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Rashid A, Cordingley L, Carrasco R, Foster HE, Baildam EM, Chieng A, Davidson JE, Wedderburn LR, Ioannou Y, McErlane F, Verstappen SMM, Hyrich KL, Thomson W. Patterns of pain over time among children with juvenile idiopathic arthritis. Arch Dis Child 2018; 103:437-443. [PMID: 29175824 PMCID: PMC5916104 DOI: 10.1136/archdischild-2017-313337] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 09/25/2017] [Accepted: 10/25/2017] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Pain is a very common symptom of juvenile idiopathic arthritis (JIA). Disease activity alone cannot explain symptoms of pain in all children, suggesting other factors may be relevant. The objectives of this study were to describe the different patterns of pain experienced over time in children with JIA and to identify predictors of which children are likely to experience ongoing pain. METHODS This study used longitudinal-data from patients (aged 1-16 years) with new-onset JIA. Baseline and up to 5-year follow-up pain data from the Childhood Arthritis Prospective Study (CAPS) were used. A two-step approach was adopted. First, pain trajectories were modelled using a discrete mixture model. Second, multinomial logistic regression was used to determine the association between variables and trajectories. RESULTS Data from 851 individuals were included (4 years, median follow-up). A three-group trajectory model was identified: consistently low pain (n=453), improved pain (n=254) and consistently high pain (n=144). Children with improved pain or consistently high pain differed on average at baseline from consistently low pain. Older age at onset, poor function/disability and longer disease duration at baseline were associated with consistently high pain compared with consistently low pain. Early increases in pain and poor function/disability were also associated with consistently high pain compared with consistently low pain. CONCLUSIONS This study has identified routinely collected clinical factors, which may indicate those individuals with JIA at risk of poor pain outcomes earlier in disease. Identifying those at highest risk of poor pain outcomes at disease onset may enable targeted pain management strategies to be implemented early in disease thus reducing the risk of poor pain outcomes.
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Affiliation(s)
- Amir Rashid
- Arthritis Research UK Centre for Epidemiology, The University of Manchester, Manchester, UK,NIHR Manchester Musculoskeletal Biomedical Research Unit, Manchester Academic Health Science Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Lis Cordingley
- Arthritis Research UK Centre for Epidemiology, The University of Manchester, Manchester, UK
| | - Roberto Carrasco
- Arthritis Research UK Centre for Epidemiology, The University of Manchester, Manchester, UK
| | - Helen E Foster
- Musculoskeletal Research Group, Institute Cellular Medicine, Newcastle University, Newcastle, UK,Paediatric Rheumatology, Great North Children’s Hospital, Newcastle, UK
| | - Eileen M Baildam
- Paediatric Rheumatology, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK
| | - Alice Chieng
- Paediatric Rheumatology, Royal Manchester Children’s Hospital, Manchester, UK
| | - Joyce E Davidson
- Paediatric Rheumatology, Royal Hospital for Children, Glasgow, UK,Paediatric Rheumatology, Royal Hospital for Sick Children, Edinburgh, UK
| | - Lucy R Wedderburn
- University College London (UCL) GOS Institute of Child Health, Great Ormond Street Hospital For Children NHS Trust, London, UK,ARUK Centre for Adolescent Rheumatology, University College London, London, UK,The NIHR Biomedical Research Centre, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Yiannis Ioannou
- University College London (UCL) GOS Institute of Child Health, Great Ormond Street Hospital For Children NHS Trust, London, UK,ARUK Centre for Adolescent Rheumatology, University College London, London, UK
| | - Flora McErlane
- Paediatric Rheumatology, Great North Children’s Hospital, Newcastle, UK
| | - Suzanne M M Verstappen
- Arthritis Research UK Centre for Epidemiology, The University of Manchester, Manchester, UK,NIHR Manchester Musculoskeletal Biomedical Research Unit, Manchester Academic Health Science Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Kimme L Hyrich
- Arthritis Research UK Centre for Epidemiology, The University of Manchester, Manchester, UK,NIHR Manchester Musculoskeletal Biomedical Research Unit, Manchester Academic Health Science Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Wendy Thomson
- NIHR Manchester Musculoskeletal Biomedical Research Unit, Manchester Academic Health Science Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK,Arthritis Research UK Center for Genetics and Genomics, The University of Manchester, London, UK
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Nunes HEG, Silva DAS. Stages of Behavioral Change for Physical Activity in High School Students. Percept Mot Skills 2016; 123:526-42. [DOI: 10.1177/0031512516667694] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Heloyse E. G. Nunes
- Department of Physical Education, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Diego A. S. Silva
- Department of Physical Education, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
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Ahn AH, Kairalla JA. Mirror, mirror on the wall: what effectiveness research shows us about headache care. Pain 2011; 152:1695-1696. [PMID: 21435787 DOI: 10.1016/j.pain.2011.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Revised: 03/04/2011] [Accepted: 03/04/2011] [Indexed: 11/26/2022]
Affiliation(s)
- Andrew H Ahn
- Department of Neurology and Neuroscience, University of Florida College of Medicine 100 S. Newell Dr., Box 100236, Gainesville, FL 32610, USA Tel.: +1 352 273 9526; fax: +1 352 273 5575 Department of College of Medicine, and Biostatistics, University of Florida Colleges of Medicine and Public Health & Health Professions, Gainesville, Florida, USA
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