain intensity during CPT. HA subscales Fear of Uncertainty and Fatigability contributed to a stronger pain experience. For character dimensions, CPSNP patients reported higher levels of Self-Transcendence (ST) and lower levels of Self-Directedness (SD) and Cooperativeness (CO) than non-CPSNP patients. Cold pain tolerance, intensity, or unpleasantness did not associate with character dimensions. CONCLUSIONS Psychobiological temperament, but not character, is independently from other psychological factors associated with primary pain processing in an experimental pain setting. Patients with and without CPSNP showed different profiles on both temperament and character dimensions suggesting a combination of heightened emotional vulnerability and lowered personality adaptability in CPSNP patients. Character dimensions associated with clinical but not experimental pain. ETHICAL COMMITTEE NUMBER The study protocol was approved by the Ethics Committee of the Helsinki and Uusimaa Hospital District (reference number: 149/13/03/00/14). TRIAL REGISTRY NUMBER The study is registered in ClinicalTrials.gov (NCT02487524).
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Affiliation(s)
- Tommi Aho
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Reetta Sipilä
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Eija Kalso
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- SleepWell Research Programme University of Helsinki, Helsinki, Finland
| | - Hanna Harno
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Clinical Neurosciences, Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Wang H, Hu F, Lyu X, Jia H, Wang B, Liu F, Yang Y. Kinesiophobia could affect shoulder function after repair of rotator cuff tears. BMC Musculoskelet Disord 2022; 23:714. [PMID: 35883122 PMCID: PMC9316366 DOI: 10.1186/s12891-022-05679-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 07/20/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose Kinesiophobia (fear of movement) is a major limiting factor in the return to pre-injury sport level after surgery of rotator cuff tears. The study aims to gain insights into how kinesiophobia affects shoulder pain and function after the repair of full-thickness rotator cuff tears. Methods A prospective study was conducted to evaluate patients who underwent rotator cuff repair between January 2019 and December 2019 in our institution. The patients were divided into a trial group with a high kinesiophobia (Tampa Scale for Kinesiophobia [TSK], TSK > 37) and a control group with a low kinesiophobia (TSK ≤ 37). The indicators of interest included the Constant-Murley scores, numerical rating scale (NRS), visual analogue scale (VAS), Oxford Shoulder Score (OSS), and the American shoulder and elbow score (ASES), shoulder function and strength, and range of motion (ROM) at 3 days, 6 weeks, and 12 months after repair of full-thickness rotator cuff tears. Results In total, 49 patients who underwent repair of full-thickness rotator cuff tears were enrolled, which was divided into a trial group involving 26 patients (mean TSK 52.54) and a control group involving 23 patients (mean TSK 33.43). There were no statistically significant differences in basic information such as age, gender, and length of stay in the two groups. The preoperative and early postoperative functional scores and the Tampa Scale for Kinesiophobia were statistically significant differences between the two groups. However, long-term postoperative follow-up showed no statistically significant difference in ASES, and Constant-Murley scores, OSS, and VAS scores between the two groups as the kinesiophobia changed from positive to negative. Conclusion Degree of kinesiophobia reduced during post-operative rehabilitation of rotator cuff repair patients, but high kinesiophobia is still present in a large portion of the patients after rotator cuff repair. Patients after rotator cuff repair will benefit from early recognition and prevention of kinesiophobia.
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Affiliation(s)
- Huihui Wang
- Department of Orthopaedics, Shandong Provincial Hospital affiliated to Shandong First Medical University, No.324, Road Jing Wu Wei Qi, Jinan, 250021, Shandong, China
| | - Fangning Hu
- Department of Orthopaedics, Shandong Provincial Hospital affiliated to Shandong First Medical University, No.324, Road Jing Wu Wei Qi, Jinan, 250021, Shandong, China
| | - Xiaolong Lyu
- Department of Orthopaedics, Shandong Provincial Hospital affiliated to Shandong First Medical University, No.324, Road Jing Wu Wei Qi, Jinan, 250021, Shandong, China
| | - Honglei Jia
- Department of Orthopaedics, Shandong Provincial Hospital affiliated to Shandong First Medical University, No.324, Road Jing Wu Wei Qi, Jinan, 250021, Shandong, China
| | - Bomin Wang
- Department of Orthopaedics, Shandong Provincial Hospital affiliated to Shandong First Medical University, No.324, Road Jing Wu Wei Qi, Jinan, 250021, Shandong, China
| | - Fanxiao Liu
- Department of Orthopaedics, Shandong Provincial Hospital affiliated to Shandong First Medical University, No.324, Road Jing Wu Wei Qi, Jinan, 250021, Shandong, China
| | - Yongliang Yang
- Department of Orthopaedics, Shandong Provincial Hospital affiliated to Shandong First Medical University, No.324, Road Jing Wu Wei Qi, Jinan, 250021, Shandong, China.
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Hass-Cohen N, Bokoch R, Goodman K, McAnuff J. Art Therapy Drawing Protocols for Chronic Pain: Qualitative Findings From a Mixed-Method Pilot Study. ART THERAPY 2022. [DOI: 10.1080/07421656.2022.2085491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Tidmarsh LV, Harrison R, Ravindran D, Matthews SL, Finlay KA. The Influence of Adverse Childhood Experiences in Pain Management: Mechanisms, Processes, and Trauma-Informed Care. FRONTIERS IN PAIN RESEARCH 2022; 3:923866. [PMID: 35756908 PMCID: PMC9226323 DOI: 10.3389/fpain.2022.923866] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 05/20/2022] [Indexed: 12/30/2022] Open
Abstract
Adverse childhood experiences (ACEs) increase the likelihood of reduced physical and psychological health in adulthood. Though understanding and psychological management of traumatic experiences is growing, the empirical exploration of ACEs and physical clinical outcomes remains under-represented and under-explored. This topical review aimed to highlight the role of ACEs in the experience of chronic pain, pain management services and clinical decision making by: (1) providing an overview of the relationship between ACEs and chronic pain; (2) identifying biopsychosocial mechanisms through which ACEs may increase risk of persistent pain; (3) highlighting the impact of ACEs on patient adherence and completion of pain management treatment; and (4) providing practical clinical implications for pain management. Review findings demonstrated that in chronic pain, ACEs are associated with increased pain complications, pain catastrophizing and depression and the combination of these factors further heightens the risk of early treatment attrition. The pervasive detrimental impacts of the COVID-19 pandemic on ACEs and their cyclical effects on pain are discussed in the context of psychological decline during long treatment waitlists. The review highlights how people with pain can be further supported in pain services by maintaining trauma-informed practices and acknowledging the impact of ACEs on chronic pain and detrimental health outcomes. Clinicians who are ACE-informed have the potential to minimize the negative influence of ACEs on treatment outcomes, ultimately optimizing the impact of pain management services.
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Affiliation(s)
- Lydia V. Tidmarsh
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
- *Correspondence: Lydia V. Tidmarsh
| | - Richard Harrison
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | | | - Samantha L. Matthews
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Katherine A. Finlay
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
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Chrisman SPD, Bollinger BJ, Mendoza JA, Palermo TM, Zhou C, Brooks MA, Rivara FP. Mobile Subthreshold Exercise Program (MSTEP) for concussion: study protocol for a randomized controlled trial. Trials 2022; 23:355. [PMID: 35473570 PMCID: PMC9040347 DOI: 10.1186/s13063-022-06239-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 03/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Subthreshold exercise, defined as aerobic exercise below the level that causes symptoms, has been utilized as a treatment for youth with persistent postconcussive symptoms (PPCS), but there is currently little evidence to guide use. In addition, prior studies of exercise for PPCS have all required multiple in-person visits. We developed a virtual approach for delivering subthreshold exercise to youth with PPCS called the Mobile Subthreshold Exercise Program (MSTEP), and we have now been funded to conduct a large national randomized controlled trial (RCT) to test its efficacy for reducing concussive symptoms and improving health-related quality of life. METHODS This investigation is an RCT comparing MSTEP to an active control. We will recruit 200 adolescents 11-18 years old with postconcussive symptoms persisting for at least 1 week but less than 1 year. Youth will be randomized to receive either 6 weeks of subthreshold exercise (MSTEP) or a stretching condition (control). Youth and parents will complete surveys of concussive symptoms at baseline, weekly during the intervention, and at 3 and 6 months. The primary outcomes will be trajectory of concussive symptoms and health-related quality of life over the 6 months of the study. Secondary outcomes will include depression, anxiety, and sleep quality. We will also assess potential mediators of treatment effects including moderate-vigorous physical activity and fear avoidance of concussive symptoms. DISCUSSION This multisite RCT of MSTEP will provide vital information regarding the efficacy of a virtually delivered subthreshold exercise program for youth with PPCS, and insight regarding potential mediators of treatment effects, including objectively measured physical activity and fear avoidance of concussive symptoms. TRIAL REGISTRATION ClinicalTrials.gov NCT04688255. Registered on December 29, 2020.
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Affiliation(s)
- Sara P D Chrisman
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, PO Box 5371, CURE-03, Seattle, WA, 98145, USA. .,Department of Pediatrics, University of Washington, Seattle, USA.
| | - Beth J Bollinger
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, PO Box 5371, CURE-03, Seattle, WA, 98145, USA
| | - Jason A Mendoza
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, PO Box 5371, CURE-03, Seattle, WA, 98145, USA.,Department of Pediatrics, University of Washington, Seattle, USA.,Fred Hutchinson Cancer Research Center, Seattle, USA
| | - Tonya M Palermo
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, PO Box 5371, CURE-03, Seattle, WA, 98145, USA.,Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, USA
| | - Chuan Zhou
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, PO Box 5371, CURE-03, Seattle, WA, 98145, USA
| | | | - Frederick P Rivara
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, PO Box 5371, CURE-03, Seattle, WA, 98145, USA.,Department of Pediatrics, University of Washington, Seattle, USA
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Rossettini G, Colombi A, Carlino E, Manoni M, Mirandola M, Polli A, Camerone EM, Testa M. Unraveling Negative Expectations and Nocebo-Related Effects in Musculoskeletal Pain. Front Psychol 2022; 13:789377. [PMID: 35369173 PMCID: PMC8966654 DOI: 10.3389/fpsyg.2022.789377] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 02/24/2022] [Indexed: 12/16/2022] Open
Abstract
This Perspective adapts the ViolEx Model, a framework validated in several clinical conditions, to better understand the role of expectations in the recovery and/or maintenance of musculoskeletal (MSK) pain. Here, particular attention is given to the condition in which dysfunctional expectations are maintained despite no longer being supported by confirmatory evidence (i.e., belief-lifting the arm leads to permanent tendon damage; evidence-after the patient lifts the arm no tendon damage occurs). While the ViolEx Model suggests that cognitive immunization strategies are responsible for the maintenance of dysfunctional expectations, we suggest that such phenomenon can also be understood from a Bayesian Brain perspective, according to which the level of precision of the priors (i.e., expectations) is the determinant factor accounting for the extent of priors' updating (i.e., we merge the two frameworks, suggesting that highly precise prior can lead to cognitive immunization responses). Importantly, this Perspective translates the theory behind these two frameworks into clinical suggestions. Precisely, it is argued that different strategies should be implemented when treating MSK pain patients, depending on the nature of their expectations (i.e., positive or negative and the level of their precision).
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Affiliation(s)
- Giacomo Rossettini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy.,School of Physiotherapy, University of Verona, Verona, Italy
| | - Andrea Colombi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Elisa Carlino
- Department of Neuroscience, University of Turin Medical School, Turin, Italy
| | - Mattia Manoni
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | | | - Andrea Polli
- Pain in Motion (PAIN) Department, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.,Research Foundation, Flanders (FWO) Postdoctoral Fellow, Brussels, Belgium
| | - Eleonora Maria Camerone
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy.,Department of Psychology, University of Milan-Bicocca, Milano, Italy
| | - Marco Testa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
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YERLİKAYA M, SARACOGLU İ. The attitudes and beliefs of physiotherapists, family physicians and physiatrists concerning chronic low back pain. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1015826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Lyu RY, Wen ZL, Tang WC, Yang XM, Wen JL, Wang B, Gao M. Data mining-based detection of the clinical effect on motion style acupuncture therapy combined with conventional acupuncture therapy in chronic neck pain. Technol Health Care 2022; 30:521-533. [PMID: 35124626 PMCID: PMC9028636 DOI: 10.3233/thc-228048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND: Neck pain is the most common symptom of cervical spondylosis. OBJECTIVE: To discuss the indications for conventional acupuncture therapy (CAT) and motion style acupuncture therapy (MSAT) combined with CAT in neck pain patients using data mining. METHOD: Seventy-six participants with neck pain were recruited and randomly divided into two paralleled groups. Participants in intervention group received two-course MSAT at Houxi (SI3) and CAT at local neck region, while the control group received CAT at neck only. Take the SF-36 score scale and pain pressure threshold (PPT) values as the raw data and use data-mining to evaluate the clinical effect of two treatments. RESULT: Both groups have the best effect after one-time and one-course treatment. The main factors influencing effect most are Role-Emotional (RE), Physical Functioning (PF) and Social Functioning (SF) in intervention group, while it transfers to General Health (GH), RE and SF in control group. To patients in intervention group who scores 41.70 to 68.70 in PF before treatment, MSAT can effectively improve the restriction of activities and play an analgesic effect; to patients in control group who score 56.09 to 66.09 in GH before treatment, CAT may have curative effect. CONCLUSION: Both MSAT and CAT can improve the life-quality of neck pain patients. Patients with high general health status before treatment can choose CAT, while patients who score mild to moderate decline in physiological function can choose MSAT combined with CAT.
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Affiliation(s)
- Ruo-yun Lyu
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Shanghai Beizhan Hospital, Shanghai, China
| | - Zong-lin Wen
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Shanghai Shuguang Hospital Affiliated by Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wen-chao Tang
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xu-ming Yang
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jun-ling Wen
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bo Wang
- Shanghai Shuguang Hospital Affiliated by Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ming Gao
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Lindberg MF, Aamodt A, Badawy M, Bergvad IB, Borchgrevink P, Furnes O, Gay C, Heir S, Holm I, Indrekvam K, Kise N, Lau B, Magnussen J, Nerhus TK, Rognsvåg T, Rudsengen DE, Rustøen T, Skou ST, Stubberud J, Småstuen MS, Lerdal A. The effectiveness of exercise therapy and education plus cognitive behavioral therapy, alone or in combination with total knee arthroplasty in patients with knee osteoarthritis - study protocol for the MultiKnee trial. BMC Musculoskelet Disord 2021; 22:1054. [PMID: 34930194 PMCID: PMC8690622 DOI: 10.1186/s12891-021-04924-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 11/29/2021] [Indexed: 11/12/2022] Open
Abstract
Background One in five patients report chronic pain following total knee arthroplasty (TKA) and are considered non-improvers. Psychological interventions such as cognitive behavioral therapy (CBT), combined with exercise therapy and education may contribute to reduced pain an improved function both for patients with OA or after TKA surgery, but the evidence for the effectiveness of such interventions is scarce. This randomized controlled trial with three arms will compare the clinical effectiveness of patient education and exercise therapy combined with internet-delivered CBT (iCBT), evaluated either as a non-surgical treatment choice or in combination with TKA, in comparison to usual treatment with TKA in patients with knee OA who are considered candidates for TKA surgery. Methods The study, conducted in three orthopaedic centers in Norway will include 282 patients between ages 18 and 80, eligible for TKA. Patients will be randomized to receive the exercise therapy + iCBT, either alone or in combination with TKA, or to a control group who will undergo conventional TKA and usual care physiotherapy following surgery. The exercise therapy will include 24 one hour sessions over 12 weeks led by a physiotherapist. The iCBT program will be delivered in ten modules. The physiotherapists will receive theoretical and practical training to advise and mentor the patients during the iCBT program. The primary outcome will be change from baseline to 12 months on the pain sub-scale from the Knee Injury and Osteoarthritis Outcome Score (KOOS). Secondary outcomes include the remaining 4 sub-scales from the KOOS (symptoms, function in daily living, function in sports and recreation, and knee-related quality of life), EQ-5D-5L, the Pain Catastrophizing Scale, the 30-s sit-to-stand test, 40-m walking test and ActiGraph activity measures. A cost-utility analysis will be performed using QALYs derived from the EQ-5D-5L and registry data. Discussion This is the first randomized controlled trial to investigate the effectiveness of exercise therapy and iCBT with or without TKA, to optimize outcomes for TKA patients. Findings from this trial will contribute to evidence-based personalized treatment recommendations for a large proportion of OA patients who currently lack an effective treatment option. Trial registration Clinicaltrials.gov: NCT03771430. Registered: Dec 11, 2018.
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Affiliation(s)
- Maren Falch Lindberg
- Department of Surgery, Lovisenberg Diaconal Hospital, Pb 4970 Nydalen, 0440, Oslo, Norway. .,Department of Nursing Science, Faculty of Medicine, University of Oslo, Pb 1072 Blindern, 0316, Oslo, Norway.
| | - Arild Aamodt
- Department of Surgery, Lovisenberg Diaconal Hospital, Pb 4970 Nydalen, 0440, Oslo, Norway
| | - Mona Badawy
- Coastal Hospital in Hagevik, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, Norway
| | - Ingvild B Bergvad
- Department of Surgery, Lovisenberg Diaconal Hospital, Pb 4970 Nydalen, 0440, Oslo, Norway.,Institute of Health and Society, Faculty of Medicine, University of Oslo, PB 1072 Blindern, 0316, Oslo, Norway
| | - Petter Borchgrevink
- Department of Pain and Complex Disorders, St Olavs Hospital, Prinsesse Kristinas gate 3, 7030, Trondheim, Norway.,Norwegian University of Science and Technology, Høgskoleringen 1, 1491, Trondheim, Norway
| | - Ove Furnes
- Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway.,Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway
| | - Caryl Gay
- Department of Surgery, Lovisenberg Diaconal Hospital, Pb 4970 Nydalen, 0440, Oslo, Norway.,Department of Family Health Care Nursing, University of California San Francisco, 505 Parnassus Ave, San Francisco, CA, 94122, USA
| | - Stig Heir
- Martina Hansens Hospital, Dønskiveien 8, 1346, Gjettum, Norway
| | - Inger Holm
- Institute of Health and Society, Faculty of Medicine, University of Oslo, PB 1072 Blindern, 0316, Oslo, Norway.,Department of Acute Medicine, Oslo University Hospital, Pb 4956 Nydalen, 0424, Oslo, Norway
| | - Kari Indrekvam
- Coastal Hospital in Hagevik, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Nina Kise
- Martina Hansens Hospital, Dønskiveien 8, 1346, Gjettum, Norway
| | - Bjørn Lau
- Department of Psychology, Faculty of Medicine, University of Oslo, PB 1072 Blindern, 0316, Oslo, Norway
| | - Jon Magnussen
- Norwegian University of Science and Technology, Høgskoleringen 1, 1491, Trondheim, Norway
| | | | - Turid Rognsvåg
- Coastal Hospital in Hagevik, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, Norway
| | - Daniil E Rudsengen
- Department of Surgery, Lovisenberg Diaconal Hospital, Pb 4970 Nydalen, 0440, Oslo, Norway
| | - Tone Rustøen
- Department of Nursing Science, Faculty of Medicine, University of Oslo, Pb 1072 Blindern, 0316, Oslo, Norway.,Department of Acute Medicine, Oslo University Hospital, Pb 4956 Nydalen, 0424, Oslo, Norway
| | - Søren T Skou
- Department of Surgery, Lovisenberg Diaconal Hospital, Pb 4970 Nydalen, 0440, Oslo, Norway.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230, Odense, Denmark.,Department of Physiotherapy and Occupational Therapy, Næstved, Slagelse and Ringsted Hospital, 4200, Slagelse, Denmark
| | - Jan Stubberud
- Department of Surgery, Lovisenberg Diaconal Hospital, Pb 4970 Nydalen, 0440, Oslo, Norway.,Department of Psychology, Faculty of Medicine, University of Oslo, PB 1072 Blindern, 0316, Oslo, Norway
| | - Milada S Småstuen
- Department of Surgery, Lovisenberg Diaconal Hospital, Pb 4970 Nydalen, 0440, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, PB 1072 Blindern, 0316, Oslo, Norway
| | - Anners Lerdal
- Department of Surgery, Lovisenberg Diaconal Hospital, Pb 4970 Nydalen, 0440, Oslo, Norway.,Institute of Health and Society, Faculty of Medicine, University of Oslo, PB 1072 Blindern, 0316, Oslo, Norway
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Ustunel F, Erden S. Evaluation of Fear of Pain Among Surgical Patients in the Preoperative Period. J Perianesth Nurs 2021; 37:188-193. [PMID: 34922831 DOI: 10.1016/j.jopan.2021.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/03/2021] [Accepted: 02/07/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE To evaluate the fear of surgery-related pain of patients in the preoperative period. DESIGN A descriptive, cross-sectional study. METHODS A total of 419 patients who were scheduled for a variety of surgical procedures in a tertiary hospital were included. Data were collected using a Patient Identification Information Form and fear of pain was evaluated using the Fear of Pain Questionnaire-III. FINDINGS 50.8% of the patients were males with a mean age of 49.2 ± 17.3 years. A total of 88.8% patients had a fear of pain after surgery, and 89.3% of them had a moderate to severe fear of pain. 84.5% of female patients, 82.5% of literate patients, and 86.1% of patients who had previously experienced severe pain had a fear of pain of moderate to severe intensity (P < .05). The mean Fear of Pain Questionnaire-III score was 75.1 ± 20.2, and the most commonly identified fears were severe pain (30.64 ± 9.5), and medical pain (24.17 ± 7.7). Patients who had a higher score of fear of severe pain and medical pain were those who had experienced severe pain previously and those who believed that they would experience postoperative pain (P < .05). CONCLUSIONS Almost all patients included in this study had a fear of moderate to severe postoperative pain while in the preoperative period. Nurses should question pain history with each patient, obtain a detailed pain history, and identify the degree of fear of pain in the preoperative period. Fear of pain should be reduced using necessary interventions and pain control should be maintained. Reduced fear of pain in the preoperative period may decrease postoperative pain and yield favorable patient outcomes.
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Affiliation(s)
- Fatmagul Ustunel
- Cukurova University Institute of Health Sciences, Adana, Turkey.
| | - Sevilay Erden
- Cukurova University Institute of Health Sciences, Adana, Turkey
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Baysalhan Öztürk İ, Garip Y, Sivas F, Parlak Özden M, Bodur H. Kinesiophobia in rheumatoid arthritis patients: Relationship with quadriceps muscle strength, fear of falling, functional status, disease activity, and quality of life. Arch Rheumatol 2021; 36:427-434. [PMID: 34870175 PMCID: PMC8612492 DOI: 10.46497/archrheumatol.2021.8535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/16/2021] [Indexed: 12/21/2022] Open
Abstract
Objectives
This study aims to determine the frequency of kinesiophobia in rheumatoid arthritis (RA) patients and to evaluate the relation of kinesiophobia with the knee range of motion (ROM), quadriceps muscle strength, fear of falling, functional status, disease activity, depression, and quality of life. Patients and methods
Between September 2018 and September 2019, a total of 100 RA patients (25 males, 75 females; mean age: 56.1±9.3 years; range, 32 to 69 years) and 50 healthy controls (14 males, 36 females; mean age: 54.6±9.8 years; range, 30 to 69 years) were included. Disease activity was evaluated using the Disease Activity Score 28 (DAS28), and functional status using the Health Assessment Questionnaire (HAQ). Pain severity was measured using the Visual Analog Scale (VAS). Tampa Kinesiophobia Scale (TKS) was used to evaluate kinesiophobia. Quadriceps muscle strength and knee ROM measurements of two extremities were recorded. Depression was evaluated using the Beck Depression Inventory (BDI), fear of falling by Falls Efficacy Scale (FES) and quality of life using the Short Form-36 (SF-36). Results
The rate of kinesiophobia was 70% in RA patients and 12% in controls, indicating a higher rate in RA patients, compared to controls (odds ratio [OR] = 44.861, 95% confidence interval [CI]: 42.571-49.052; p<0.05). This rate was 76% in females and 52% in males. Regression analysis revealed that the number of swollen and tender joints, DAS28, VAS-pain, and HAQ scores were positively associated with the TKS scores (p<0.05). Quadriceps muscle strength and knee flexion were negatively associated with the TKS scores (p<0.05). The TKS was significantly correlated with FES and BDI (p<0.05). The TKS was negatively correlated with SF-36 subscales (p<0.05). Conclusion
Kinesiophobia is common in RA patients. Our study is the first to evaluate the frequency of kinesiophobia in RA patients and to show pain level, disease activity, functional status, knee flexion ROM, and quadriceps muscle strength are effective on kinesiophobia. Kinesiophobia is also associated with fear of falling and depression, negatively affecting the quality of life in terms of physical, emotional, social and mental functions. Therefore, evaluating kinesiophobia and developing targeted treatment approaches seem to be useful in increasing the quality of life in RA.
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Affiliation(s)
- İlkay Baysalhan Öztürk
- Department of Physical Medicine and Rehabilitation, Ankara Bilkent City Hospital Physical Therapy and Rehabilitation Hospital, Ankara, Turkey
| | - Yeşim Garip
- Pediatric Brain Injury Rehabilitation Clinic, Ankara Bilkent City Hospital Physical Therapy and Rehabilitation Hospital, Ankara, Turkey
| | - Filiz Sivas
- Brain Injury Rehabilitation Clinic, Ankara Bilkent City Hospital Physical Therapy and Rehabilitation Hospital, Ankara, Turkey
| | - Merve Parlak Özden
- Kahramankazan District Health Directorate, Public Health, Ankara, Turkey
| | - Hatice Bodur
- Ankara Bilkent City Hospital Physical Therapy and Rehabilitation Hospital, Rheumatology, Orthopedic Rehabilitation and Pain, Ankara, Turkey
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Chandan JS, Thomas T, Raza K, Bradbury-Jones C, Taylor J, Bandyopadhyay S, Nirantharakumar K. Intimate Partner Violence and the Risk of Developing Fibromyalgia and Chronic Fatigue Syndrome. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP12279-NP12298. [PMID: 31805821 DOI: 10.1177/0886260519888515] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Intimate partner violence (IPV) is a global public health issue with a variety of ill health consequences associated with exposure. Due to the stimulation of chronic stress and inflammatory pathways, childhood abuse has been associated with the subsequent development of functional syndromes such as fibromyalgia and chronic fatigue syndrome (CFS). Although IPV in women appears to elicit similar biochemical responses, this association has not been tested thoroughly in IPV survivors. These functional syndromes are complex in etiology and any indication of their risk factors would benefit health care professionals managing this population. Therefore, we aimed to investigate the association between exposure to IPV with functional syndromes: fibromyalgia and CFS. We conducted a retrospective open cohort study using "The Heath Improvement Network" database between January 1, 1995 and December 1, 2017. A total of 18,547 women who were exposed to IPV were each matched by age to four controls who were not exposed (n = 74,188). The main outcome measures were the risk of developing fibromyalgia and CFS. These were presented as adjusted incidence rate ratios (aIRR) with 95% confidence intervals (CIs). We found that 97 women in the exposed group developed fibromyalgia (incidence rate [IR] = 1.63 per 1,000 person-years) compared to 239 women in the unexposed group (IR = 0.83 per 1,000 person-years). Following adjustment, this translated to an IRR of 1.73 (95% CI = [1.36, 2.22]). Similarly, 19 women developed CFS in the exposed group (IR = 0.32 per 1,000 person-years), compared to 53 in the unexposed group (0.18 per 1,000 person-years), which translates to an aIRR of 1.92 (95% CI = [1.11, 3.33]). Therefore, we have identified an association between a history of IPV in women and the development of these functional syndromes, which may provide more information to inform the biopsychosocial pathway precipitating the development of fibromyalgia and CFS.
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Affiliation(s)
| | | | - Karim Raza
- University of Birmingham, UK
- Sandwell and West Birmingham Hospitals NHS Trust, UK
| | | | - Julie Taylor
- University of Birmingham, UK
- Birmingham Women's and Children's NHS Foundation Trust, UK
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Clark CJ, Kalanaviciute G, Bartholomew V, Cheyne H, Hundley VA. Exploring pain characteristics in nulliparous women; A precursor to developing support for women in the latent phase of labour. Midwifery 2021; 104:103174. [PMID: 34753016 DOI: 10.1016/j.midw.2021.103174] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/08/2020] [Accepted: 10/17/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Admission to hospital in the latent phase of labour is associated with a cascade of unnecessary intervention. Women who seek early hospital admission may have heightened fear and anxiety in relation to pain routed in their pre-pregnancy experiences. OBJECTIVE To determine the prevalence of pain catastrophising in a healthy non-pregnant population and explore previous pain experiences and fear of childbirth as characteristics that might predict pain catastrophising. DESIGN Prospective observational study across two higher education institutions in Scotland and England using a semi-structured survey administered through Bristol Online Surveys. Four validated questionnaires were used to identify the prevalence of pain catastrophising and fear of childbirth in nulliparous women of reproductive age. RESULTS The survey was completed by 122 women undertaking an undergraduate degree and aged between 18 and 23 years. A high prevalence of pain catastrophising was found: a cut-off score of 20 and above = 47.5% (58/122 participants), a cut-off score of 30 and above = 21.3% (26/122). Fear of pain (β = 0.14, t = 4.21, p <0 .001) and pain-related anxiety (β = 0.40, t = 11.39, p <0 .001) were significant predictors of pain catastrophisation. However, there was no correlation between fear of childbirth and pain catastrophisation. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE It is reasonable to hypothesise that the pain catastrophising scale may be a good tool to predict those women likely to require additional support in the latent phase of labour; however further work is needed to explore this with a group of pregnant women.
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Affiliation(s)
- Carol J Clark
- Head of Department and Professor In Physiotherapy, Department of Rehabilitation and Sport Sciences, Faculty of Health & Social Sciences, Bournemouth University.
| | - Guste Kalanaviciute
- Psychology Graduate, Faculty of Science and Technology, Bournemouth University
| | - Vanessa Bartholomew
- Clinical Academic Doctoral Student, Department of Midwifery & Health Sciences, Faculty of Health & Social Sciences, Bournemouth University
| | - Helen Cheyne
- RCM (Scotland) Professor of Midwifery Research, NMAHP Research Unit, University of Stirling
| | - Vanora A Hundley
- Professor of Midwifery, Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health & Social Sciences, Bournemouth University
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Noh JH, Byun DY, Han SH, Kim J, Roh JA, Kim MY, Kim SN, Kim ES, Park KS, Lee J, Ha IH. Effectiveness and safety of motion style acupuncture treatment of the pelvic joint for herniated lumbar disc with radiating pain: A prospective, observational pilot study. Explore (NY) 2021; 18:240-249. [PMID: 34674966 DOI: 10.1016/j.explore.2021.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 03/16/2021] [Accepted: 09/23/2021] [Indexed: 11/30/2022]
Abstract
CONTEXT Conservative treatment is effective for treating and managing herniated lumbar disc with radiating leg pain. OBJECTIVES To investigate the effects of motion style acupuncture treatment (MSAT) on the pelvic joint for this condition. DESIGN This prospective observational study was a pilot study for a future randomized, controlled trial (RCT). SETTING [masked for review]. PATIENTS/INTERVENTIONS We enroled 40 patients and allocated them to two groups (both n = 20). Groups 1 and 2 received integrative Korean medicine treatment (KMT) and integrative KMT with MSAT for pelvic joint, respectively. Primary outcome was the Numeric Rating Scale (NRS) score for low back pain. Secondary outcomes were the Oswestry Disability Index (ODI), Visual analogue Scale (VAS), and EuroQol 5-Dimension-5-level (EQ-5D-5 L) scores. Efficacy was assessed by comparing the baseline and Day 4 results. Safety was assessed based on the frequency and severity of all adverse events. RESULTS On Day 14, except for ODI in Group 1, the NRS, VAS, and EQ-5D-5 L scores showed significant improvements in both groups. On Day 90, both groups showed significant improvements in the NRS, ODI, and EQ-5D-5 L scores. There was a significant between-group difference in the NRS score on Day 7. On Day 14, Group 2 had a significantly lower VAS score for radiating leg pain than Group 1. Twelve patients reported adverse events associated with integrative KMT; however, there was no association with pelvic joint MSAT. CONCLUSION Adding MSAT for pelvic joint to conventional integrative KMT may ameliorate radiating leg pain and improve the quality of life.
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Affiliation(s)
- Je-Heon Noh
- Daejeon Jaseng Hospital of Korean Medicine, Republic of Korea
| | - Da-Young Byun
- Daejeon Jaseng Hospital of Korean Medicine, Republic of Korea
| | - Si-Hoon Han
- Daejeon Jaseng Hospital of Korean Medicine, Republic of Korea
| | - Jeongyoon Kim
- Daejeon Jaseng Hospital of Korean Medicine, Republic of Korea
| | - Ji-Ae Roh
- Daejeon Jaseng Hospital of Korean Medicine, Republic of Korea
| | - Min-Young Kim
- Daejeon Jaseng Hospital of Korean Medicine, Republic of Korea
| | - Su-Na Kim
- Daejeon Jaseng Hospital of Korean Medicine, Republic of Korea
| | - Eun-San Kim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 3F JS Tower, 538 Gangnam-daero, Gangnam-gu, Seoul, 06110, Republic of Korea
| | - Kyoung Sun Park
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 3F JS Tower, 538 Gangnam-daero, Gangnam-gu, Seoul, 06110, Republic of Korea; Jaseng Hospital of Korean Medicine, Republic of Korea
| | - Jinho Lee
- Jaseng Hospital of Korean Medicine, Republic of Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 3F JS Tower, 538 Gangnam-daero, Gangnam-gu, Seoul, 06110, Republic of Korea.
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Battison EAJ, Wilson AC, Holley AL. Perceived Injustice Is Associated With Pain-related Function and Mood in Youth With Acute Musculoskeletal Pain. Clin J Pain 2021; 37:575-582. [PMID: 34008507 PMCID: PMC8273116 DOI: 10.1097/ajp.0000000000000947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 04/23/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Perceived injustice (PI), which is one's appraisal of justice or fairness regarding the pain experience, is an emerging area of interest in pediatric pain research. No previous studies have investigated PI in youth with acute pain. To fill this gap, this study examined (1) associations among PI, pain-related function, and psychological function in treatment-seeking youth with acute musculoskeletal (MSK) pain, and (2) the impact of parent-child PI discordance on children's pain and psychosocial function. MATERIALS AND METHODS Participants were youth (aged 11 to 17, 55% male) with acute pain (onset <1 mo) recruited from emergency departments or outpatient clinics and participating parents (102 parent-child dyads). Dyads completed study questionnaires within 1 month of the child's pain onset. RESULTS Youth-reported PI was significantly correlated with poorer physical and psychosocial quality of life, higher pain catastrophizing, higher fear of pain, increased pain-related disability, and greater depression and anxiety. Furthermore, PI was significantly associated with the physical quality of life, psychosocial quality of life, and pain-related disability. Moreover, discordance in youth and parent ratings of PI was associated with children's psychological and pain-related function. Specifically, compared with Concordant dyads, youth in the Discordant dyads (youth high PI/parent low PI) reported significantly poorer physical quality of life, psychosocial quality of life, higher pain-related disability, depression, anxiety, and pain catastrophizing. DISCUSSION These findings reveal that PI in youth with acute MSK pain is associated with quality of life and pain-related disability. Furthermore, results highlight the importance of discordance between youth and parent reports of PI on pain-related functioning.
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Affiliation(s)
- Eleanor A J Battison
- Department of Pediatrics, Division of Psychology, Oregon Health & Science University, Portland, OR
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Khatibi A, Weiland TJ, Dehghani M. Fear of relapse in patients suffering from RRMS influence their quality of life. Mult Scler Relat Disord 2021; 54:103137. [PMID: 34252838 DOI: 10.1016/j.msard.2021.103137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 06/16/2021] [Accepted: 07/01/2021] [Indexed: 11/24/2022]
Abstract
Multiple Sclerosis (MS) is a chronic, potentially debilitating disease that affects millions of patients worldwide. About 85% of patients experience a disease subtype characterised by relapses and remittance (RRMS). While many studies have investigated factors influencing patients'' health-related quality of life (HRQoL) in RRMS, none have taken patients' fear of relapses into account. In this study, we measured the patients' self-reported HRQoL, fear of relapse (FoR), health anxiety (HA), number of relapses, duration of disease, type of medication and perceived level of side effects. Treating neurologists provided an estimate of patients' disease severity. All covariates and demographic (personal and disease-related) characteristics were included in regression modelling of their association with HRQoL. The model showed that HRQoL was most strongly associated with disease severity estimated by neurologists, which was highly correlated with the number of relapses and disease duration. However, upon adjustment for FoR (in the presence of all covariates), this association between disease severity and HRQoL attenuated, and FoR remained the only covariate significantly associated with HRQoL. Notably, our modelling also revealed a significant association between HA and FoR in RRMS patients. This study's findings have important implications for the management of MS in RRMS patients and point to the critical roles of FoR and HA as drivers of HRQoL in RRMS. Given the importance of HRQoL to the patient experience and economically, we argue that a more nuanced understanding is needed of the subjective nature of quality of life and its determinants. Interventions aimed at reducing psychological distress and anxiety should be explored.
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Affiliation(s)
- Ali Khatibi
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK; Centre for Human Brain Health, University of Birmingham, Birmingham, UK.
| | - Tracey J Weiland
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Mohsen Dehghani
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; Department of Psychology, Shahid Beheshti University, Tehran, Iran
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Sieberg CB, Lebel A, Silliman E, Holmes S, Borsook D, Elman I. Left to themselves: Time to target chronic pain in childhood rare diseases. Neurosci Biobehav Rev 2021; 126:276-288. [PMID: 33774086 PMCID: PMC8738995 DOI: 10.1016/j.neubiorev.2021.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 02/02/2021] [Accepted: 03/04/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Chronic pain is prevalent among patients with rare diseases (RDs). However, little is understood about how biopsychosocial mechanisms may be integrated in the unique set of clinical features and therapeutic challenges inherent in their pain conditions. METHODS This review presents examples of major categories of RDs with particular pain conditions. In addition, we provide translational evidence on clinical and scientific rationale for psychosocially- and neurodevelopmentally-informed treatment of pain in RD patients. RESULTS Neurobiological and functional overlap between various RD syndromes and pain states suggests amalgamation and mutual modulation of the respective conditions. Emotional sequelae could be construed as an emotional homologue of physical pain mediated via overlapping brain circuitry. Given their clearly defined genetic and molecular etiologies, RDs may serve as heuristic models for unraveling pathophysiological processes inherent in chronic pain. CONCLUSIONS Systematic evaluation of chronic pain in patients with RD contributes to sophisticated insight into both pain and their psychosocial correlates, which could transform treatment.
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Affiliation(s)
- Christine B Sieberg
- Biobehavioral Pediatric Pain Lab, Department of Psychiatry & Behavioral Sciences, Boston Children's Hospital, Boston, MA, 02115, USA; Center for Pain and the Brain (P.A.I.N Group), Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston, MA 02115, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
| | - Alyssa Lebel
- Center for Pain and the Brain (P.A.I.N Group), Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston, MA 02115, USA; Department of Anesthesiology, Harvard Medical School, Boston, MA, 02115, USA
| | - Erin Silliman
- Biobehavioral Pediatric Pain Lab, Department of Psychiatry & Behavioral Sciences, Boston Children's Hospital, Boston, MA, 02115, USA; Division of Graduate Medical Sciences, Boston University School of Medicine, Boston, MA, 02118, USA
| | - Scott Holmes
- Center for Pain and the Brain (P.A.I.N Group), Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston, MA 02115, USA; Department of Anesthesiology, Harvard Medical School, Boston, MA, 02115, USA
| | - David Borsook
- Center for Pain and the Brain (P.A.I.N Group), Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston, MA 02115, USA; Department of Anesthesiology, Harvard Medical School, Boston, MA, 02115, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, 02114, USA.
| | - Igor Elman
- Center for Pain and the Brain (P.A.I.N Group), Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston, MA 02115, USA; Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, 02139, USA
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