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Paré C, Yamada K, Sullivan MJL. Temporal Relations Between Pain Catastrophizing and Adverse Health and Mental Health Outcomes After Whiplash Injury. Clin J Pain 2024; 40:10-17. [PMID: 37855307 DOI: 10.1097/ajp.0000000000001168] [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: 05/04/2023] [Accepted: 10/11/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVES Pain catastrophizing has been shown to be a prognostic indicator for pain severity and the co-occurrence of mental health conditions such as depression and post-traumatic stress disorder after whiplash injury. However, the pattern of available findings is limited in its implications for the possible "antecedent" or "causal" role of pain catastrophizing. The purpose of the present study was to examine the temporal relations between pain catastrophizing, pain severity, depressive symptoms, and post-traumatic stress symptoms (PTSS) in individuals receiving treatment for whiplash injury. MATERIALS AND METHODS The sample consisted of 388 individuals enrolled in a multidisciplinary program for whiplash injury. Participants completed self-report measures of pain catastrophizing, pain severity, depressive symptoms, and PTSS at the time of admission, mid-treatment (4 week), and treatment completion (7 week). A cross-lagged panel analysis was used to examine the temporal relations between pain catastrophizing, pain severity, depressive symptoms, and PTSS across all 3 timepoints. RESULTS Model fit was acceptable after the inclusion of modification indices. Pain catastrophizing at the time of admission predicted all other variables at 4 weeks. Pain catastrophizing at 4 weeks also predicted all other variables at 7 weeks. In addition, some bidirectional relations were present, particularly for variables assessed at week 4 and week 7. DISCUSSION Findings support the view that pain catastrophizing might play a transdiagnostic role in the onset and maintenance of health and mental health conditions. The findings call for greater emphasis on the development of treatment techniques that target pain catastrophizing in intervention programs for whiplash injury.
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Affiliation(s)
- Catherine Paré
- Department of Psychology, McGill University, Montréal, QC, Canada
| | - Keiko Yamada
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Trouvin AP, Carvès S, Rouquette A, Coste J, Meyer S, Colin F, Deleens R, Medkour T, Collet MP, Perrot S, Laroche F. "FastSchool": A single session of an interprofessional pain management program for chronic pain patients inspired by cognitive behavioral therapy. PATIENT EDUCATION AND COUNSELING 2022; 105:3509-3514. [PMID: 36115735 DOI: 10.1016/j.pec.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 08/23/2022] [Accepted: 09/09/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Multidisciplinary approaches to treating chronic pain have been proven effective. Currently, chronic pain patients face lengthy waitlists in pain medicine departments. To overcome this problem, we developed the "FastSchool" program to educate patients about pain management and treatment. In this study, we evaluated the benefit of a "FastSchool" session on pain and catastrophizing in chronic pain patients. METHODS Included patients had chronic non-cancer pain, no more than 2 visits to a pain medicine department. Patients attended a single 3-hour session, conducted by an interprofessional team. Four topics were addressed: chronic pain mechanisms, pharmacological therapies, physical activity, and the management of analgesics. Patients completed questionnaires at baseline and at 3 months post-session to assess pain interference, pain intensity, and catastrophizing. RESULTS The study population included 88 patients; 71 completed the follow-up questionnaires. Pain interference (p = 0.002), average pain intensity (p = 0.013), and catastrophizing (p < 0.001) decreased 3 months after FastSchool. At M3, 35 % of patients felt their pain had improved based on the Patient Global Impression of Change. CONCLUSION FastSchool, an innovative short-term educational program inspired by cognitive behavioral therapy, showed positive results in reducing pain impact. PRACTICE IMPLICATIONS Implementation of FastSchool in pain medicine departments would reduce waitlist times for non-pharmacological treatment.
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Affiliation(s)
| | | | - Alexandra Rouquette
- Department of Epidemiology and Public Health, Bicêtre Universitary Hospital, Le Kremlin-Bicêtre, France
| | - Joël Coste
- Pain Department, GHU Paris Centre-Cochin, Paris, France; Biostatistics and Epidemiology Unit, GHU Paris Centre-Cochin, Paris, France
| | - Sinja Meyer
- Pain Department, Saint-Antoine Sorbonne University Hospital, APHP, Paris, France
| | - Faustine Colin
- Pain Department, Saint-Antoine Sorbonne University Hospital, APHP, Paris, France
| | | | | | | | - Serge Perrot
- Pain Department, GHU Paris Centre-Cochin, Paris, France
| | - Françoise Laroche
- Pain Department, Saint-Antoine Sorbonne University Hospital, APHP, Paris, France
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The Association Between Sleep Disturbance and Health Outcomes in Chronic Whiplash-Associated Disorders: A Series of Mediation Analyses. Clin J Pain 2022; 38:612-619. [PMID: 36037089 DOI: 10.1097/ajp.0000000000001066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 08/18/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To investigate the association between sleep disturbance and clinical features of chronic whiplash-associated disorders. We also aimed to use a bootstrapped mediation analysis approach to systematically examine both direct and indirect pathways by which sleep disturbance may affect chronic pain and functional status. METHODS One hundred and sixty-five people (63% female) with chronic whiplash-associated disorders and not taking medications for sleep disturbance completed questionnaires evaluating sleep disturbance, pain intensity, pain interference, disability, physical and mental health quality of life, stress, anxiety, depression, pain catastrophizing, and posttraumatic stress severity. RESULTS Greater sleep disturbance was associated with increased duration of symptoms, higher levels of pain and disability, higher levels of emotional distress and pain catastrophizing, and functional impairment (reduced health-related quality of life). Mediation analyses demonstrated that sleep disturbance influenced chronic pain intensity and interference through both direct and indirect associations inclusive of stress, anxiety and pain catastrophizing. Similarly, sleep disturbance was associated with higher levels of disability and poor health-related quality of life, both directly and also through its negative association with pain intensity and interference. DISCUSSION Sleep disturbance in chronic WAD was associated with worse health outcomes and demonstrated both direct and indirect effects on both chronic pain and function.
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Kim HS, Muschong KM, Fishman IL, Schauer JM, Seitz AL, Strickland KJ, Lambert BL, McCarthy DM, Vu MH, Ciolino JD. Embedded emergency department physical therapy versus usual care for acute low back pain: a protocol for the NEED-PT randomised trial. BMJ Open 2022; 12:e061283. [PMID: 35613820 PMCID: PMC9131058 DOI: 10.1136/bmjopen-2022-061283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Low back pain is a common problem and a substantial source of morbidity and disability worldwide. Patients frequently visit the emergency department (ED) for low back pain, but many experience persistent symptoms at 3 months despite frequent receipt of opioids. Although physical therapy interventions have been demonstrated to improve patient functioning in the outpatient setting, no randomised trial has yet to evaluate physical therapy in the ED setting. METHODS AND ANALYSIS This is a single-centre cluster-randomised trial of an embedded ED physical therapy intervention for acute low back pain. We used a covariate-constrained approach to randomise individual physicians (clusters) at an urban academic ED in Chicago, Illinois, USA, to receive, or not receive, an embedded physical therapist on their primary treatment team to evaluate all patients with low back pain. We will then enrol individual ED patients with acute low back pain and allocate them to the embedded physical therapy or usual care study arms, depending on the randomisation assignment of their treating physician. We will follow patients to a primary endpoint of 3 months and compare a primary outcome of change in PROMIS-Pain Interference score and secondary outcomes of change in modified Oswestry Disability Index score and patient-reported opioid use. Our primary approach will be a modified intention-to-treat analysis, whereby all participants who complete at least one follow-up data time point will be included in analyses, regardless of their or their physicians' adherence to their assigned study arm. ETHICS AND DISSEMINATION This trial is funded by the US Agency for Healthcare Research and Quality (R01HS027426) and was approved by the Northwestern University Institutional Review Board. All physician and patient participants will give written informed consent to study participation. Trial results will be submitted for presentation at scientific meetings and for publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER ClinicalTrials.gov (NCT04921449).
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Affiliation(s)
- Howard S Kim
- Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kayla M Muschong
- Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ivy L Fishman
- Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jacob M Schauer
- Division of Biostatistics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Amee L Seitz
- Department of Physical Therapy & Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kyle J Strickland
- Rehabilitation Services Department, Northwestern Memorial Hospital, Chicago, Illinois, USA
| | - Bruce L Lambert
- Department of Communication Studies, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Danielle M McCarthy
- Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - My H Vu
- Division of Biostatistics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jody D Ciolino
- Division of Biostatistics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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5
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Andreani A, Lorusso M, Salomon M, Paci M, Brindisino F. The burden of words in shoulder pain: A case report of a water polo player. J Bodyw Mov Ther 2022; 29:215-222. [DOI: 10.1016/j.jbmt.2021.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 08/09/2021] [Accepted: 10/30/2021] [Indexed: 11/29/2022]
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Smits EJ, Gane EM, Brakenridge CL, Andrews NE, Johnston V. Expert consensus and perspectives on recovery following road traffic crashes: a Delphi study. Disabil Rehabil 2020; 44:3122-3131. [PMID: 33305970 DOI: 10.1080/09638288.2020.1855677] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE To reach expert consensus on a definition for recovery following minor and moderate road traffic crash-related injuries and key factors that influence recovery, and to explore expert perspectives on risk identification methods. MATERIALS AND METHODS A three-round Delphi study was conducted in which 47 experts (insurance representatives, health care professionals and researchers) were consulted. RESULTS Strong expert agreement (86%) was reached for the definition: "Recovery is multifaceted and includes return to activities of daily living (ADLs), work and social/leisure activities at pre-injury level or at a level deemed acceptable by the individual, with minimal ongoing pain and symptoms, considering physical and mental health and wellbeing". Agreed key factors that influenced recovery included: resilience; coping skills; recovery expectations; pre-existing physical and mental health; workplace support; and, collaboration between the injured individual, treating providers and claim handlers. Expert perspectives on risk identification methods were mixed. CONCLUSIONS An accepted definition for recovery following minor and moderate road traffic crash-related injury was established, which could facilitate communication and engagement between different rehabilitation stakeholders. Strong consensus was achieved on nine key factors that influenced recovery. Further research is needed to evaluate whether injured persons agree with this definition and on the utility of risk identification methods.Implications for rehabilitationExpert consensus was established for a definition of recovery following minor and moderate road traffic crash-related injuries and nine key influencing factors.An established definition could facilitate communication and engagement between all rehabilitation stakeholders, which could improve the recovery process of the injured person.Rehabilitation professionals need to be familiar with the role of psychosocial factors, such as recovery expectations, resilience and coping skills, in the recovery process.The use of physical and psychological outcome measures at regular intervals could help to identify risk of poor recovery following minor and moderate road traffic crash-related injuries.
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Affiliation(s)
- Esther J Smits
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia
| | - Elise M Gane
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.,Physiotherapy Department, Princess Alexandra Hospital, Brisbane, Australia.,Centre for Functioning and Health Research, Metro South Health, Brisbane, Australia
| | | | - Nicole E Andrews
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia.,Occupational Therapy Department, The Professor Tess Cramond Multidisciplinary Pain Centre, The Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Venerina Johnston
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia
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Shearer HM, Carroll LJ, Côté P, Randhawa K, Southerst D, Varatharajan S, Wong JJ, Yu H, Sutton D, van der Velde G, Nordin M, Gross DP, Mior S, Stupar M, Jacobs C, Taylor-Vaisey A. The course and factors associated with recovery of whiplash-associated disorders: an updated systematic review by the Ontario protocol for traffic injury management (OPTIMa) collaboration. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2020. [DOI: 10.1080/21679169.2020.1736150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Heather M. Shearer
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College (CMCC), Oshawa, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
| | - Linda J. Carroll
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Pierre Côté
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College (CMCC), Oshawa, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Canada Research Chair in Disability Prevention and Rehabilitation, Ontario Tech University, Oshawa, Canada
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
| | | | - Danielle Southerst
- Occupational and Industrial Orthopaedic Centre, NYU Langone Orthopaedic Hospital, NY, USA
| | - Sharanya Varatharajan
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | - Jessica J. Wong
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College (CMCC), Oshawa, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Hainan Yu
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College (CMCC), Oshawa, Canada
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
- Undergraduate Education, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Deborah Sutton
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College (CMCC), Oshawa, Canada
| | - Gabrielle van der Velde
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, Toronto, Canada
- Institute for Work and Health, Toronto, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - Margareta Nordin
- Departments of Orthopedic Surgery and Environmental Medicine, Occupational and Industrial Orthopedic Center of NYU School of Medicine, New York University, NY, USA
| | - Douglas P. Gross
- Department of Physical Therapy, University of Alberta, Edmonton, Canada
| | - Silvano Mior
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College (CMCC), Oshawa, Canada
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Maja Stupar
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Craig Jacobs
- Division of Clinical Education, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Anne Taylor-Vaisey
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College (CMCC), Oshawa, Canada
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
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Giummarra MJ, Lau G, Grant G, Gabbe BJ. A systematic review of the association between fault or blame-related attributions and procedures after transport injury and health and work-related outcomes. ACCIDENT; ANALYSIS AND PREVENTION 2020; 135:105333. [PMID: 31863937 DOI: 10.1016/j.aap.2019.105333] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 06/07/2019] [Accepted: 10/15/2019] [Indexed: 06/10/2023]
Abstract
Attributions of fault are often associated with worse injury outcomes; however, the consistency and magnitude of these impacts is not known. This review examined the prognostic role of fault on health, mental health, pain and work outcomes after transport injury. A systematic search of five electronic databases (Medline, Embase, CINAHL, PsycINFO, Cochrane Library) yielded 16,324 records published between 2000 and January 2018. Eligibility criteria were: adult transport injury survivors; prospective design; multivariable analysis; fault-related factor analysed; pain, mental health, general health or work-related outcome. Citations (n = 10,558, excluding duplicates) and full text articles (n = 555) were screened manually (Reviewer 1), and using concurrent machine learning and text mining (Reviewer 2; using Abstrackr, WordStat and QDA miner). Data from 55 papers that met all inclusion criteria were extracted, papers were evaluated for risk of bias using the QUIPS tool, and overall level of evidence was assessed using the GRADE tool. There were six main fault-related factors classified as: fault or responsibility, fault-based compensation, lawyer involvement or litigation, blame or guilt, road user or position in vehicle, and impact direction. Overall there were inconsistent associations between fault and transport injury outcomes, and 60% of papers had high risk of bias. There was moderate evidence that fault-based compensation claims were associated with poorer health-related outcomes, and that lawyer involvement was associated with poorer work outcomes beyond 12 months post-injury. However, the evidence of negative associations between fault-based compensation claims and work-related outcomes was limited. Lawyer involvement and fault-based compensation claims were associated with adverse mental health outcomes six months post-injury, but not beyond 12 months. The most consistent associations between fault and negative outcomes were not for fault attributions, per se, but were related to fault-related procedures (e.g., lawyer engagement, fault-based compensation claims).
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Affiliation(s)
- Melita J Giummarra
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, VIC, Australia.
| | - Georgina Lau
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Genevieve Grant
- Australian Centre for Justice Innovation and Faculty of Law, Monash University, Clayton, VIC, Australia
| | - Belinda J Gabbe
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Health Data Research UK, Swansea University Medical School, Swansea University, Wales, UK
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Luque-Suarez A, Falla D, Morales-Asencio JM, Martinez-Calderon J. Is kinesiophobia and pain catastrophising at baseline associated with chronic pain and disability in whiplash-associated disorders? A systematic review. Br J Sports Med 2019; 54:892-897. [PMID: 31217158 DOI: 10.1136/bjsports-2018-099569] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Kinesiophobia and pain catastrophising may be associated with patients' transition from having acute to chronic pain following a whiplash injury. OBJECTIVE To systematically review and critically appraise the literature to determine whether kinesiophobia and pain catastrophising are associated with greater likelihood of patients developing chronic pain and disability following a whiplash injury. DESIGN A systematic review of the literature DATA SOURCES: Electronic searches of PubMed, AMED, CINAHL, PsycINFO, and PubPsych, and grey literature were undertaken from inception to September 2017. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Study selection was based on longitudinal studies evaluating how kinesiophobia and/or pain catastrophising at baseline are associated with pain intensity, disability or both after a whiplash injury. RESULTS We included 14 longitudinal studies that described 12 independent cohorts with a total sample of 2733 participants with whiplash-associated disorder. Kinesiophobia at baseline was not associated with pain intensity over time (three studies). Whether kinesiophobia at baseline was associated with disability was unclear as results were conflicting (six studies). There were also conflicting results when we examined the association between pain catastrophising and both pain intensity (five studies) and disability (eight studies). SUMMARY/CONCLUSIONS Kinesiophobia at baseline was not associated with pain intensity over time. There were conflicting results for the remaining analyses. The size of the associations was small. The overall quality of the evidence was very low. TRIAL REGISTRATION NUMBER CRD42016053864.
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Affiliation(s)
- Alejandro Luque-Suarez
- Faculty of Health Sciences, Department of Physiotherapy, University of Malaga, Malaga, Spain .,Instituto de Investigacion Biomedica de Malaga (IBIMA), Malaga, Spain
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Jose Miguel Morales-Asencio
- Instituto de Investigacion Biomedica de Malaga (IBIMA), Malaga, Spain.,Faculty of Health Sciences, Department of Physiotherapy, University of Malaga, Malaga, Spains
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Garg S, Sachdeva J. Role of Patient Beliefs and Expectations in Pain and Disability. Pain 2019. [DOI: 10.1007/978-3-319-99124-5_93] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Barros MA, Dibai-Filho AV, de Oliveira AK, de Jesus Guirro RR. Reliability of skin impedance in subjects with chronic neck pain. J Back Musculoskelet Rehabil 2018; 31:331-336. [PMID: 28946533 DOI: 10.3233/bmr-169753] [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] [Indexed: 02/04/2023]
Abstract
BACKGROUND Skin impedance is a biological signal that has been employed in the measurement of pain. However, there are few scientific data on skin impedance, with a great variety of assessment methods and controversial results. OBJECTIVE To examine the intra- and inter-rater reliability of skin impedance measurement in individuals with chronic neck pain. METHODS This is a blind cross-sectional study. Thirty individuals of both genders, aged between 18 and 45 years and with chronic neck pain were included in the study. Two examiners assessed skin impedance of the upper and lower limbs and torso at two intervals separated by one week. For statistical analysis, we used the intraclass correlation coefficient (ICC2,3) to determine the intra- and inter-rater reliability of skin impedance, with its respective confidence interval of 95%, standard error of measurement (SEM) and minimum detectable change (MDC). RESULTS The intra-rater reliability was considered substantial to excellent, with ICC values ranging between 0.843 and 0.978, SEM between 0.58 and 15.26 Ω, and MDC between 1.61 and 42.31 Ω. The inter-rater reliability was moderate to excellent, with ICC values ranging between 0.761 and 0.997, SEM ranging between 0.22 and 16.72 Ω, and MDC ranging between 0.63 and 46.35 Ω. CONCLUSION The measurement of skin impedance of the upper and lower limbs and torso in individuals with chronic neck pain has acceptable reliability values when considered at different times and by different examiners.
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12
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Psychological Factors and the Development of Chronic Whiplash–associated Disorder(s). Clin J Pain 2018; 34:755-768. [DOI: 10.1097/ajp.0000000000000597] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Samoborec S, Ruseckaite R, Ayton D, Evans S. Biopsychosocial factors associated with non-recovery after a minor transport-related injury: A systematic review. PLoS One 2018; 13:e0198352. [PMID: 29894490 PMCID: PMC5997362 DOI: 10.1371/journal.pone.0198352] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 05/17/2018] [Indexed: 11/29/2022] Open
Abstract
Background Globally, road transport accidents contribute significantly to mortality and burden of disability. Up to 50 million people suffer a transport-related non-fatal injury each year, which often leads to long-term disability. A substantial number of people with minor injuries struggle to recover and little is known about the factors leading to poor or non-recovery. The aim of this paper is to present a systematic review of biopsychosocial factors related to poor or non-recovery after a minor transport-related injury. Methods and findings Studies were selected through searches of PubMed, Medline, Embase, and Cochrane library. Methodological quality was assessed using a Scottish Intercollegiate Guidelines Network (SIGN) critical appraisal checklist for quantitative cohort studies and Standards for Reporting Qualitative Research (SRQR) checklist for qualitative articles. Data were extracted using the Cochrane data extraction tool based on the biopsychosocial model of health (BPS). In total, there were 37 articles included. However, heterogeneity of the techniques and tools used to assess factors and outcomes across studies meant that pooling of results to determine biopsychosocial factors most predictive of poor or non-recovery was not possible. Hence, a narrative synthesis was conducted and shown multiple factors to be associated with poorer outcomes or non-recovery, most being identified in the biological and psychological domain of the BPS model. Factors that were the most representative across studies and have shown to have the strongest associations with poor or non-recovery were high initial pain intensity, pain duration and severity, pre-accident physical and mental health status and pain catastrophising. Conclusions This review demonstrates the complexity of recovery and a challenge in reporting on predictors of recovery. It is evident that a range of multi-factorial biopsychosocial factors impact recovery. These factors are often inter-connected and multi-faceted and therefore, it was not feasible to select or focus on one single factor. In defining the most predictive factors, further research is required, yet the consensus around which tools to use to measure recovery outcomes is needed and is highly recommended. Regardless of the descriptive nature, the review demonstrated that high levels of post-injury pain are associated with poorer outcomes such as chronic pain and physical and mental disability. Therefore, early targeting of modifiable factors such as pain, pain catastrophizing and arising comorbidities such as PTSD, depression and anxiety may assist in reducing chronic pain and ongoing related disabilities. Systematic review trial registration number Systematic review protocol was registered in International Prospective Register for Systematic Reviews (PROSPERO) on 14 December 2016. Registration number CRD42016052276.
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Affiliation(s)
- Stella Samoborec
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
- * E-mail:
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Darshini Ayton
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Sue Evans
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
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The Impact of Psychosocial and Contextual Factors on Individuals Who Sustain Whiplash-Associated Disorders in Motor Vehicle Collisions. PSYCHOLOGICAL INJURY & LAW 2018. [DOI: 10.1007/s12207-018-9317-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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15
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Ilkevitch A, Lawler T, Rindfleisch JA. Neck Pain. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00068-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Vanhaudenhuyse A, Gillet A, Malaise N, Salamun I, Grosdent S, Maquet D, Nyssen AS, Faymonville ME. Psychological interventions influence patients' attitudes and beliefs about their chronic pain. J Tradit Complement Med 2017; 8:296-302. [PMID: 29736385 PMCID: PMC5934699 DOI: 10.1016/j.jtcme.2016.09.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 08/25/2016] [Accepted: 09/02/2016] [Indexed: 10/27/2022] Open
Abstract
Background Patients' changing attitudes and beliefs about pain are considered as improvements in the treatment of chronic pain. Multidisciplinary approaches to pain allow modifications of coping strategies of patients, from passive to active. Methods We investigate how two therapeutic treatments impact patients' attitudes and beliefs regarding pain, as measured with the Survey of Pain Attitudes (SOPA). We allocated 415 patients with chronic pain either to psychoeducation combined with physiotherapy, self-hypnosis combined with self-care learning, or to control groups. Pain intensity, global impression of change, and beliefs and attitudes regarding pain were assessed before and after treatment. Results Our main results showed a significant effect of psychoeducation/physiotherapy on control, harm, and medical cure SOPA subscales; and a significant effect of self-hypnosis/self-care on control, disability and medical cure subscales. Correlation results showed that pain perception was negatively associated with control, while positively associated with disability, and a belief that hurt signifies harm. Patients' impression of improvement was associated with greater control, lower disability, and lower belief that hurt signifies harm. Conclusions The present study showed that self-hypnosis/self-care and psychoeducation/physiotherapy were associated with patients' evolution of coping strategies from passive to active, allowing them to reduce pain perception and improve their global impression of treatment effectiveness.
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Affiliation(s)
- Audrey Vanhaudenhuyse
- Algology-Palliative Care Department, University Hospital of Liège, University of Liège, Belgium.,GIGA (ULg) B34, Quartier Hôpital, Sart-Tilman, Belgium
| | - Aline Gillet
- Department of Work Psychology, University of Liège, Belgium
| | - Nicole Malaise
- Algology-Palliative Care Department, University Hospital of Liège, University of Liège, Belgium
| | - Irène Salamun
- Algology-Palliative Care Department, University Hospital of Liège, University of Liège, Belgium
| | - Stéphanie Grosdent
- Department of Motricity Sciences, University Hospital of Liège, University of Liège, Belgium
| | - Didier Maquet
- Department of Motricity Sciences, University Hospital of Liège, University of Liège, Belgium
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Laporte S, Wang D, Lecompte J, Blancho S, Sandoz B, Feydy A, Lindberg P, Adrian J, Chiarovano E, de Waele C, Vidal PP. An Attempt of Early Detection of Poor Outcome after Whiplash. Front Neurol 2016; 7:177. [PMID: 27812348 PMCID: PMC5072109 DOI: 10.3389/fneur.2016.00177] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 10/03/2016] [Indexed: 12/17/2022] Open
Abstract
The main concern with whiplash is that a large proportion of whiplash patients experience disabling symptoms or whiplash-associated disorders (WAD) for months if not years following the accident. Therefore, identifying early prognostic factors of WAD development is important as WAD have widespread clinical and economic consequences. In order to tackle that question, our study was specifically aimed at combining several methods of investigation in the same WAD patients at the acute stage and 6 months later. Our longitudinal, open, prospective, multi-center study included 38 whiplash patients, and 13 healthy volunteers matched for age, gender, and socio-economic status with the whiplash group. Whiplash patients were evaluated 15-21 days after road accident, and 6 months later. At each appointment, patients underwent a neuropsychological evaluation, a full clinical neurological examination, neurophysiological and postural tests, oto-neurological tests, cervical spine cord magnetic resonance imaging (MRI) with tractography (DTI). At 6 months, whiplash patients were categorized into two subgroups based on the results of the Diagnostic and Statistical Manual of Mental Disorders as having either favorable or unfavorable progression [an unfavorable classification corresponding to the presence of post-concussion symptom (PCS)] and we searched retrospectively for early prognostic factors of WAD predicting the passage to chronicity. We found that patients displaying high level of catastrophizing at the acute stage and/or post-traumatic stress disorder associated with either abnormalities in head or trunk kinematics, abnormal test of the otolithic function and at the Equitest or a combination of these syndromes, turned to chronicity. This study suggests that low-grade whiplash patients should be submitted as early as possible after the trauma to neuropsychological and motor control tests in a specialized consultation. In addition, they should be evaluated by a neuro-otologist for a detailed examination of vestibular functions, which should include cervical vestibular evoked myogenic potential. Then, if diagnosed at risk of WAD, these patients should be subjected to an intensive preventive rehabilitation program, including vestibular rehabilitation if required.
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Affiliation(s)
- Sebastien Laporte
- LBM/Institut de Biomécanique Humaine Georges Charpak, Arts et Metiers ParisTech , Paris , France
| | - Danping Wang
- Plateforme d'étude de la Sensorimotricité, Université Paris Descartes , Paris , France
| | - Jennyfer Lecompte
- LBM/Institut de Biomécanique Humaine Georges Charpak, Arts et Metiers ParisTech , Paris , France
| | - Sophie Blancho
- Institut pour la Recherche sur la Moelle épinière et l'Encéphale (IRME) , Paris , France
| | - Baptiste Sandoz
- LBM/Institut de Biomécanique Humaine Georges Charpak, Arts et Metiers ParisTech , Paris , France
| | - Antoine Feydy
- FR 3636, Université Paris Descartes, INSERM U894, Paris, France; Service de Radiologie B, APHP, CHU Cochin, Faculté de Médecine, Université Paris Descartes, Paris, France
| | - Pavel Lindberg
- FR 3636, Université Paris Descartes, INSERM U894 , Paris , France
| | | | - Elodie Chiarovano
- COGNition and ACtion Group (COGNAC-G), Université Paris Descartes - CNRS UMR-MD - SSA , Paris , France
| | - Catherine de Waele
- COGNition and ACtion Group (COGNAC-G), Université Paris Descartes - CNRS UMR-MD - SSA , Paris , France
| | - Pierre-Paul Vidal
- COGNition and ACtion Group (COGNAC-G), Université Paris Descartes - CNRS UMR-MD - SSA , Paris , France
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18
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Comparative Effectiveness of Conservative Interventions for Nonspecific Chronic Spinal Pain: Physical, Behavioral/Psychologically Informed, or Combined? A Systematic Review and Meta-Analysis. THE JOURNAL OF PAIN 2016; 17:755-74. [PMID: 26844416 DOI: 10.1016/j.jpain.2016.01.473] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 12/05/2015] [Accepted: 01/14/2016] [Indexed: 12/11/2022]
Abstract
UNLABELLED Nonspecific chronic spinal pain (NSCSP) is highly disabling. Current conservative rehabilitation commonly includes physical and behavioral interventions, or a combination of these approaches. Physical interventions aim to enhance physical capacity by using methods such as exercise, manual therapy, and ergonomics. Behavioral/psychologically informed interventions aim to enhance behaviors, cognitions, or mood by using methods such as relaxation and cognitive behavioral therapy. Combined interventions aim to target physical and also behavioral/psychological factors contributing to patients' pain by using methods such as multidisciplinary pain management programs. Because it remains unclear whether any of these approaches are superior, this review aimed to assess the comparative effectiveness of physical, behavioral/psychologically informed, and combined interventions on pain and disability in patients with NSCSP. Ten electronic databases were searched for randomized controlled trials (RCTs) including participants reporting NSCSP. Studies were required to have an "active" conservative treatment control group for comparison. Studies were not eligible if the interventions were from the same domain (eg, if the study compared 2 physical interventions). Study quality was assessed used the Cochrane Back Review Group risk of bias criteria. The treatment effects of physical, behavioral/psychologically informed, and combined interventions were assessed using meta-analyses. Twenty-four studies were included. No clinically significant differences were found for pain and disability between physical, behavioral/psychologically informed, and combined interventions. The simple categorization of interventions into physical, behavioral/psychologically informed, and combined could be considered a limitation of this review, because these interventions may not be easily differentiated to allow accurate comparisons to be made. Further work should consider investigating whether tailoring rehabilitation to individual patients and their perceived risk of chronicity, as seen in recent RCTs for low back pain, can enhance outcomes in NSCSP. PERSPECTIVE In this systematic review of RCTs in NSCSP, only small differences in pain or disability were observed between physical, behavioral/psychologically informed, and combined interventions.
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19
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20
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Magin MN, Auer C. [Expert evidence in whiplash injury: interdisciplinary orthopaedic and biomechanical approach]. Unfallchirurg 2015; 117:263-73. [PMID: 24504496 DOI: 10.1007/s00113-013-2544-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Considering the controversially discussed issue of whiplash injury a pragmatic approach based on our own experience in the area of forensic expert opinion is presented. Findings of accident analysis and biomechanics are correlated with the individual situation after the accident (initial clinical appearance), the course of the ailment and the indispensable physical examination. The latter leads to determination of the individual vulnerability (not increased/increased) which is important for the evaluation of the physical condition and estimation of the physical stress limit. These limits vary widely between individuals and must be considered carefully when relating dose and effect of accident severity to a possible physical injury. Determination of the accident severity is especially important when there are no objective signs of injury and the existence of a minor whiplash injury (Quebec Task Force degree 1 or 2) is in question.
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Affiliation(s)
- M N Magin
- Spezialpraxis für Orthopädie und Unfallchirurgie, Bahnhofsweg 10, 82008, Unterhaching/München, Deutschland,
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Condello C, Piano V, Dadam D, Pinessi L, Lantéri-Minet M. Pain Beliefs and Perceptions Inventory: A Cross-Sectional Study in Chronic and Episodic Migraine. Headache 2014; 55:136-48. [DOI: 10.1111/head.12503] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Cecilia Condello
- Department of Neuroscience; Headache Center; University of Torino; Turin Italy
| | | | - Daria Dadam
- Statistics; British Trust for Ornithology; Thetford UK
| | - Lorenzo Pinessi
- Department of Neuroscience; Headache Center; University of Torino; Turin Italy
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Walton DM, Carroll LJ, Kasch H, Sterling M, Verhagen AP, Macdermid JC, Gross A, Santaguida PL, Carlesso L. An Overview of Systematic Reviews on Prognostic Factors in Neck Pain: Results from the International Collaboration on Neck Pain (ICON) Project. Open Orthop J 2013; 7:494-505. [PMID: 24115971 PMCID: PMC3793581 DOI: 10.2174/1874325001307010494] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 01/02/2013] [Accepted: 01/02/2013] [Indexed: 01/08/2023] Open
Abstract
Given the challenges of chronic musculoskeletal pain and disability, establishing a clear prognosis in the acute stage has become increasingly recognized as a valuable approach to mitigate chronic problems. Neck pain represents a condition that is common, potentially disabling, and has a high rate of transition to chronic or persistent problems. As a field of research, prognosis in neck pain has stimulated several empirical primary research papers, and a number of systematic reviews. As part of the International Consensus on Neck (ICON) project, we sought to establish the general state of knowledge in the area through a structured, systematic review of systematic reviews (overview). An exhaustive search strategy was created and employed to identify the 13 systematic reviews (SRs) that served as the primary data sources for this overview. A decision algorithm for data synthesis, which incorporated currency of the SR, risk of bias assessment of the SRs using AMSTAR scoring and consistency of findings across SRs, determined the level of confidence in the risk profile of 133 different variables. The results provide high confidence that baseline neck pain intensity and baseline disability have a strong association with outcome, while angular deformities of the neck and parameters of the initiating trauma have no effect on outcome. A vast number of predictors provide low or very low confidence or inconclusive results, suggesting there is still much work to be done in this field. Despite the presence of multiple SR and this overview, there is insufficient evidence to make firm conclusions on many potential prognostic variables. This study demonstrates the challenges in conducting overviews on prognosis where clear synthesis critieria and a lack of specifics of primary data in SR are barriers.
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Affiliation(s)
- David M Walton
- Faculty of Health Sciences, The University of Western Ontario, London Ontario, Canada
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Sansone RA, Watts DA, Wiederman MW. The demographics of pain catastrophizing in a primary care sample. INNOVATIONS IN CLINICAL NEUROSCIENCE 2013; 10:12-14. [PMID: 24307976 PMCID: PMC3849873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Randy A Sansone
- Dr. Sansone is a Professor in the Departments of Psychiatry and Internal Medicine at Wright State University School of Medicine in Dayton, Ohio, and Director of Psychiatry Education at Kettering Medical Center in Kettering, Ohio. Dr. Watts is a resident in the Department of Psychiatry at Wright State University School of Medicine in Dayton, Ohio. Dr. Wiederman is a Professor in Psychology at Columbia College in Columbia, South Carolina
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