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Usuki K, Ueda H, Yamaguchi T, Suzuki T, Hamaguchi T. Action observation intervention using three-dimensional movies improves the usability of hands with distal radius fractures in daily life-A nonrandomized controlled trial in women. PLoS One 2024; 19:e0294301. [PMID: 39423206 PMCID: PMC11488734 DOI: 10.1371/journal.pone.0294301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 06/10/2024] [Indexed: 10/21/2024] Open
Abstract
OBJECTIVE Prolonged immobilization of joints after distal radius fracture (DRF) causes cerebral disuse-dependent plasticity (DDP) and deterioration of upper extremity function. Action observation therapy (AOT) can improve DDP. TRIAL DESIGN This nonrandomized controlled trial (UMIN 000039973) tested the hypothesis that AOT improves hand-use difficulties during activities of daily living in patients with DRF. METHOD Right-handed women with volar locking plate fixation for DRF were divided into AOT and Non-AOT groups for a 12-week intervention. The primary outcome was difficulty in using the fractured hand, assessed with the Japanese version of the Patient-related Wrist Evaluation (PRWE). The secondary outcomes were range of motion (ROM) of the injured side and gap between measured ROM and patient-estimated ROM. The survey was administered immediately post operation and at postoperative weeks 4, 8, and 12. The AOT group used a head-mounted display and three-dimensional video during ROM exercises. The Non-AOT group used active ROM exercises alone. A generalized linear model (GLM) was used to confirm interactions and main effects by group and time period, and multiple comparisons were performed. RESULTS Thirty-five patients were assigned to the AOT group (n = 18, median age, 74 years) or the Non-AOT group (n = 17, median age, 70 years). In the GLM, PRWE Total, PRWE Specific, and PRWE Usual scores revealed interactions between groups and periods. The post-hoc test revealed that the PRWE Specific scores (z = 3.43, p = 0.02) and PRWE Usual scores (z = 7.53, p<0.01) were significantly lower in the AOT group than in the Non-AOT group at 4 weeks postoperatively, whereas PRWE Total scores (z = 3.29, p = 0.04) were lower at 8 weeks postoperatively. CONCLUSIONS These results suggested that AOT can improve hand-use difficulties in right-handed women after DRF surgery. AOT positively affects the motor imagery of patients with DRF and can reverse the patient's perceived difficulty in using the fractured hand during rehabilitation.
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Affiliation(s)
- Kengo Usuki
- Department of Rehabilitation, Graduate School of Health Sciences, Saitama Prefectural University, Saitama, Japan
- Rehabilitation Center, Kitasato University Medical Center, Saitama, Japan
| | - Hiroaki Ueda
- Rehabilitation Center, Kitasato University Medical Center, Saitama, Japan
| | | | - Takako Suzuki
- Department of Rehabilitation, Graduate School of Health Sciences, Saitama Prefectural University, Saitama, Japan
| | - Toyohiro Hamaguchi
- Department of Rehabilitation, Graduate School of Health Sciences, Saitama Prefectural University, Saitama, Japan
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2
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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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3
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Chan BHT, Snowdon DA, Williams CM. Describing characteristics clinicians believe predictive of patient reported outcomes after adult's ankle fracture - A modified Delphi study. Musculoskelet Sci Pract 2022; 62:102632. [PMID: 35933826 DOI: 10.1016/j.msksp.2022.102632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Despite explanatory studies have identified a wide range of modifiable and non-modifiable characteristics, uncertainty persists as to what characteristics are predictive of patient reported outcome following ankle fracture in adults, therefore hindering the selection of candidate variables in prognostic models without compromising the accuracy. OBJECTIVE To establish consensus-based characteristics which clinicians believe are predictive of patient reported outcomes following ankle fracture. DESIGN Three-round online modified Delphi survey. METHODS In Round 1, participants provided responses to open-ended questions, as to what characteristics within the first eight weeks following ankle fracture are predictive of short- (<6 months), medium- (6 months-2 years) and long-term (>2 years) patient reported outcome. Rounds 2 and 3 presented consensus and gathered agreement on statements. RESULTS Twenty participants answered the open-ended questions, including 13 physiotherapists and seven orthopaedic/trauma surgeons. Participants reached consensus for fracture characteristics and agreement for age, recovery of signs and symptoms, fracture management complexity, medical comorbidities, mental health status and patient journey at the short-term timepoint; agreement for age, engagement in recovery process, recovery of signs and symptoms, fracture characteristics, medical comorbidities and socioeconomic status at the medium-term timepoint; agreement for engagement in recovery process, fracture characteristics and medical comorbidities at the long-term timepoint. CONCLUSION Clinicians believed in certain modifiable and non-modifiable characteristics predictive of patient reported outcome following ankle fracture. Our findings may provide insights about characteristics which can be selected in prognostic model development and future explanatory studies, allowing targeting adults at risk of developing long-standing symptoms and disability.
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Affiliation(s)
- Billy H T Chan
- School of Primary and Allied Health Care, Monash University, Frankston, Victoria, 3199, Australia.
| | - David A Snowdon
- Peninsula Clinical School, Central Clinical School, Monash University, Frankston, Victoria, 3199, Australia; Peninsula Health, Academic Unit, Frankston, Victoria, 3199, Australia; National Centre for Healthy Ageing, Melbourne, Australia.
| | - Cylie M Williams
- School of Primary and Allied Health Care, Monash University, Frankston, Victoria, 3199, Australia; Peninsula Health, Academic Unit, Frankston, Victoria, 3199, Australia.
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4
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Rolls C, Van der Windt DA, McCabe C, Babatunde OO, Bradshaw E. Prognostic factors for persistent pain after a distal radius fracture: a systematic review. HAND THERAPY 2022; 27:123-136. [PMID: 37904895 PMCID: PMC10584063 DOI: 10.1177/17589983221124973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 08/03/2022] [Indexed: 11/01/2023]
Abstract
Introduction The aim of this systematic review was to synthesize the evidence regarding prognostic factors for persistent pain, including Complex Regional Pain Syndrome (CRPS), after a distal radius fracture (DRF), a common condition after which persistent pain can develop. Methods Medline, Pubmed, Embase, Psychinfo, CINAHL, BNI, AMED and the Cochrane Register of Clinical Trials were searched from inception to May 2021 for prospective longitudinal prognostic factor studies investigating persistent pain in adults who had sustained a DRF. The Quality in Prognostic Studies (QUIPS) tool and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework were used to assess the strength of evidence. Results A search yielded 440 studies of which 7 studies met full eligibility criteria. From five studies we found low evidence for high baseline pain or an ulnar styloid fracture as prognostic factors for persistent pain, and very low evidence for diabetes or older age. From two studies, investigating an outcome of CRPS, there was low evidence for high baseline pain, slow reaction time, dysynchiria, swelling and catastrophising as prognostic factors, and very low evidence for depression. Sex was found not to be a prognostic factor for CRPS or persistent pain. Conclusions The associations between prognostic factors and persistent pain following a DRF are unclear. The small number of factors investigated in more than one study, along with poor reporting and methodological limitations contributed to an assessment of low to very low strength of evidence. Further prospective studies, investigating psychosocial factors as candidate predictors of multidimensional pain outcomes are recommended.
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Affiliation(s)
- Catherine Rolls
- Therapy Department, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | | | - Candy McCabe
- School for Health and Social Wellbeing, University West of England, Bristol, UK
| | | | - Elizabeth Bradshaw
- Therapy Department, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
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5
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Foster KS, Greenlee TA, Young JL, Janney CF, Rhon DI. How Common is Subsequent Posterior Tibial Tendon Dysfunction or Tarsal Tunnel Syndrome After Ankle Sprain Injury? J Knee Surg 2022; 35:1181-1191. [PMID: 35944572 DOI: 10.1055/s-0042-1751246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Posterior tibial tendon dysfunction (PTTD) and tarsal tunnel syndrome (TTS) are debilitating conditions reported to occur after ankle sprain due to their proximity to the ankle complex. The objective of this study was to investigate the incidence of PTTD and TTS in the 2 years following an ankle sprain and which variables are associated with its onset. In total, 22,966 individuals in the Military Health System diagnosed with ankle sprain between 2010 and 2011 were followed for 2 years. The incidence of PTTD and TTS after ankle sprain was identified. Binary logistic regression was used to identify potential demographic or medical history factors associated with PTTD or TTS. In total, 617 (2.7%) received a PTTD diagnosis and 127 (0.6%) received a TTS diagnosis. Active-duty status (odds ratio [OR] 2.18, 95% confidence interval [CI] 1.70-2.79), increasing age (OR 1.03, 95% CI 1.02-1.04), female sex (OR 1.58, 95% CI 1.28-1.95), and if the sprain location was specified by the diagnosis (versus unspecified location) and did not include a fracture contributed to significantly higher (p < 0.001) risk of developing PTTD. Greater age (OR 1.06, 95% CI 1.03-1.09), female sex (OR 2.73, 95% CI 1.74-4.29), history of metabolic syndrome (OR 1.73, 95% CI 1.03-2.89), and active-duty status (OR 2.28, 95% CI 1.38-3.77) also significantly increased the odds of developing TTS, while sustaining a concurrent ankle fracture with the initial ankle sprain (OR 0.45, 95% CI 0.28-0.70) significantly decreased the odds. PTTD and TTS were not common after ankle sprain. However, they still merit consideration as postinjury sequelae, especially in patients with persistent symptoms. Increasing age, type of sprain, female sex, metabolic syndrome, and active-duty status were all significantly associated with the development of one or both subsequent injuries. This work provides normative data for incidence rates of these subsequent injuries and can help increase awareness of these conditions, leading to improved management of refractory ankle sprain injuries.
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Affiliation(s)
- Kaitlyn S Foster
- Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio, Texas
| | - Tina A Greenlee
- Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio, Texas
| | - Jodi L Young
- Doctor of Science Program in Physical Therapy, Bellin College, Green Bay, Wisconsin
| | - Cory F Janney
- Naval Medical Center San Diego, San Diego, California
| | - Daniel I Rhon
- Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio, Texas.,Department of Rehabilitation Medicine, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
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Lindahl M, Teljigović S, Nielsen NO. Six-months outcome after fracture for working-age persons analyzed using the International Classification of Functioning, Disability, and Health - a prospective cohort observational study. Physiother Theory Pract 2022:1-14. [PMID: 35257632 DOI: 10.1080/09593985.2022.2048932] [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: 10/18/2022]
Abstract
BACKGROUND Fractures following trauma affect physical and mental health for working-age persons, and the International Classification of Functioning, Disability, and Health (ICF) can help therapists understand the fractures' impact on daily lives. PURPOSE To examine self-reported functioning and outcomes six months after upper and lower body fractures and compare limitations using the ICF. METHODS Data were collected from 160 patients with fractures as part of a prospective cohort study. The primary outcome measure was the Short Musculoskeletal Function Assessment questionnaire that covers all domains of the ICF. Moreover, sick leave, sense of coherence, and physical activity were reported. RESULTS Six months after the injury, function had improved significantly, but patients reported problems on all domains in the ICF with few differences between the upper and lower body groups. Leisure activities caused problems for 63 (38.8%) of the patients and bothered 86 (53.8%). Problems performing work bothered 63 (39.4%) with no significant difference between the groups, although a significantly higher proportion in the upper body group had returned to work within two months (p < .001). CONCLUSION Six months after fractures, adults reported problems on all ICF domains, especially on the participation dimension, which therapists should address in the rehabilitation process.
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Affiliation(s)
- Marianne Lindahl
- Center of Nutrition and Rehabilitation, University College Absalon, Roskilde, Denmark
| | - Sanel Teljigović
- Center of Nutrition and Rehabilitation, University College Absalon, Roskilde, Denmark
| | - Nina Odgaard Nielsen
- Center of Nutrition and Rehabilitation, University College Absalon, Roskilde, Denmark
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Mahdavi M, Farzad M, Mehta SP, MacDermid JC, Vahedi M, Hosseini SA, Shafiee E, Farhoud AR. Severity of persistent pain and disability can accurately screen for presence of pain catastrophizing and fear of performing wrist movements in individuals with distal radius fracture. Musculoskelet Sci Pract 2022; 57:102474. [PMID: 34773896 DOI: 10.1016/j.msksp.2021.102474] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 10/22/2021] [Accepted: 10/27/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND The evidence indicating presence of psychological factors concerns in individuals who report persistent residual pain and disability over a longer term after distal radius fractures (DRF) is emerging but requires further inquiry. OBJECTIVES To examine the associations of persistent wrist pain and disability at 6-months after DRF with the presence of psychological factors. METHODS Eighty-five patients with DRF were evaluated for wrist pain and disability with subscales of Patient-rated wrist evaluation (PRWE), 6-months after the fracture. The associations of wrist pain and disability with these psychological factors at 6-months after DRF were examined using multivariable logistic regression models. The ability of PRWE scores at 6-months after DRF to accurately classify individuals with and without these psychological factors was examined using the area under the receiver operating characteristic curve (AUC). RESULTS Higher PRWE-P scores were significantly associated with worse pain catastrophizing, having emotional distress, and fear of performing wrist movements. In addition, higher PRWE-F scores were also highly associated with worse pain catastrophizing, having emotional distress, and fear of performing wrist movements. The PRWE-P or PRWE-F Scores of ≥18/50 showed the best combination of sensitivity and specificity in identifying individuals with pain catastrophizing, emotional distress, and fear of performing wrist movements at 6-months after DRF (AUC values of ≥0.88). CONCLUSION The novel finding of this study is that scores of ≥18/50 PRWE-P or PRWEF can be used to screen for the presence of these psychological factors.
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Affiliation(s)
- Mohammad Mahdavi
- Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Maryam Farzad
- School of Physical Therapy, Department of Health and Rehabilitation Sciences, University of Western Ontario, London, Ontario, Canada; University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Saurabh P Mehta
- School of Physical Therapy, Marshall University, Huntington, WV, USA; Department of Orthopedic Surgery, Joan C Edwards School of Medicine, Marshall University, Huntington, WV, USA.
| | - Joy C MacDermid
- Physical Therapy and Surgery, Western University, London, ON, Canada; Co-director Clinical Research Lab, Hand and Upper Limb Center, St. Joseph's Health Center, London, Ontario, Canada; Professor Rehabilitation Science McMaster University, Hamilton, ON, Canada.
| | - Mohsen Vahedi
- Department of Biostatistics and Epidemiology, University of Social Welfare and Rehabilitation Science, Tehran, Iran.
| | - Seyed Ali Hosseini
- Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Erfan Shafiee
- School of Physical Therapy, Department of Health and Rehabilitation Sciences, University of Western Ontario, London, Ontario, Canada.
| | - Amir Reza Farhoud
- Imam Hospital Complex, Tehran University of Medical Sciences, Joint Reconstruction Research Center, Iran.
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Hevonkorpi TP, Raittio L, Vähä-Tuisku S, Launonen AP, Mattila VM. Long-term subjective results and radiologic prognosis of a distal radius fracture in working-aged patients - a prognostic cohort study of 201 patients. J Int Med Res 2021; 49:3000605211060985. [PMID: 34929107 PMCID: PMC8733368 DOI: 10.1177/03000605211060985] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To investigate long-term outcomes associated with distal radius fracture (DRF) in working-aged patients. The authors hypothesized that the majority of patients experience no permanent loss of function when measured with patient-rated wrist evaluation (PRWE). METHODS This was a retrospective cohort study of patients with a DRF aged between 18 and 65 years. The primary outcome measure was PRWE score at a minimum of 4 years after DRF. Secondary outcome measures were pain catastrophizing scale (PCS) and radiographic measurements. RESULTS Of 201 patients included, 179 were primarily treated non-operatively with a 5-week cast treatment and 22 were primarily operated. The mean follow-up duration was 5 years. The mean PRWE score was 10.9 (95% confidence interval 8.4, 13.4) and median PRWE was 3.5 (interquartile range, 0.0-13.0). There was minor correlation between PCS and PRWE score (correlation coefficient [CC] 0.3), and between PRWE score and dorsal angulation of the fracture measured after closed reduction (CC 0.2) and in one-week follow-up radiographs (CC 0.2). CONCLUSIONS Working-aged patients seem to gain nearly normal wrist function after DRF in longer follow-up. Pain catastrophizing appears to correlate with long-term treatment outcome.
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Affiliation(s)
- Teemu P Hevonkorpi
- Department of Surgery, 236131Central Finland Central Hospital, Central Finland Central Hospital, Jyväskylä, Finland.,Faculty of Medicine and Health Technology, 7840Tampere University, Tampere University, Tampere, Finland
| | - Lauri Raittio
- Faculty of Medicine and Health Technology, 7840Tampere University, Tampere University, Tampere, Finland.,Department of Orthopaedics, and Traumatology, 60670Tampere University Hospital, Tampere, Finland
| | - Susanna Vähä-Tuisku
- Faculty of Medicine and Health Technology, 7840Tampere University, Tampere University, Tampere, Finland
| | - Antti P Launonen
- Department of Orthopaedics, and Traumatology, 60670Tampere University Hospital, Tampere, Finland
| | - Ville M Mattila
- Faculty of Medicine and Health Technology, 7840Tampere University, Tampere University, Tampere, Finland.,Department of Orthopaedics, and Traumatology, 60670Tampere University Hospital, Tampere, Finland
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9
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Bérubé M, Martorella G, Côté C, Gélinas C, Feeley N, Choinière M, Parent S, Streiner DL. The Effect of Psychological Interventions on the Prevention of Chronic Pain in Adults: A Systematic Review and Meta-analysis. Clin J Pain 2021; 37:379-395. [PMID: 33577194 DOI: 10.1097/ajp.0000000000000922] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 01/22/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Up to 50% of patients develop high-impact chronic pain after an acute care experience and many psychological variables have been identified in this process. We conducted a systematic review and meta-analysis of randomized controlled trials to assess the effect of psychological interventions within 3 months after pain onset. METHODS We searched databases for articles published from databases inceptions until July 2019. We used standardized mean differences with 95% confidence intervals to assess treatment effect. RESULTS In all, 18 trials were found eligible; 11 of which were included in the meta-analyses. Trials were mainly performed in back pain patients in the middle to late adulthood. Regarding pain intensity, the effect of psychological interventions compared with standard treatments was nonsignificant at 3, 6, and 12 months. We found a moderate significant effect size in favor of psychological interventions compared with standard treatments with regard to disability at 12 months and a small significant effect with regard to coping with pain at 3 months when compared with information alone. Most of meta-analysis findings were associated with a low level of evidence. DISCUSSION This systematic review and meta-analysis showed no significant effect of psychological interventions on pain intensity. A positive and significant trend related to these interventions was shown on disability and coping with pain, when compared with standard treatment and information, respectively. However, these findings must be interpreted with caution considering the limited sample of trials. More rigorous randomized controlled trials performed in patients with a high-risk psychological profile are required to elucidate the efficacy of psychological interventions in preventing chronic pain.
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Affiliation(s)
- Mélanie Bérubé
- Faculty of Nursing, Laval University
- Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, Research Center of the Quebec University Health Center (Enfant-Jesus Hospital), Quebec City
| | - Géraldine Martorella
- College of Nursing, Florida State University
- Tallahassee Memorial Hospital Center for Research and Evidence-Based Practice, Tallahassee, FL
| | | | - Céline Gélinas
- Ingram School of Nursing, McGill University
- Center for Nursing Research and Lady Davis Institute, Jewish General Hospital
| | - Nancy Feeley
- Ingram School of Nursing, McGill University
- Center for Nursing Research and Lady Davis Institute, Jewish General Hospital
| | - Manon Choinière
- Research Center of the Montreal University Health Center
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Montreal University
| | - Stefan Parent
- Orthopaedic Department, Montreal University Health Center (Ste-Justine Hospital)
- Surgery Department, University of Montreal, Montreal, QC
| | - David L Streiner
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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10
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Bérubé M. Evidence-Based Strategies for the Prevention of Chronic Post-Intensive Care and Acute Care-Related Pain. AACN Adv Crit Care 2020; 30:320-334. [PMID: 31951659 DOI: 10.4037/aacnacc2019285] [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: 11/01/2022]
Abstract
Chronic pain is prevalent in intensive care survivors and in patients who require acute care treatments. Many adverse consequences have been associated with chronic post-intensive care and acute care-related pain. Hence, interest in interventions to prevent these pain disorders has grown. To improve the understanding of the mechanisms of action of these interventions and their potential impacts, this article outlines the pathophysiology involved in the transition from acute to chronic pain, the epidemiology and consequences of chronic post-intensive care and acute care- related pain, and risk factors for the development of chronic pain. Pharmacological, nonpharmacological, and multimodal preventive interventions specific to the targeted populations and their levels of evidence are presented. Nursing implications for preventing chronic pain in patients receiving critical and acute care are also discussed.
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Affiliation(s)
- Melanie Bérubé
- Mélanie Bérubé is a Researcher in the Population Health and Optimal Practices research unit (Trauma, Emergency, and Critical Care Medicine) at the CHU de Québec Université Laval Research Center, Quebec City, QC, Canada, and Assistant Professor in the Faculty of Nursing, Laval University, 1050 Avenue de la Médecine, Quebec City, QC, Canada, G1V 0A6
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11
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Luokkala T, Laitinen MK, Hevonkorpi TP, Raittio L, Mattila VM, Launonen AP. Distal radius fractures in the elderly population. EFORT Open Rev 2020; 5:361-370. [PMID: 32655892 PMCID: PMC7336190 DOI: 10.1302/2058-5241.5.190060] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
We found no clear evidence of the clinical superiority of distal radius fracture surgery among older adults at one year. Surgical treatment, however, may yield a faster recovery to previous level of activity in elderly patients. With operative treatment, hardware-based problems may warrant secondary operations and implant removal, whereas in non-operative treatment, symptomatic loss of alignment and malunion can occur. In elderly patients, non-operative treatment can be considered to be the gold standard.
Cite this article: EFORT Open Rev 2020;5:361-370. DOI: 10.1302/2058-5241.5.190060
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Affiliation(s)
- Toni Luokkala
- Department of Orthopaedics, Central Finland Central Hospital, Jyväskylä, Finland
| | - Minna K Laitinen
- Department of Orthopaedics, Helsinki University Hospital, Helsinki, Finland
| | - Teemu P Hevonkorpi
- Department of Orthopaedics, Central Finland Central Hospital, Jyväskylä, Finland.,Faculty of Medicine and Health Technology, Tampere University Hospital, Tampere, Finland
| | - Lauri Raittio
- Faculty of Medicine and Health Technology, Tampere University Hospital, Tampere, Finland
| | - Ville M Mattila
- Faculty of Medicine and Health Technology, Tampere University Hospital, Tampere, Finland.,Department of Orthopaedics and Traumatology, Tampere University Hospital, Finland
| | - Antti P Launonen
- Department of Orthopaedics and Traumatology, Tampere University Hospital, Finland
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12
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Johansson M, Nielsen CP, Brekke AF, Lindahl M. Return to physical activity six months after fracture – a prospective cohort study. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2020. [DOI: 10.1080/21679169.2020.1713884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Martin Johansson
- Faculty of Physiotherapy, Center of Nutrition and Rehabilitation, University College Absalon, Roskilde, Denmark
| | - Camilla Paludan Nielsen
- Faculty of Physiotherapy, Center of Nutrition and Rehabilitation, University College Absalon, Roskilde, Denmark
| | - Anders Falk Brekke
- Faculty of Physiotherapy, Center of Nutrition and Rehabilitation, University College Absalon, Roskilde, Denmark
| | - Marianne Lindahl
- Faculty of Physiotherapy, Center of Nutrition and Rehabilitation, University College Absalon, Roskilde, Denmark
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Bérubé M, Gélinas C, Feeley N, Martorella G, Côté J, Laflamme GY, Rouleau DM, Choinière M. Feasibility of a Hybrid Web-Based and In-Person Self-management Intervention Aimed at Preventing Acute to Chronic Pain Transition After Major Lower Extremity Trauma (iPACT-E-Trauma): A Pilot Randomized Controlled Trial. PAIN MEDICINE (MALDEN, MASS.) 2019; 20:2018-2032. [PMID: 30840085 PMCID: PMC6784743 DOI: 10.1093/pm/pnz008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Objective 1) To assess the feasibility of research methods to test a self-management intervention aimed at preventing acute to chronic pain transition in patients with major lower extremity trauma (iPACT-E-Trauma) and 2) to evaluate its potential effects at three and six months postinjury. Design A pilot randomized controlled trial (RCT) with two parallel groups. Setting A supraregional level 1 trauma center. Methods Fifty-six adult patients were randomized. Participants received the intervention or an educational pamphlet. Several parameters were evaluated to determine the feasibility of the research methods. The potential efficacy of iPACT-E-Trauma was evaluated with measures of pain intensity and pain interference with activities. Results More than 80% of eligible patients agreed to participate, and an attrition rate of ≤18% was found. Less than 40% of screened patients were eligible, and obtaining baseline data took 48 hours postadmission on average. Mean scores of mild pain intensity and pain interference with daily activities (<4/10) on average were obtained in both groups at three and six months postinjury. Between 20% and 30% of participants reported moderate to high mean scores (≥4/10) on these outcomes at the two follow-up time measures. The experimental group perceived greater considerable improvement in pain (60% in the experimental group vs 46% in the control group) at three months postinjury. Low mean scores of pain catastrophizing (Pain Catastrophizing Scale score < 30) and anxiety and depression (Hospital Anxiety and Depression Scale scores ≤ 10) were obtained through the end of the study. Conclusions Some challenges that need to be addressed in a future RCT include the small proportion of screened patients who were eligible and the selection of appropriate tools to measure the development of chronic pain. Studies will need to be conducted with patients presenting more serious injuries and psychological vulnerability or using a stepped screening approach.
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Affiliation(s)
- M Bérubé
- Faculty of Nursing, Laval University, Quebec City, Quebec, Canada
- Research Center of the CHU de Québec, Quebec City, Quebec, Canada
| | - C Gélinas
- Faculty of Nursing, Laval University, Quebec City, Quebec, Canada
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada
| | - N Feeley
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada
- Centre for Nursing Research and Lady Davis Institute, Jewish General Hospital, Montréal, Quebec, Canada
| | - G Martorella
- College of Nursing, Florida State University, Tallahassee, Florida, USA
| | - J Côté
- Centre de Recherche, Centre Hospitalier de l’Université Montréal (CRCHUM), Montréal, Québec, Canada
| | - G Y Laflamme
- Hôpital du Sacré-Cœur de Montréal, Centre Intégré Universitaire du Nord de l’Île-de-Montréal, Montréal, Québec, Canada
| | - D M Rouleau
- Hôpital du Sacré-Cœur de Montréal, Centre Intégré Universitaire du Nord de l’Île-de-Montréal, Montréal, Québec, Canada
| | - M Choinière
- Centre de Recherche, Centre Hospitalier de l’Université Montréal (CRCHUM), Montréal, Québec, Canada
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Keene DJ, Vadher K, Willett K, Mistry D, Costa ML, Collins GS, Lamb SE. Predicting patient-reported and objectively measured functional outcome 6 months after ankle fracture in people aged 60 years or over in the UK: prognostic model development and internal validation. BMJ Open 2019; 9:e029813. [PMID: 31340972 PMCID: PMC6661636 DOI: 10.1136/bmjopen-2019-029813] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 04/18/2019] [Accepted: 06/26/2019] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To predict functional outcomes 6 months after ankle fracture in people aged ≥60 years using post-treatment and 6-week follow-up data to inform anticipated recovery, and identify people who may benefit from additional monitoring or rehabilitation. DESIGN Prognostic model development and internal validation. SETTING 24 National Health Service hospitals, UK. METHODS Participants were the Ankle Injury Management clinical trial cohort (n=618) (ISRCTN04180738), aged 60-96 years, 459/618 (74%) female, treated surgically or conservatively for unstable ankle fracture. Predictors were injury and sociodemographic variables collected at baseline (acute hospital setting) and 6-week follow-up (clinic). Outcome measures were 6-month postinjury (primary) self-reported ankle function, using the Olerud and Molander Ankle Score (OMAS), and (secondary) Timed Up and Go (TUG) test by blinded assessor. Missing data were managed with single imputation. Multivariable linear regression models were built to predict OMAS or TUG, using baseline variables or baseline and 6-week follow-up variables. Models were internally validated using bootstrapping. RESULTS The OMAS baseline data model included: alcohol per week (units), postinjury EQ-5D-3L visual analogue scale (VAS), sex, preinjury walking distance and walking aid use, smoking status and perceived health status. The baseline/6-week data model included the same baseline variables, minus EQ-5D-3L VAS, plus five 6-week predictors: radiological malalignment, injured ankle dorsiflexion and plantarflexion range of motion, and 6-week OMAS and EQ-5D-3L. The models explained approximately 23% and 26% of the outcome variation, respectively. Similar baseline and baseline/6 week data models to predict TUG explained around 30% and 32% of the outcome variation, respectively. CONCLUSIONS Predictive accuracy of the prognostic models using commonly recorded clinical data to predict self-reported or objectively measured ankle function was relatively low and therefore unlikely to be beneficial for clinical practice and counselling of patients. Other potential predictors (eg, psychological factors such as catastrophising and fear avoidance) should be investigated to improve predictive accuracy. TRIAL REGISTRATION NUMBER ISRCTN04180738; Post-results.
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Affiliation(s)
- David J Keene
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Karan Vadher
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Keith Willett
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Dipesh Mistry
- Warwick Clinical Trial Unit, University of Warwick, Coventry, UK
| | - Matthew L Costa
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Gary S Collins
- Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Sarah E Lamb
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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15
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Goudie S, Dixon D, McMillan G, Ring D, McQueen M. Is Use of a Psychological Workbook Associated With Improved Disabilities of the Arm, Shoulder and Hand Scores in Patients With Distal Radius Fracture? Clin Orthop Relat Res 2018; 476:832-845. [PMID: 29406451 PMCID: PMC6260104 DOI: 10.1007/s11999.0000000000000095] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Symptom intensity and magnitude of limitations correlate with stress, distress, and less effective coping strategies. It is unclear if interventions to target these factors can be used to improve outcomes after distal radius fracture in either the short- or longer term. QUESTIONS/PURPOSES (1) Are there any factors (including the use of a workbook aimed at optimizing psychological response to injury, demographic, radiographic, medical, or psychosocial) associated with improved Disabilities of the Arm, Shoulder and Hand (DASH) and Numerical Rating Scale pain (NRS pain) scores at 6 weeks after management of distal radius fracture? (2) Are any of these factors associated with improved DASH and NRS pain scores at 6 months after management of distal radius fracture? METHODS We conducted a double-blind randomized controlled trial comparing a workbook designed to optimize rehabilitation by improving psychological response to injury using recognized psychological techniques (the LEARN technique and goal setting) versus a workbook containing details of stretching exercises in the otherwise routine management of distal radius fracture. Patients older than 18 years of age with an isolated distal radius fracture were recruited within 3 weeks of injury from a single academic teaching hospital between March and August 2016. During recruitment, 191 patients who met the inclusion criteria were approached; 52 (27%) declined participation and 139 were enrolled. Eight patients (6%) were lost to followup by 6 weeks. The remaining cohort of 129 patients was included in the analysis. DASH scores and NRS pain scores were recorded at 6 weeks and 6 months after injury. Multivariable regression analysis was used to identify factors associated with outcome scores. RESULTS At 6 weeks after distal radius fracture, when compared with an information-only workbook, use of a psychologic workbook was not associated with improved DASH (workbook DASH: 38 [range, 21-48]; control DASH: 35 [range, 21-53]; difference of medians: 3; p = 0.949) nor NRS pain scores (workbook NRS: 3 [range, 1-5]; control NRS: 2 [range, 1-4]; difference of medians: 1; p = 0.128). Improved DASH scores were associated with less radial shortening (β = 0.2, p = 0.009), less dorsal tilt (β = 0.2, p = 0.035), and nonoperative treatment (β = 0.2, p = 0.027). Improved NRS pain scores were associated with nonoperative treatment (β = 0.2, p = 0.021) and no posttraumatic stress disorder (PTSD) (β = 0.2, p = 0.046). At 6 months, use of a psychologic workbook was not associated with improved DASH (workbook DASH: 11 [range, 5-28]; control DASH: 11 [range, 3-20]; difference of medians: 0; p = 0.367) nor NRS pain scores (workbook NRS: 1 [range, 0-2]; control NRS: 1 [range, 0-2]; difference of medians: 0; p = 0.704). Improved DASH score at 6 months was associated with having fewer medical comorbidities (β = 0.3, p < 0.001) and lower enrollment PTSD (β = 0.3, p < 0.011). Lower NRS pain scores at 6 months were associated with having fewer medical comorbidities (β = 0.2, p = 0.045), lower enrollment PTSD (β = 0.3, p = 0.008), and lower enrollment Tampa Scale for Kinesiophobia (β = 0.2, p = 0.042). CONCLUSIONS Our study demonstrates that there is no benefit from the untargeted use of a psychological workbook based on the LEARN approach and goal-setting strategies in patients with distal radius fracture. Future research should investigate if there is a subgroup of patients with a negative psychological response to injury that benefits from psychological intervention and, if so, how best to identify these patients and intervene. LEVEL OF EVIDENCE Level II, therapeutic study.
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Affiliation(s)
- Stuart Goudie
- S. Goudie, M. McQueen, Edinburgh Orthopaedic Trauma Unit, Royal Infirmary of Edinburgh, Edinburgh, UK D. Dixon, G. McMillan, Department of Psychology, University of Strathclyde, Glasgow, UK D. Ring, Dell Medical School, University of Texas at Austin, Austin, TX, USA
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16
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Bérubé M, Choinière M, Laflamme YG, Gélinas C. Acute to chronic pain transition in extremity trauma: A narrative review for future preventive interventions (part 2). Int J Orthop Trauma Nurs 2016; 24:59-67. [PMID: 27527536 DOI: 10.1016/j.ijotn.2016.04.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 03/13/2016] [Accepted: 04/07/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND The first part of this series of 2 articles revealed that chronic pain is an important issue post extremity trauma (ET) involving permanent biological transformations. Interventions aimed at preventing chronic pain in ET patients are therefore required. OBJECTIVE To conduct a comprehensive analysis of literature on risk and protective factors for chronic pain post-ET to guide the development of relevant preventive interventions. METHODS A narrative review of the literature was undertaken. Databases were searched to identify studies on chronic pain prognostic factors in ET patients. RESULTS Demographic, injury-related and psychological factors were shown to either contribute to or limit acute to chronic pain transition. High-intensity acute pain hasconsistently been identified as an important chronic pain risk factor. Other significant documented risk factors include: female gender, older age, less than college education, lower limb injury, symptoms of anxiety and depression and pain catastrophizing. Pain self-efficacy and pain acceptance have been shown to protect individuals against chronic pain. CONCLUSIONS This narrative review highlights factors placing ET patients at higher risk of chronic pain or protecting them against this problem. Determining how these factors could be addressed in preventive interventions is the next step before undertaking their development.
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Affiliation(s)
- Mélanie Bérubé
- Ingram School of Nursing, McGill University, 3506 University Street, Montréal H3A 2A7, Canada; Departments of Nursing, Orthopedics and Trauma, Hôpital du Sacré-Coeur de Montréal, 5400 Boulevard Gouin Ouest, Montréal H4J 1C5, Canada; Research Centre, Hôpital du Sacré-Coeur de Montréal, 5400 Boulevard Gouin Ouest, Montréal H4J 1C5, Canada.
| | - Manon Choinière
- Centre de recherche du Centre of the Centre hospitalier de l'Université de Montréal (CRCHUM), Saint-Antoine Building, 850 Saint-Denis Street, Montréal H2X 0A9, Canada
| | - Yves G Laflamme
- Departments of Nursing, Orthopedics and Trauma, Hôpital du Sacré-Coeur de Montréal, 5400 Boulevard Gouin Ouest, Montréal H4J 1C5, Canada; Research Centre, Hôpital du Sacré-Coeur de Montréal, 5400 Boulevard Gouin Ouest, Montréal H4J 1C5, Canada; Surgery Department, Faculty of Medicine, Université de Montréal, C. P. 6128, Succursale, Centre-ville, Montréal H3C 3J7, Canada
| | - Céline Gélinas
- Ingram School of Nursing, McGill University, 3506 University Street, Montréal H3A 2A7, Canada; Research Centre, Hôpital du Sacré-Coeur de Montréal, 5400 Boulevard Gouin Ouest, Montréal H4J 1C5, Canada; Centre for Nursing Research and Lady Davis Institute, Jewish General Hospital, 3755 Chemin, Côte-Ste-Catherine, Montréal H3T 1E2, Canada
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Alghnam S, Wegener ST, Bhalla K, Colantuoni E, Castillo R. Long-term outcomes of individuals injured in motor vehicle crashes: A population-based study. Injury 2015; 46:1503-8. [PMID: 26100209 DOI: 10.1016/j.injury.2015.06.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 04/21/2015] [Accepted: 06/02/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND Despite decline in U.S. traffic fatalities, non-fatal injuries remain a main cause of reduced self-reported health. The authors used a nationally representative survey to examine the long-term (≥1 year) implications of traffic injuries on self-care, depression, mobility, pain and activity domains of a widely used measure assessing Health-Related Quality of Life (HRQOL). METHODS 30,576 participants from panels (2000-2002) of the Medical Expenditure Panel Survey (MEPS) were followed for about two years. The associations between reporting a traffic injury in the first follow-up year and the five domains of the Euroqol Health index (EQ-5D) were assessed using mixed logistic models with outcome severe/moderate problem in each domain. Models adjustment variables included age, gender, education, income, diabetes, asthma, smoking and insurance status. RESULTS 590 participants reported traffic injuries. In the first follow-up analysis, having an injury was associated with deficits in all domains of the EQ-5D. With the exception of self-care, similar findings were reported in the second follow-up (≥1 year) after injuries with strongest associations between traffic injuries and both mobility and activity (both OR=2.9, P<0.01). CONCLUSIONS Traffic injuries are significantly associated with long-term reduced HRQOL. Injured individuals may benefit from early intervention programs to prevent the development of secondary complications and reduced HRQOL.
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Affiliation(s)
- Suliman Alghnam
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, HH 598 624 N. Broadway, Baltimore, MD 21205, USA; King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, KAIMRC, KSAU-HS, Riyadh, Saudi Arabia.
| | - Stephen T Wegener
- Division of Rehabilitation Psychology, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, USA
| | - Kavi Bhalla
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E8138, Baltimore, MD 21205, USA
| | - Elizabeth Colantuoni
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E3539, Baltimore, MD 21205, USA
| | - Renan Castillo
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, HH 544 624 N. Broadway, Baltimore, MD 21205, USA
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Carstens J, Shaw W, Boersma K, Reme S, Pransky G, Linton S. When the wind goes out of the sail - declining recovery expectations in the first weeks of back pain. Eur J Pain 2013; 18:269-78. [DOI: 10.1002/j.1532-2149.2013.00357.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2013] [Indexed: 11/08/2022]
Affiliation(s)
- J.K.P. Carstens
- Center of Health and Medical Psychology (CHAMP), School of Law, Psychology, and Social Work; Örebro University; Sweden
| | - W.S. Shaw
- Liberty Mutual Research institute for Safety; Hopkinton USA
- University of Massachusetts Medical School; Worcester USA
| | - K. Boersma
- Center of Health and Medical Psychology (CHAMP), School of Law, Psychology, and Social Work; Örebro University; Sweden
| | - S.E. Reme
- Uni Health, Uni Research; Bergen Norway
- Harvard School of Public Health; Boston USA
| | - G. Pransky
- Liberty Mutual Research institute for Safety; Hopkinton USA
- University of Massachusetts Medical School; Worcester USA
| | - S.J. Linton
- Center of Health and Medical Psychology (CHAMP), School of Law, Psychology, and Social Work; Örebro University; Sweden
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Abstract
Stretching exercises are an important part of recovery after sustaining a fracture of the distal radius. However, from the patient's perspective, painful stretching exercises can be counterintuitive after injury. Stretching exercises are straightforward and do not require a significant amount of coaching. It is ultimately the protectiveness, passivity, and sometimes a sense of futility that require coaching. The key for the provider is to empathize with the difficult and counterintuitive nature of the recovery process.
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Affiliation(s)
- Arjan G J Bot
- Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
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20
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Lindal E, Breivik H. Fear and catastrophizing thoughts aggravate risks of chronic pain after a fracture. Scand J Pain 2010; 1:7. [PMID: 29913920 DOI: 10.1016/j.sjpain.2009.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Eirikur Lindal
- HVERT-Occupational Rehabilitation, Thonglabakki 1, 109 Reykjavik, Iceland
| | - Harald Breivik
- University of Oslo and Rikshospitalet, 0027 Oslo, Norway
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