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Tavares LF, Gadotti IC, Melo RA, Moura ABG, Ferreira LM, Figueiredo-Ribeiro KMOB. Quality of life and level of physical activity of individuals with temporomandibular disorders with and without otological symptoms: Secondary analysis of a cross-sectional study. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2024; 29:e2104. [PMID: 38861658 DOI: 10.1002/pri.2104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 03/15/2024] [Accepted: 05/28/2024] [Indexed: 06/13/2024]
Abstract
BACKGROUND AND PURPOSE Otological symptoms (OS) are highly prevalent in individuals with temporomandibular disorders (TMD). Individuals with TMD and OS have more neck disability and decreased deep neck muscles endurance when compared to individuals without OS. However, no studies have evaluated whether OS is associated with lower Quality of Life (QoL) and worse levels of physical activity. This study aimed to evaluate the QoL and level of physical activity of individuals with TMD with and without OS. METHODS In this cross-sectional study, 62 individuals with TMD were allocated into 2 groups: TMD with OS (n = 36) or TMD without OS (n = 26). Self-reported complaints of dizziness, vertigo, tinnitus, earache, ear fullness, or hypoacusis were considered as OS. QoL was assessed with the WHOQOL-Bref and physical activity with the IPAQ-SF. Independent t-test and chi-squared test were used for analysis between-groups. Effect sizes were reported using Cohen's d. A Pearson correlation was used to compare the number of OS and QoL scores. A significance level of p < 0.05% and 95% confidence intervals were considered statistically significant. RESULTS The total generic scores for QoL were not different between-groups (p = 0.076), but individuals with TMD with OS had lower satisfaction (p = 0.015; d: 0.63) and physical domain (p = 0.015; d: 0.64) scores with a moderate effect size. In TMD with OS, 69.4% of individuals were irregularly active and 50% for the TMD without OS, with no statistical significance (p > 0.05). The number of OSs was inversely and weakly associated with the QoL total score. CONCLUSION Individuals with TMD and OS are associated with worsened QoL (physical domain and satisfaction) when compared to individuals with TMD without OS. The higher the number of OS, the worse the QoL score. Individuals with TMD with and without OS had similar levels of physical activity, but a high prevalence of irregularly active and sedentary individuals within TMD diagnosed population was found.
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Affiliation(s)
- Luiz Felipe Tavares
- Department of Physical Therapy, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Inae Caroline Gadotti
- Department of Physical Therapy, Florida International University, Miami, Florida, USA
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Mingels S, Granitzer M, Schmid A, Graven-Nielsen T, Dankaerts W. Cross-sectional experimental assessment of pain modulation as part of multidimensional profiling of people with cervicogenic headache: protocol for a feasibility study. BMJ Open 2024; 14:e074743. [PMID: 38890144 PMCID: PMC11191774 DOI: 10.1136/bmjopen-2023-074743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/05/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND An endogenous pain modulation profile, reflecting antinociceptive and pronociceptive mechanisms, may help to direct management by targeting the involved pain mechanism. For individuals with cervicogenic headache (CeH), the characteristics of such profiles were never investigated. However, the individual nature of experiencing pain demands profiling within a multidimensional framework including psychosocial lifestyle characteristics. The objective of the current protocol is to assess the pain modulation profile, which includes psychosocial lifestyle characteristics among people with CeH. METHODS AND ANALYSIS A protocol is described to map pain modulation profiles in people with CeH. A cross-sectional non-randomised experimental design will be used to assess feasibility of mapping these profiles. The pain modulation profile is composed based on results on the Depression, Anxiety, Stress Scale, Pittsburgh Sleep Quality Index, Headache Impact Test and on responses to temporal summation of pain (pinprick), conditioned pain modulation and widespread hyperalgesia (mechanical pressure pain threshold and cuff algometry). Primary analyses will report results relating to outcomes on feasibility. Secondary analyses will involve an analysis of proportions (%) of the different psychosocial lifestyle profiles and pain profiles. ETHICS AND DISSEMINATION Ethical approval was granted by the Ethics Committee Research UZ/KU Leuven (Registration number B3222024001434) on 30 May 2024. Results will be published in peer-reviewed journals, at scientific conferences and, through press releases. Protocol V.3. protocol date: 3 June 2024.
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Affiliation(s)
- Sarah Mingels
- Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Leuven University, Leuven, Belgium
- REVAL Rehabilitation Research Centre, Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Marita Granitzer
- REVAL Rehabilitation Research Centre, Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Annina Schmid
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Thomas Graven-Nielsen
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Wim Dankaerts
- Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Leuven University, Leuven, Belgium
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Bijker L, Scholten-Peeters GGM, Donker MH, Coppieters MW, Cuijpers P, Busink V, Poolman EY, de Wit LM. 'Leaving my comfort zone'. A qualitative study of physiotherapists' experiences blending an eHealth psychosocial intervention with face-to-face physiotherapy. Musculoskelet Sci Pract 2024; 73:103121. [PMID: 38936263 DOI: 10.1016/j.msksp.2024.103121] [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: 03/22/2024] [Revised: 05/21/2024] [Accepted: 06/10/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Many physiotherapists do not feel adequately equipped to address psychosocial risk factors in people with complex pain states. Hence, a biopsychosocial blended intervention (Back2Action) was developed to assist physiotherapists to manage people with persistent spinal pain and coexisting psychosocial risk factors associated with the development or maintenance of persistent pain. OBJECTIVE This study aimed to gain insight into the experiences of physiotherapists with this blended psychosocial intervention. DESIGN and methods: This was an interpretative qualitative study with a reflexive thematic analysis of semi-structured interviews with physiotherapists (N = 15) who delivered Back2Action. The interview started with the grand-tour question: "What was your experience in using Back2Action?" Physiotherapist were encouraged to provide examples, and follow-up questions were posed to ensure a deeper understanding could be reached. RESULTS Four themes were constructed: Physiotherapists became increasingly aware of (1) their own implicit expectations, biases and skills, and underlying treatment paradigms, and (2) the implicit expectations from their patients towards them. This led to (3) creating a deeper and stronger therapeutic alliance with the patient, but also (4) an understanding that implementation of a true biopsychosocial intervention - even if offered in a blended form - requires more practice, confidence and resources. CONCLUSIONS Back2Action is considered a valuable treatment to deliver a biopsychosocial intervention in primary care. Considering the high level of knowledge, skills and competency of the participating physiotherapists, the perceived barriers may be more difficult to overcome for more junior physiotherapists.
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Affiliation(s)
- L Bijker
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences - Program Musculoskeletal Health, the Netherlands; Amsterdam Public Health Research Institute, Department of Clinical Psychology, Vrije Universiteit Amsterdam, the Netherlands.
| | - G G M Scholten-Peeters
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences - Program Musculoskeletal Health, the Netherlands.
| | - M H Donker
- Department of Health Sciences, Vrije Universiteit Amsterdam, the Netherlands.
| | - M W Coppieters
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences - Program Musculoskeletal Health, the Netherlands; School of Health Sciences and Social Work, and Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Australia.
| | - P Cuijpers
- Amsterdam Public Health Research Institute, Department of Clinical Psychology, Vrije Universiteit Amsterdam, the Netherlands.
| | - V Busink
- Amsterdam Public Health Research Institute, Department of Clinical Psychology, Vrije Universiteit Amsterdam, the Netherlands
| | - E Y Poolman
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences - Program Musculoskeletal Health, the Netherlands; Amsterdam Public Health Research Institute, Department of Clinical Psychology, Vrije Universiteit Amsterdam, the Netherlands.
| | - L M de Wit
- Amsterdam Public Health Research Institute, Department of Clinical Psychology, Vrije Universiteit Amsterdam, the Netherlands.
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Sidiq M, Muzaffar T, Janakiraman B, Masoodi S, Vasanthi RK, Ramachandran A, Bansal N, Chahal A, Kashoo FZ, Rizvi MR, Sharma A, Rai RH, Verma R, Sharma M, Alam S, Vajrala KR, Sharma J, Muthukrishnan R. Effects of pain education on disability, pain, quality of life, and self-efficacy in chronic low back pain: A randomized controlled trial. PLoS One 2024; 19:e0294302. [PMID: 38805446 PMCID: PMC11132453 DOI: 10.1371/journal.pone.0294302] [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: 12/12/2023] [Accepted: 04/10/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Low back pain stands as a prevalent contributor to pain-related disability on a global scale. In addressing chronic low back pain (CLBP), there is a growing emphasis on incorporating psychological strategies into the management process. Among these, pain education interventions strive to reshape pain beliefs and mitigate the perceived threat of pain. This randomized controlled trial sought to assess the effects of pain education on various aspects, including pain levels, disability, quality of life, self-efficacy, and prognostic characteristics in individuals grappling with CLBP. METHODS The clinical trial, retrospectively registered with the Clinical Trials Registry of India (CTRI/2021/08/035963), employed a two-arm parallel randomized design. Ninety-two participants with CLBP were randomly assigned to either the standard physiotherapy care with a pain education program or the control group. Both groups underwent a 6-week intervention. Assessment of pain intensity (using NPRS), disability (using RMDQ), self-efficacy (using the general self-efficacy scale), and well-being (using WHO 5I) occurred both before and after the 6-week study intervention. FINDINGS Post-intervention score comparisons between the groups revealed that the pain education intervention led to a significant reduction in disability compared to the usual standard care at 6 weeks (mean difference 8.2, p < 0.001, effect size Cohen d = 0.75), a decrease in pain intensity (mean difference 3.5, p < 0.001, effect size Cohen d = 0.82), and an improvement in the well-being index (mean difference 13.7, p < 0.001, effect size Cohen d = 0.58). CONCLUSION The findings suggest that integrating a pain education program enhances the therapeutic benefits of standard physiotherapy care for individuals dealing with chronic LBP. In conclusion, the clinical benefits of pain education become apparent when delivered in conjunction with standard care physiotherapy during the management of chronic low back pain.
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Affiliation(s)
- Mohammad Sidiq
- Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Tufail Muzaffar
- Departmet of Physical Medicine & Rehabilitation, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, India
| | - Balamurugan Janakiraman
- SRM College of Physiotherapy, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology (SRMIST), Kattankulathur, Chennai, Tamil Nadu, India
- Madhav College of Physiotherapy, Faculty of Allied Health Sciences, Madhav University, Rajasthan, India
| | - Shariq Masoodi
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, India
| | | | - Arunachalam Ramachandran
- Madhav College of Physiotherapy, Faculty of Allied Health Sciences, Madhav University, Rajasthan, India
| | - Nitesh Bansal
- Jindal School of Public Health & Human Development, O P Jindal Global University, Sonipat, Haryana, India
| | - Aksh Chahal
- Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Faizan Zaffar Kashoo
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia
| | - Moattar Raza Rizvi
- Department of Physiotherapy, Faculty of Allied Health Sciences, Manav Rachna International Institute of Research Studies, Faridabad, Haryana, India
| | - Ankita Sharma
- Department of Physiotherapy, Faculty of Allied Health Sciences, Manav Rachna International Institute of Research Studies, Faridabad, Haryana, India
| | - Richa Hirendra Rai
- School of Physiotherapy, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Rituraj Verma
- Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Monika Sharma
- Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Sajjad Alam
- Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Krishna Reddy Vajrala
- Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Jyoti Sharma
- Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
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Mingels S, Granitzer M, Luedtke K, Dankaerts W. Therapeutic Patient Education as Part of the Physiotherapy Management of Adults with Headache: A Scoping Review. Curr Pain Headache Rep 2024:10.1007/s11916-024-01253-3. [PMID: 38613735 DOI: 10.1007/s11916-024-01253-3] [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] [Accepted: 03/30/2024] [Indexed: 04/15/2024]
Abstract
PURPOSE OF REVIEW Physiotherapy interventions for headache mostly include exercise and manual therapy. Yet, the complex nature of headache, sometimes characterized by symptoms of facilitated central pain mechanisms, demands an individualized approach in which therapeutic patient education could be supportive. This scoping review aimed to summarize the position of therapeutic patient education within the physiotherapy management of adults with headache. PubMed, EMBASE, Web of Science, and Scopus were searched. The search-query comprised terminology relating to "headache", "education", and "physiotherapy". Eligibility criteria were: adults with headache, interventions including education within the domain of physiotherapy, reviews, clinical trials, cohort, case report, case-control studies. RECENT FINDINGS Eleven publications were included from the 281 retrieved publications. These publications were clinical trials (n = 4), reviews (n = 4), case-reports (n = 2), and a guideline (n = 1). Type of headaches studied were migraine (n = 3), post-traumatic headache (n = 2), tension-type headache (n = 2), cervicogenic headache (n = 1), primary headaches (n = 1), chronic daily headache (n = 1), and mixed migraine-cervicogenic headache (n = 1). Education seems an umbrella-term for postural education, lifestyle advice, and pain education. Three themes emerged across the publications: handling headache triggers (migraine, post-traumatic headache), promoting active lifestyle (post-traumatic headache, chronic daily headache, migraine), evaluating posture (post-traumatic headache, chronic daily headache, tension-type headache, cervicogenic headache). All publications recommended education in the management of headache. Only one (of the 11 included) publication described the educational program and determined its efficacy. Based on this scoping review, therapeutic patient education seems supported within physiotherapy management of headache. However, it is unclear how such education is tailored to the specific needs of the individual, the headache subtype, or when it should be added to physiotherapy management of headache.
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Affiliation(s)
- Sarah Mingels
- Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, Leuven University, Tervuursevest, 101, 3001, Leuven, Belgium.
- Faculty of Rehabilitation Sciences and Physiotherapy, REVAL Rehabilitation Research Centre, Hasselt University, Hasselt, Belgium.
| | - Marita Granitzer
- Faculty of Rehabilitation Sciences and Physiotherapy, REVAL Rehabilitation Research Centre, Hasselt University, Hasselt, Belgium
| | - Kerstin Luedtke
- Department of Physiotherapy, Pain and Exercise Research, Universität Zu Lübeck, Lübeck, Germany
| | - Wim Dankaerts
- Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, Leuven University, Tervuursevest, 101, 3001, Leuven, Belgium
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Esposto M, Pellicciari L, Cecchetto S, Chiarotto A, Testa M, Turolla A, Polli A. Italian versions of the Neurophysiology of Pain Questionnaire (NPQ): psychometric properties and an investigation on the understanding of pain neurophysiology in physical therapists. Musculoskelet Sci Pract 2024; 72:102957. [PMID: 38642475 DOI: 10.1016/j.msksp.2024.102957] [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: 10/15/2023] [Revised: 02/29/2024] [Accepted: 04/09/2024] [Indexed: 04/22/2024]
Abstract
OBJECTIVES The Neurophysiology of Pain Questionnaire (NPQ) is widely used to assess pain knowledge among clinicians and patients with pain, but an Italian version is not available. This study aimed to translate and cross-culturally adapt the NPQ into Italian, to test its psychometric properties, to assess the knowledge of Italian physical therapists (PTs) on pain, and to evaluate which characteristics are associated with pain knowledge. METHODS The NPQ was translated into Italian, integrated with some additional questions (IT-NPQ-New), and sent by email via the Italian Association of Physiotherapy newsletter. Rasch analysis (RA) was used to test the psychometric properties of the Italian versions. Multivariable regression analyses were used to check for associations between participants' characteristics and their NPQ scores. RESULTS A sample of 753 PTs completed the survey. RA of the NPQ-19 and IT-NPQ-New revealed that 10 (IT-NPQ-10) and 18 (IT-NPQ-18) items fit the model. Both questionnaires showed good psychometric properties. The overall median score among Italian PTs was 6.0 [5.0-7.0] and 11.0 [9.0-13.0] points for the IT-NPQ-10 and the IT-NPQ-18, respectively. These scores were statistically different among groups according to gender, age, years of professional activity, post-graduate specialization and days attended of targeted pain courses, with the latter being the most influential variable. CONCLUSIONS Italian PTs now dispose of two tools to assess their basic knowledge related to pain science. Our study also showed that pain knowledge among Italian PTs needs improvement, especially considering recent biopsychosocial approaches to pain.
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Affiliation(s)
- Massimo Esposto
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, C/o Cardarelli Hospital, C/da Tappino, 86100, Campobasso, Italy
| | | | - Simone Cecchetto
- Health Professional and Rehabilitation Service APSS Trento, Trento, Italy
| | - Alessandro Chiarotto
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Marco Testa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Andrea Turolla
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy; Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Andrea Polli
- Pain in Motion Research Group, Department of Physiotherapy, Human Physiology, and Anatomy, Vrije Universiteit Brussel (VUB), Centre for Environment & Health, Department of Public Health and Primary Care, Katholieke Universiteit Leuven (KUL), Research Foundation - Flanders (FWO), Belgium
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Lendraitienė E, Styraitė B, Šakalienė R, Misytė G, Bileviciute-Ljungar I. Effects of Pain Neuroscience Education and Physiotherapy on Chronic Low Back Pain, Fear of Movement and Functional Status: A Randomised Pilot Study. J Clin Med 2024; 13:2081. [PMID: 38610845 PMCID: PMC11012892 DOI: 10.3390/jcm13072081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/04/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Chronic non-specific low back pain is a non-harmous condition often found in the general population. It is one of the most significant disabilities and needs different treatment modalities. This study investigates the effects of pain neuroscience education and physiotherapy on pain intensity, fear of movement and functional status in a Lithuanian cohort with non-specific low back pain. Methods: The study was performed at the primary health care unit in Kaunas, Lithuania. The key inclusion criterion was persistent non-specific low back pain longer than three months and which affects daily life functions. Thirty participants (mean 33.47, SD 4.38 years age, 70% women) were randomised into two training groups with and without pain neuroscience education (for a total of 60 min of teaching). Physiotherapy was performed twice per week during 45 min/session for a period of 10 weeks with exercises which strengthen, stabilize, and stretch the spinal cord muscles. Outcomes included pain intensity, kinesiophobia and disability and these were measured by self-scored questionnaires (numeric rating scale, Tampa scale for kinesiophobia-11, Oswestry disability index and the Roland-Morris questionnaire, respectively). Results: The results indicate that both groups improved in the measured outcomes, with the only difference between them being a better improvement in kinesiophobia in the group receiving physiotherapy and pain neuroscience education. Conclusions: The results of this study confirm that a relatively short intervention of pain neuroscience education enhances the effects of physiotherapy and should be implemented in clinical practice.
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Affiliation(s)
- Eglė Lendraitienė
- Department of Rehabilitation, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (E.L.); (B.S.); (G.M.)
| | - Barbora Styraitė
- Department of Rehabilitation, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (E.L.); (B.S.); (G.M.)
| | - Rasa Šakalienė
- Department of Rehabilitation, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (E.L.); (B.S.); (G.M.)
| | - Gabija Misytė
- Department of Rehabilitation, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (E.L.); (B.S.); (G.M.)
| | - Indre Bileviciute-Ljungar
- Department of Clinical Sciences, Karolinska Institutet at Danderyd University Hospital, 18288 Stockholm, Sweden
- Multidisciplinary Pain Clinic, Capio St. Göran Hospital, 11219 Stockholm, Sweden
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Faria BSFD, Carvalho C, Triches MI, Vieira LMSMDA, Sato TDO. Mobile health technologies for workers' health and wellbeing: A systematic search of mHealth applications in Brazil. J Bodyw Mov Ther 2024; 38:54-59. [PMID: 38763605 DOI: 10.1016/j.jbmt.2024.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 01/13/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND Inadequate working conditions and sedentary work can exert a negative impact on workers' health and wellbeing, leading to musculoskeletal disorders and disability. Mobile health (mHealth) applications (apps) have high potential for the self-management of workers' health. OBJECTIVE To identify mHealth apps aimed at promoting workers' health and wellbeing available in Brazilian online stores and assess these apps in terms of engagement, functionality, aesthetics and information quality. METHODS A systematic search for apps was conducted in the Brazilian online App Store and Play Store in December 2022. Only smartphone apps in Brazilian Portuguese directed at workers' health were assessed. The appraisal of the quality of the applications was performed using the Mobile App Rating Scale (MARS). RESULTS Among the 3449 mHealth apps found, ten were eligible for inclusion. The mean overall score was 3.15 ± 0.91 on a scale of 1-5. The lowest score was found for the "credibility" item. Exercises and breaks were the most frequent strategies. Most apps provided low-quality information from questionable sources and therefore received a mean score of 2.1 ± 1.5 on the MARS information subscale. CONCLUSION Ten relevant mHealth apps were eligible for inclusion. The mHealth apps for the promotion of workers' health and wellbeing currently available in Brazil exhibited moderate quality and limited functionality.
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Affiliation(s)
| | - Cristiano Carvalho
- Biosciences Department, Universidade Federal de São Paulo, Baixada Santista Campus, Santos, Brazil
| | - Maria Isabel Triches
- Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, Brazil
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Munneke W, Demoulin C, Nijs J, Morin C, Kool E, Berquin A, Meeus M, De Kooning M. Development of an interdisciplinary training program about chronic pain management with a cognitive behavioural approach for healthcare professionals: part of a hybrid effectiveness-implementation study. BMC MEDICAL EDUCATION 2024; 24:331. [PMID: 38519899 PMCID: PMC10960450 DOI: 10.1186/s12909-024-05308-2] [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: 08/23/2023] [Accepted: 03/13/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Many applied postgraduate pain training programs are monodisciplinary, whereas interdisciplinary training programs potentially improve interdisciplinary collaboration, which is favourable for managing patients with chronic pain. However, limited research exists on the development and impact of interdisciplinary training programs, particularly in the context of chronic pain. METHODS This study aimed to describe the development and implementation of an interdisciplinary training program regarding the management of patients with chronic pain, which is part of a type 1 hybrid effectiveness-implementation study. The targeted groups included medical doctors, nurses, psychologists, physiotherapists, occupational therapists, dentists and pharmacists. An interdisciplinary expert panel was organised to provide its perception of the importance of formulated competencies for integrating biopsychosocial pain management with a cognitive behavioural approach into clinical practice. They were also asked to provide their perception of the extent to which healthcare professionals already possess the competencies in their clinical practice. Additionally, the expert panel was asked to formulate the barriers and needs relating to training content and the implementation of biopsychosocial chronic pain management with a cognitive behavioural approach in clinical practice, which was complemented with a literature search. This was used to develop and adapt the training program to the barriers and needs of stakeholders. RESULTS The interdisciplinary expert panel considered the competencies as very important. Additionally, they perceived a relatively low level of healthcare professionals' possession of the competencies in their clinical practice. A wide variety of barriers and needs for stakeholders were formulated and organized within the Theoretical Domain Framework linked to the COM-B domains; 'capability', 'opportunity', and 'motivation'. The developed interdisciplinary training program, including two workshops of seven hours each and two e-learning modules, aimed to improve HCP's competencies for integrating biopsychosocial chronic pain management with a cognitive behavioural approach into clinical practice. CONCLUSION We designed an interdisciplinary training program, based on formulated barriers regarding the management of patients with chronic pain that can be used as a foundation for developing and enhancing the quality of future training programs.
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Affiliation(s)
- Wouter Munneke
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Pain in Motion International Research Group (PiM)
- Department of Sport and Rehabilitation Sciences, University of Liège, Liege, Belgium
| | - Christophe Demoulin
- Department of Sport and Rehabilitation Sciences, University of Liège, Liege, Belgium
| | - Jo Nijs
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Pain in Motion International Research Group (PiM)
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Department of rehabilitation medicine and physiotherapy, University Hospital Brussels, Brussels, Belgium
| | - Carine Morin
- Société Scientifique de Médecine Générale (SSMG), Brussels, Belgium
| | | | - Anne Berquin
- Department of Physical and Rehabilitation Medicine, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Mira Meeus
- Pain in Motion International Research Group (PiM)
- MOVANT research group, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Health Sciences and Medicine, University of Antwerp, Antwerp, Belgium
| | - Margot De Kooning
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
- Pain in Motion International Research Group (PiM), .
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Shkodina AD, Bardhan M, Chopra H, Anyagwa OE, Pinchuk VA, Hryn KV, Kryvchun AM, Boiko DI, Suresh V, Verma A, Delva MY. Pharmacological and Non-pharmacological Approaches for the Management of Neuropathic Pain in Multiple Sclerosis. CNS Drugs 2024; 38:205-224. [PMID: 38421578 DOI: 10.1007/s40263-024-01072-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/14/2024] [Indexed: 03/02/2024]
Abstract
Multiple sclerosis is a chronic inflammatory disease that affects the central nervous system and can cause various types of pain including ongoing extremity pain, Lhermitte's phenomenon, trigeminal neuralgia, and mixed pain. Neuropathic pain is a major concern for individuals with multiple sclerosis as it is directly linked to myelin damage in the central nervous system and the management of neuropathic pain in multiple sclerosis is challenging as the options available have limited efficacy and can cause unpleasant side effects. The literature search was conducted across two databases, PubMed, and Google Scholar. Eligible studies included clinical trials, observational studies, meta-analyses, systematic reviews, and narrative reviews. The objective of this article is to provide an overview of literature on pharmacological and non-pharmacological strategies employed in the management of neuropathic pain in multiple sclerosis. Pharmacological options include cannabinoids, muscle relaxants (tizanidine, baclofen, dantrolene), anticonvulsants (benzodiazepines, gabapentin, phenytoin, carbamazepine, lamotrigine), antidepressants (duloxetine, venlafaxine, tricyclic antidepressants), opioids (naltrexone), and botulinum toxin variants, which have evidence from various clinical trials. Non-pharmacological approaches for trigeminal neuralgia may include neurosurgical methods. Non-invasive methods, physical therapy, and psychotherapy (cognitive behavioral therapy, acceptance and commitment therapy and mindfulness-based stress reduction) may be recommended for patients with neuropathic pain in multiple sclerosis. The choice of treatment depends on the severity and type of pain as well as other factors, such as patient preferences and comorbidities. There is a pressing need for healthcare professionals and researchers to prioritize the development of better strategies for managing multiple sclerosis-induced neuropathic pain.
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Affiliation(s)
- Anastasiia D Shkodina
- Department of Neurological diseases, Poltava State Medical University, Poltava, Ukraine
| | - Mainak Bardhan
- Neuro Medical Oncology, Miami Cancer Institute, Baptist Health South Florida, 8900 N. Kendall Drive, Miami, FL, 33176, USA.
| | - Hitesh Chopra
- Department of Biosciences, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences, Chennai, 602105, Tamil Nadu, India
| | | | - Viktoriia A Pinchuk
- Department of Neurological diseases, Poltava State Medical University, Poltava, Ukraine
| | - Kateryna V Hryn
- Department of Neurological diseases, Poltava State Medical University, Poltava, Ukraine
| | - Anzhelina M Kryvchun
- Department of Neurological diseases, Poltava State Medical University, Poltava, Ukraine
| | - Dmytro I Boiko
- Department of Psychiatry, Narcology and Medical Psychology, Poltava State Medical University, Poltava, Ukraine
| | - Vinay Suresh
- King George's Medical University, Lucknow, India
| | - Amogh Verma
- Rama Medical College Hospital and Research Centre, Hapur, India
| | - Mykhailo Yu Delva
- Department of Neurological diseases, Poltava State Medical University, Poltava, Ukraine
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11
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Foy JG, Kechichian S, Foy MR, Ziadni M. Psychological/behavioral interventions for emerging adults with chronic pain. FRONTIERS IN PAIN RESEARCH 2024; 5:1253700. [PMID: 38476354 PMCID: PMC10927809 DOI: 10.3389/fpain.2024.1253700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 02/13/2024] [Indexed: 03/14/2024] Open
Abstract
Background Emerging adults, of whom significant numbers report chronic pain, are characterized as having unique needs and challenges. Psychological/behavioral treatments found to be beneficial for reducing pain outcomes in children and adults are understudied in emerging adults. Following a systematic review of the literature, our objective is to report on quantitative studies of psychological/behavioral interventions for chronic pain in emerging adults. Method We conducted a search of six databases (Cochrane Central Register of Controlled Trials, Google Scholar, ProQuest, PsycINFO, PubMed, and Web of Science) and reference sections in dissertations and systematic reviews to 4/29/2023. Keywords and phrases were search term combinations of "chronic/persistent pain", "emerging/young adults," and "intervention/treatment" using Boolean logic. Results Our review resulted in identifying 37 articles, of which 2 duplicates were removed, and 31 were further excluded by a screening process based on various inclusionary and exclusionary criteria. The search yielded four studies on psychological/behavioral interventions (yoga, acceptance and commitment therapy and relaxation), all of which positively affected the pain experience and/or pain-related outcomes. These studies presented issues in design such as not being blinded or randomized, having a small sample size, and potential confounds that were not reported or examined. Discussion The low number of studies reveals a large gap in the literature and is a call-to-action to further expand our understanding of effective and safer psychological/behavioral therapies for chronic pain in emerging adults. Successful pain management during this developmental phase may help young adults achieve positive trajectories for personal, occupational, relational, and health aspects of their lives.
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Affiliation(s)
- Judith G. Foy
- Department of Psychological Science, Loyola Marymount University, Los Angeles, CA, United States
| | - Sandra Kechichian
- Graduate School of Education and Psychology, Pepperdine University, Malibu, CA, United States
| | - Michael R. Foy
- Department of Psychological Science, Loyola Marymount University, Los Angeles, CA, United States
| | - Maisa Ziadni
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
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12
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Najem C, Wijma AJ, Meeus M, Cagnie B, Ayoubi F, Van Oosterwijck J, De Meulemeester K, Van Wilgen CP. Facilitators and barriers to the implementation of pain neuroscience education in the current Lebanese physical therapist health care approach: a qualitative study. Disabil Rehabil 2024; 46:524-532. [PMID: 36655277 DOI: 10.1080/09638288.2023.2168076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 01/07/2023] [Indexed: 01/20/2023]
Abstract
PURPOSE The purpose of this paper was first to gain an in-depth understanding of the barriers and facilitators to implementing the BPS model and pain neuroscience education in the current Lebanese physical therapy health care approach and explore its acceptability. METHOD A qualitative semi-structured interview using purposive sampling was conducted with eight Lebanese physical therapists practising in different governorates. The transcribed text from the interviews was analyzed using inductive thematic analysis. RESULTS Two topics were generated and constructed by the researchers: (1) "barriers to the implementation of pain neuroscience education, with subthemes including (a) "current health care approach," (b) "basic curriculum and continuing education," (c) "patients' barriers"; (2) "facilitators to the implementation of pain neuroscience education," with subthemes containing (a) "interest in the BPS model, (b) "therapeutic alliance," and (c) "motivation for future training on BPS approach." CONCLUSION The analysis of the results showed that Lebanese physical therapists currently hold a strong biomedical view of chronic pain, assessment, and treatment. However, despite the presence of barriers and challenges, they are aware and open to consider the implementation and future training about the BPS model and pain neuroscience education in their approach.IMPLICATIONS FOR REHABILITATIONThe exploration of potential barriers and facilitators to the bio-psychosocial model and pain neuroscience education implementation may provide an opportunity for better development and design of a culturally sensitive pain neuroscience education material for Arab-speaking and Lebanese physical therapists.The exploration of barriers and facilitators to the implementation of pain neuroscience education will help to improve pain education and ensure better clinical pain management.The most important barriers were the dominant characteristic of the Lebanese physical therapist's health approach, which is focused on a biomechanically oriented model, and their lack of knowledge to approach chronic pain from a biopsychosocial perspective.
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Affiliation(s)
- C Najem
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium
- Department of physiotherapy, Faculty of Public Health, Antonine University, Hadath Baabda, Lebanon
- Pain in Motion International Research Group www. paininmotion.be
| | - A J Wijma
- Pain in Motion International Research Group www. paininmotion.be
- Transcare Transdisciplinary Pain Management Center, Groningen, the Netherlands
- PAIN - VUB Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium
| | - M Meeus
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium
- Pain in Motion International Research Group www. paininmotion.be
- MOVANT Research group, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium
| | - B Cagnie
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium
| | - F Ayoubi
- Department of physiotherapy, Faculty of Public Health, Antonine University, Hadath Baabda, Lebanon
- Department of physiotherapy, Faculty of Public Health, Lebanese University, Lebanon
| | - J Van Oosterwijck
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium
- Pain in Motion International Research Group www. paininmotion.be
- MOVANT Research group, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium
- Research Foundation - Flanders (FWO), Belgium
| | - K De Meulemeester
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium
- Pain in Motion International Research Group www. paininmotion.be
| | - C P Van Wilgen
- Pain in Motion International Research Group www. paininmotion.be
- Transcare Transdisciplinary Pain Management Center, Groningen, the Netherlands
- PAIN - VUB Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium
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13
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Mashola MK, Korkie E, Mothabeng DJ. Pain medication misuse in the South African spinal cord injury context. Health SA 2024; 29:2377. [PMID: 38322368 PMCID: PMC10839206 DOI: 10.4102/hsag.v29i0.2377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 10/31/2023] [Indexed: 02/08/2024] Open
Abstract
Background Pain after spinal cord injury (SCI) is debilitating and has been reported to be difficult to treat, despite pharmacological interventions. Pain medication misuse (PMM) and associated individual factors among people with spinal cord injury (PWSCI) are scarce. Aim To determine PMM and the associated factors in PWSCI. Setting Homes of community-dwelling manual wheelchair users with SCI in South Africa. Methods Community-dwelling PWSCI (n = 122) were consecutively sampled and the Pain Medication Questionnaire (PMQ) was used to determine PMM. Descriptive statistics, Fisher's exact test, independent t-tests, and simple linear regression tests were performed using SPSS v27. Testing was conducted at the 0.05 level of significance. Results Eighty-five per cent of the participants reported the presence of pain and 48.1% of them used pain medication. Forty-four percent of people who used pain medication scored ≥ 30, indicative of serious aberrant drug-taking behaviours. Opioids were mainly used for neuropathic pain and in combination with other types of medications such as anticonvulsants and non-steroidal anti-inflammatories (44.0%). Pain severity and the type of pain medication were found to be predictors of PMM (p < 0.01 respectively). Conclusion Pain relief after SCI remains difficult to achieve, with an evident high risk of PMM, which may lead to long-lasting side effects, dependency, or overdose. Contribution This study has shown the need for the assessment of the potential risk of dependency before prescribing pain medication, particularly opioids to PWSCI.
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Affiliation(s)
- Mokgadi K Mashola
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Elzette Korkie
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Diphale J Mothabeng
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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14
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Oosterhaven J, Pell CD, Schröder CD, Popma H, Spierenburg L, Devillé WL, Wittink H. Health literacy and pain neuroscience education in an interdisciplinary pain management programme: a qualitative study of patient perspectives. Pain Rep 2023; 8:e1093. [PMID: 37868618 PMCID: PMC10586826 DOI: 10.1097/pr9.0000000000001093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 05/17/2023] [Accepted: 06/10/2023] [Indexed: 10/24/2023] Open
Abstract
Introduction Pain neuroscience education is part of interdisciplinary pain management programs (IPMPs). To date, the role of health literacy on patients' understanding of pain neuroscience education has not sufficiently been examined. Objectives Drawing on interviews with patients with diverse levels of health literacy, this article explores patient perspectives on pain neuroscience education. Methods Purposively sampled patients from an IPMP were interviewed twice (waiting list and after 4 weeks). A directed qualitative content analysis was performed with the Integrated Conceptual Model of Health Literacy as an analytic framework. Results Thirteen patients with chronic musculoskeletal pain were interviewed: 4 men and 9 women aged from 21 to 77 years with diverse educational and mostly low health literacy. One participant dropped out after baseline. Some participants gained access to health information actively; others relied on the expertise of their healthcare providers. Most participants did not seem to receive the information in the pain neuroscience education as intended, experienced difficulties with understanding the message, negatively appraised the information, and were not able to apply this in their daily lives. Health literacy levels likely played a role in this. Conclusions Pain neuroscience education tailored to patients' health literacy levels, information needs, and learning strategies is needed.
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Affiliation(s)
- Janke Oosterhaven
- Research Group Lifestyle and Health, University of Applied Sciences Utrecht, Utrecht, The Netherlands
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, the Netherlands
| | - Christopher D. Pell
- Department of Global Health, Academic Medical Centre, Amsterdam Institute for Global Health and Development (AIGHD), University of Amsterdam, Amsterdam, the Netherlands
| | - Carin D. Schröder
- Ecare4you, Amersfoort, the Netherlands
- Center of Excellence for Rehabilitation Medicine Utrecht, UMC Utrecht Brain Center, University Medical Center Utrecht, and de Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Hans Popma
- Rehabilitation Centre Heliomare, Wijk aan Zee, the Netherlands
| | - Loes Spierenburg
- Research Group Lifestyle and Health, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Walter L.J.M. Devillé
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, the Netherlands
- Julius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, the Netherlands
| | - Harriet Wittink
- Research Group Lifestyle and Health, University of Applied Sciences Utrecht, Utrecht, The Netherlands
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15
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McGrath RL, Shephard S, Parnell T, Verdon S, Pope R. Recommended approaches to assessing and managing physiotherapy clients experiencing psychological distress: a systematic mapping review. Physiother Theory Pract 2023:1-31. [PMID: 38009858 DOI: 10.1080/09593985.2023.2284823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/05/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Some physiotherapists find assessing and managing clients experiencing psychological distress challenging and are uncertain regarding the boundaries of the profession's scope. OBJECTIVE To map the approaches recommended for physiotherapists in scholarly literature, with respect to the assessment and management of clients experiencing psychological distress. METHODS A systematic mapping review was conducted. CINAHL, APA PsycINFO, Embase, and Medline ALL databases were systematically searched for secondary and tertiary literature relevant to the research objective. Recommended approaches were extracted from each article and analyzed descriptively and thematically. RESULTS 3884 records were identified with 40 articles meeting the inclusion/exclusion criteria. Most recommendations related to identifying, assessing, and managing pain-related distress, with depression screening and referral also receiving some attention. Three approaches to detecting and assessing psychological distress were identified: 1) brief depression screen; 2) integrated suicide/nonsuicidal self-harm and depression screen; and 3) multidimensional screen and health-related distress assessment. Regarding the management of psychological distress the main approaches identified were: 1) education and reassurance; 2) cognitive-behavioral approaches; 3) mindfulness; and 4) case management. CONCLUSION While assessment and management of health-related distress by physiotherapists is commonly recommended, further guidance is needed to differentiate various forms of distress.
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Affiliation(s)
- Ryan L McGrath
- Department of Rural Health, University of Melbourne, Shepparton, Australia
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Albury, Australia
- Allied Health Education and Research Unit, Goulburn Valley Health, Shepparton, Australia
| | - Sophie Shephard
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Albury, Australia
| | - Tracey Parnell
- Department of Rural Health, University of Melbourne, Shepparton, Australia
| | - Sarah Verdon
- Department of Rural Health, University of Melbourne, Shepparton, Australia
| | - Rodney Pope
- Department of Rural Health, University of Melbourne, Shepparton, Australia
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16
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Bassimtabar A, Alfuth M. [Development and validation of a questionnaire to assess physiotherapists' postural-structural-biomechanical-oriented beliefs about pain]. Schmerz 2023:10.1007/s00482-023-00757-y. [PMID: 37845560 DOI: 10.1007/s00482-023-00757-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 08/15/2023] [Accepted: 08/22/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Therapists frequently use the postural-structural-biomechanical (PSB) model in clinical practice to explain the symptom of pain using biomechanical deficits. Adequate knowledge about pain encompasses not only the neurophysiology of pain but also knowledge that existing PSB-oriented explanations of the development and enhancement of pain are outdated. There is no assessment to evaluate physiotherapists' PSB-oriented beliefs about pain. AIM The aim of the present study was to develop a questionnaire to assess physiotherapists' PSB-oriented beliefs about pain and to evaluate its reliability (internal consistency), validity, and agreement. METHODS The Essential Knowledge of Pain Questionnaire (EKPQ) was constructed on the basis of a literature search and discussions between experts. In a pilot study, 32 pupils of a physiotherapy school were then asked to complete the German version of the revised Neurophysiology of Pain Questionnaire (rNPQ-D) and the EKPQ using the SoSci Survey in order to assess their knowledge and beliefs about pain. RESULTS The internal consistency of the EKPQ was acceptable with a Cronbach's α = 0.784. There was a strong positive significant correlation between the questionnaires (r = 0.518; p = 0.002). The Bland-Altman analysis revealed a mean difference of 28.9% (± standard deviation of the difference 15.3%) with an upper limit of 95% agreement of 58.8% and a lower limit of 95% agreement of -1.0% between the questionnaires. Participants achieved a mean score of 60.7% in the rNPQ‑D and a mean score of 31.8% in the EKPQ. CONCLUSION The newly developed EKPQ questionnaire seems to be a reliable and valid assessment to determine physiotherapists' PSB-oriented beliefs about pain. The results also confirm that a high level of knowledge about the neurophysiology of pain does not exclude a PSB orientation. Whether the EKPQ can be used alongside the rNPQ as an additional assessment to evaluate beliefs about pain should be investigated in the future with suitable study designs, e.g. Delphi study.
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Affiliation(s)
- Ahura Bassimtabar
- Fachbereich Gesundheitswesen, Hochschule Niederrhein, Reinarzstr. 49, 47805, Krefeld, Deutschland
- Universitäre Weiterbildung M.Sc. Sportphysiotherapie, Deutsche Sporthochschule Köln, Am Sportpark Müngersdorf 6, 50933, Köln, Deutschland
- Bayer 04 Leverkusen Fußball GmbH, Bismarckstr. 122-124, 51373, Leverkusen, Deutschland
| | - Martin Alfuth
- Fachbereich Gesundheitswesen, Hochschule Niederrhein, Reinarzstr. 49, 47805, Krefeld, Deutschland.
- Universitäre Weiterbildung M.Sc. Sportphysiotherapie, Deutsche Sporthochschule Köln, Am Sportpark Müngersdorf 6, 50933, Köln, Deutschland.
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17
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Blanch A, Solé S. Classification of pain intensity with the pain beliefs and perceptions inventory (PBPI) and the pain catastrophizing scales (PCS). Qual Life Res 2023; 32:2853-2859. [PMID: 37233965 PMCID: PMC10214345 DOI: 10.1007/s11136-023-03444-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2023] [Indexed: 05/27/2023]
Abstract
PURPOSE The pain beliefs and perceptions inventory (PBPI) and the pain catastrophizing scales (PCS) characterize beliefs or distress dimensions of the pain experience. It is relatively unknown, however, to what degree the PBPI and the PCS are well suited to classifying pain intensity. METHODS This study applied a receiver operating characteristic (ROC) approach to these instruments against the criterion of a visual analogue scale (VAS) of pain intensity with fibromyalgia and chronic back pain patients (n = 419). RESULTS The largest areas under the curve (AUC) were moderate and limited to the constancy subscale (71%) and total score (70%) of the PBPI and to the helplessness subscale (75%) and total score (72%) of the PCS. The best cut-off scores for the PBPI and PCS were better off at detecting true negatives than true positives, with larger specificity than sensitivity values. CONCLUSION Whereas, the PBPI and PCS are certainly useful instruments to evaluate diverse pain experiences, they may be inappropriate to classify intensity. The PCS performs marginally better than the PBPI for classifying pain intensity.
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Affiliation(s)
- Angel Blanch
- Department of Psychology, University of Lleida, Lleida, Spain
| | - Sílvia Solé
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Department of Physiotherapy, Andalucia TECH, University of Malaga, Málaga, Spain
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18
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Carpintero-Rubio C, Pastor-Galiano V, Torres-Chica B. Therapeutic expectancy in physiotherapy. Physiother Theory Pract 2023:1-12. [PMID: 37776307 DOI: 10.1080/09593985.2023.2264378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 09/21/2023] [Indexed: 10/02/2023]
Abstract
In health sciences, including physical therapy, communication techniques are a critical part of the success in the therapeutic process. Managing the patient's beliefs, perceptions, and the narrative of their problems, becomes an essential part of the therapeutic process. This is the key to achieving real changes regarding how the patient copes with pain, illness, dysfunction, as well as the ability to develop adequate resources for facing them. We call this "Therapeutic expectancy" a new concept that originates from the well-known Therapeutic alliance and incorporates practices from the field of Motivational interviewing and Strategic dialogue. The Therapeutic expectancy starts from the first interaction with the patient and continues throughout the different stages of the therapeutic process. This article describes the structure of the relationship with the patient and some verbal communication techniques to generate an effective physical therapist-patient interaction, building Therapeutic expectancy, through a "centered on the patient's narrative" strategy. Expectancy constitutes a desirable goal in any patient and in any pathological condition as it pursues a change in an individual's perception of their state of health, thereby enhancing the desire for healing and empowerment.
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Affiliation(s)
- Carlos Carpintero-Rubio
- Health Sciences Department, Comillas Pontifical University, San Juan de Dios Foundation, Madrid, Spain
| | - Vicente Pastor-Galiano
- Health Sciences Department, Comillas Pontifical University, San Juan de Dios Foundation, Madrid, Spain
| | - Bárbara Torres-Chica
- Health Sciences Department, Comillas Pontifical University, San Juan de Dios Foundation, Madrid, Spain
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19
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Soheili S, Letafatkar A, Hosseinzadeh M. The effect of patient-led goal setting approach combined with pain neuroscience education or manual therapy in patients with chronic low back pain: protocol for a parallel-group randomized controlled trial. Trials 2023; 24:573. [PMID: 37684646 PMCID: PMC10485946 DOI: 10.1186/s13063-023-07617-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Low back pain (LBP) is a multifactorial disorder associated with a high range of physical and psychological burden on the society. Patient-led goal-setting approach has shown potential effects for improving chronic LBP. However, there are few studies investigating its benefits when combined with a supplementary intervention. This paper, therefore, presents a protocol for a randomized control trial (RCT) to study the effect of a patient-led goal-setting approach combined with pain neuroscience education (PNE) or manual therapy (MT) among patients with chronic LBP. METHODS A total of 105 patients suffering from chronic LBP will be recruited via flyers displayed in hospitals and universities, and those meeting the study's criteria will randomly be allocated into a patient-led goal-setting approach with the PNE group, and/or with the MT program group, and/or a control group. The primary outcomes will be the pain intensity and disability. Secondary outcomes include quality of life, depression, anxiety and stress, fear avoidance beliefs, kinesophobia, pain self-efficacy, catastrophic pain, neurophysiology of pain, and central sensitivity. All the outcomes will be recorded at 2 months after receiving the treatment as post-test sessions and after 4 and 12 months as follow-up sessions. The Ethics Committee in Research at Sport Sciences Research Institute of Iran approved the protocol of this trial (IR.SSRC.REC.1400.084). Written, informed consent to participate will be obtained from all participants. All methods will be conducted in accordance with the ethical standards of the Declaration of Helsinki and in accordance with relevant guidelines and regulations. We will disseminate the findings through peer-reviewed publications and conference presentations and send them to the participants. DISCUSSION This trial will demonstrate which supplementary intervention can better improve the impact of a patient-led goal-setting approach to treat LBP. If successful, the results will potentially have implications for athletic trainers, physiotherapists, and health care practitioners. TRIAL REGISTRATION IRCT Iranian Registry of Clinical Trials IRCT20210927052616N1. Registered on November 03, 2021.
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Affiliation(s)
- Sahar Soheili
- Department of Biomechanics and Sport Injuries, Faculty of Physical Education and Sport Sciences, Kharazmi University, Tehran, Iran
| | - Amir Letafatkar
- Sports Injury and Corrective Exercises, Kharazmi University, Tehran, Iran
| | - Mahdi Hosseinzadeh
- Department of Sport Injuries and Corrective Exercises, Sport Sciences Research Institute, No. 3, 5Th Alley, Miremad Street, Motahhari Street, Tehran, 1587958711, Iran.
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20
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Baroni A, Margelli M, Saoncella A, Toigo I, Antonellini G, Straudi S. Physiotherapy management of nociplastic pain: A Delphi study of Italian specialists. Pain Pract 2023; 23:734-742. [PMID: 37143408 DOI: 10.1111/papr.13238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 04/21/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND AND PURPOSE Nociplastic pain due to central sensitization (CS) is common in people suffering from chronic pain, but no clinical practice guideline is available in rehabilitative settings for patients' management. The aim of this study is to achieve expert consensus on physiotherapy competencies in the management of people with nociplastic pain and suspected CS mechanisms. METHODS A web-based Delphi process was employed. Experts in the rehabilitation field were recruited following pre-defined eligibility criteria. Following completion of three Delphi rounds, the final list of competencies was generated. RESULTS In all, 23 participants were recruited. They all completed Round 1 (23/23, 100%), twenty Round 2 and Round 3 (20/23, 87%). Following Round 1, seven areas were identified by the panel as crucial for CS physiotherapy management; 19 competencies out of 40 reached the consensus between experts, and nine additional competencies were added to Round 2 following literary review. Round 2 identified the agreement for all the 29 competencies. During Round 3, all the experts confirmed the final list generated through the consensus process. DISCUSSION An agreement between experts was found for the final list of competencies that a physiotherapist should implement every time it approaches people with suspected CS mechanisms. Further research is needed to support the clinical utility of our findings and their applicability in daily practice.
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Affiliation(s)
- Andrea Baroni
- Neuroscience and Rehabilitation Department, Ferrara University Hospital, Ferrara, Italy
| | - Michele Margelli
- Department of Morphology Surgery and Experimental Medicine, Ferrara University, Ferrara, Italy
| | - Anna Saoncella
- Neuroscience and Rehabilitation Department, Ferrara University Hospital, Ferrara, Italy
| | - Ilenia Toigo
- Neuroscience and Rehabilitation Department, Ferrara University Hospital, Ferrara, Italy
| | - Giulia Antonellini
- Neuroscience and Rehabilitation Department, Ferrara University Hospital, Ferrara, Italy
| | - Sofia Straudi
- Neuroscience and Rehabilitation Department, Ferrara University Hospital, Ferrara, Italy
- Neuroscience and Rehabilitation Department, Ferrara University, Ferrara, Italy
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21
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Escriche-Escuder A, Nijs J, Silbernagel KG, van Wilgen CP, Plinsinga ML, Casaña J, Cuesta-Vargas AI. Pain neuroscience education in persistent painful tendinopathies: A scoping review from the Tendon PNE Network. Phys Ther Sport 2023; 63:38-49. [PMID: 37499463 DOI: 10.1016/j.ptsp.2023.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 07/29/2023]
Abstract
OBJECTIVE to conduct and report a scoping review of the available evidence of the effects and content of pain neuroscience education for patients with persistent painful tendinopathies. METHODS PubMed, Embase, Web of Science, CINAHL, SPORTDiscus, and grey literature databases were searched from database inception to May 2022. Randomised and non-randomised controlled trials, non-controlled clinical trials, cohort studies, case series, case studies including people with persistent painful tendinopathy aged ≥18 years, a pain education intervention, and in English were included. Studies were excluded if they were cross-sectional studies, reviews, editorials, abstracts, or full-text not available or if included heterogeneous study cohorts, patients with tendon rupture, or patients with systemic diseases. RESULTS five studies (n = 164) were included. Pain neuroscience education entailed face-to-face discussion sessions or educational materials including videos, brochures, paper drawings, and review questions. All studies used pain neuroscience education in conjunction with other interventions, obtaining significant benefits in outcomes related to pain, physical performance, or self-reported function, among others. CONCLUSIONS The application of pain neuroscience education in conjunction with other interventions seemed to improve several outcomes. However, considering the current knowledge about tendon pain and the scarcity of well-designed trials studying pain neuroscience education in tendinopathy, additional research is needed.
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Affiliation(s)
- Adrian Escriche-Escuder
- Department of Physiotherapy, University of Malaga, Malaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Malaga, Spain
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium; Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Belgium; Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | | | - C Paul van Wilgen
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium; Transcare Transdisciplinary Pain Management Center, Groningen, the Netherlands
| | - Melanie L Plinsinga
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - José Casaña
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Antonio I Cuesta-Vargas
- Department of Physiotherapy, University of Malaga, Malaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Malaga, Spain; School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.
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22
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Nijs J, De Baets L, Hodges P. Phenotyping nociceptive, neuropathic, and nociplastic pain: who, how, & why? Braz J Phys Ther 2023; 27:100537. [PMID: 37639943 PMCID: PMC10470273 DOI: 10.1016/j.bjpt.2023.100537] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023] Open
Affiliation(s)
- Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education & Physical Therapy, Vrije Universiteit Brussel, Belgium; Chronic pain rehabilitation, Department of Physical Medicine and Physical Therapy, University Hospital Brussels, Belgium; Department of Health and Rehabilitation, Unit of Physical Therapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Liesbet De Baets
- Pain in Motion Research Group (PAIN), Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education & Physical Therapy, Vrije Universiteit Brussel, Belgium.
| | - Paul Hodges
- The University of Queensland, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
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23
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Zimney K, Van Bogaert W, Louw A. The Biology of Chronic Pain and Its Implications for Pain Neuroscience Education: State of the Art. J Clin Med 2023; 12:4199. [PMID: 37445234 DOI: 10.3390/jcm12134199] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/06/2023] [Accepted: 06/14/2023] [Indexed: 07/15/2023] Open
Abstract
Pain is an individualized experience for the person suffering from chronic pain. Significant strides have been made in the last few decades in understanding various biological changes that coincide with chronic pain. This state-of-the-art overview looks at the current evidence related to the biology of chronic pain and the implications these findings have on the delivery of pain neuroscience education (PNE). The paper summarizes the various (epi)genetic, neural, endocrine, and immune factors discovered and explored in the scientific literature concerning chronic pain. Each of these biological factors has various implications for the content and delivery of PNE. We discuss the future directions these biological factors have for the clinical implementation of PNE by linking the importance of behavior change, optimizing the learning environment, and using an individualized multimodal treatment approach with PNE. In addition, future directions for research of PNE based on these biological factors are provided with importance placed on individualized patient-centered care and how PNE can be used with traditional modes of care and growing trends with other care methods. PNE was originally and continues to be rooted in understanding chronic pain biology and how that understanding can improve patient care and outcomes.
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Affiliation(s)
- Kory Zimney
- Department of Physical Therapy, University of South Dakota, 414 East Clark St., Vermillion, SD 57069, USA
| | - Wouter Van Bogaert
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 121, 1000 Brussels, Belgium
- Research Foundation-Flanders (FWO), Leuvenseweg 38, 1000 Brussels, Belgium
- Interuniversity Centre for Health Economics Research (I-CHER), Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1000 Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Laarbeeklaan 101, 1000 Brussels, Belgium
| | - Adriaan Louw
- Evidence in Motion, 618 Broad Street, Suite B, Story City, IA 50248, USA
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Bondesson E, Jöud A, Rivano Fischer M, Trulsson Schouenborg A. Can Baseline Characteristics Predict Successful Outcomes after Individual, Physiotherapist-Led Rehabilitation in Patients with Chronic Musculoskeletal Pain? Pain Res Manag 2023; 2023:5182996. [PMID: 37360748 PMCID: PMC10289872 DOI: 10.1155/2023/5182996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/24/2023] [Accepted: 06/02/2023] [Indexed: 06/28/2023]
Abstract
Background No strong and consistent variables to predict outcome after pain rehabilitation have been reported in patients with chronic musculoskeletal pain. The aim of the present study was to clarify if baseline variables could predict successful outcome after a unique, individualized, physiotherapist-led rehabilitation of nine sessions. Methods In 274 individuals with severe chronic musculoskeletal pain, the risk ratio (RR) and 95% confidence intervals (CIs) were estimated for potentially predictive baseline variables on successful outcomes of pain management, overall health, and pain rating. Results Statistically significant results show that patients rating moderate or severe baseline pain were in both cases 14% less likely to improve pain management compared to patients rating mild baseline pain (RR = 0.86; 95% CI 0.77-0.97, RR = 0.86; 95% CI 0.74-1.00). Patients with the shortest pain duration were 1.61 times more likely to improve overall health (RR = 1.61; 95% CI 1.13-2.29) compared to patients reporting the longest pain duration (>5 years). Patients reporting anxiety/depression or severe pain were in both cases 1.48 times more likely to improve overall health compared to better baseline presentations (RR = 1.48; 95% CI 1.16-1.88, RR = 1.48; 95% CI 1.03-2.15). Patients with regional/generalized pain were 36% less likely to rate pain reduction (RR = 0.64; 95% CI 0.41-1.00) compared to patients rating localized baseline pain. Of 17 potentially predictive baseline variables, four reached statistical significance for at least one of the three outcomes; although none of them for all three outcomes. Conclusions Of 17 potentially predictive baseline variables, mild pain ratings, short pain duration, and localized baseline pain were statistically significantly associated with improvements after individual, physiotherapist-led rehabilitation for patients with chronic musculoskeletal pain. This suggests that this type of rehabilitation probably should be offered early in the pain process. Reporting anxiety/depression or severe pain at the baseline did not hinder the improvements of overall health.
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Affiliation(s)
- Elisabeth Bondesson
- Lund University, Department of Clinical Sciences Lund, Lund, Sweden
- Skåne University Hospital, Department of Neurosurgery and Pain Rehabilitation, Lund, Sweden
| | - Anna Jöud
- Lund University, Department of Clinical Sciences Lund, Lund, Sweden
- Lund University, Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund, Sweden
- Skåne University Hospital, Department of Research and Education, Lund, Sweden
| | - Marcelo Rivano Fischer
- Skåne University Hospital, Department of Neurosurgery and Pain Rehabilitation, Lund, Sweden
- Lund University, Department of Health Sciences, Research Group Rehabilitation Medicine, Lund, Sweden
| | - Anna Trulsson Schouenborg
- Skåne University Hospital, Department of Neurosurgery and Pain Rehabilitation, Lund, Sweden
- Lund University, Department of Health Sciences, Research Group Human Movement-Health and Rehabilitation, Lund, Sweden
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25
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Otero-Ketterer E, Peñacoba-Puente C, Ortega-Santiago R, Galán-Del-Río F, Valera-Calero JA. Consideration of Psychosocial Factors in Acute Low Back Pain by Physical Therapists. J Clin Med 2023; 12:jcm12113865. [PMID: 37298060 DOI: 10.3390/jcm12113865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/24/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023] Open
Abstract
Clinical guidelines consistently recommend screening psychosocial (PS) factors in patients with low back pain (LBP), regardless of its mechanical nature, as recognized contributors to pain chronicity. However, the ability of physiotherapists (PTs) in identifying these factors remains controversial. This study aimed to assess the current identification of psychosocial risk factors by physical therapists (PTs) and which characteristics of PTs are associated with the identification of the main risk for chronicity (physical or psychosocial). A cross-sectional descriptive study surveying Spanish PTs in public and private health services was conducted, including questions on PT characteristics and three low back pain (LBP) patient vignettes with different biopsychosocial (BPS) clinical presentations. From 484 respondents, the majority of PTs agreed regarding the main risk for chronicity for each vignette (PS 95.7% for vignette A, PS and physical 83.5% for vignette B and PS 66% for vignette C). Female PTs were more likely to rate psychosocial compared with males (p < 0.05). PTs with higher levels of social and emotional intelligence (both, p < 0.05) were more likely to identify the main risk for chronicity. However, only gender and social information processing for vignette A (p = 0.024) and emotional clarity for vignette B (p = 0.006) were able to predict the identification of psychosocial and physical risk, respectively. The main risk for chronicity was correctly identified by a large majority of PTs through patient vignettes. Gender, social and emotional intelligence played a relevant role in the recognition of psychosocial risk and biopsychosocial factors.
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Affiliation(s)
- Emilia Otero-Ketterer
- Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Physiotherapy Department, Mutua Universal Mugenat, 28801 Alcalá de Henares, Spain
| | | | - Ricardo Ortega-Santiago
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
| | - Fernando Galán-Del-Río
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
| | - Juan Antonio Valera-Calero
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
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26
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Cheng AL, Carbonell KV, Prather H, Hong BA, Downs DL, Metzler JP, Hunt DM. Unique characteristics of patients who choose an intensive lifestyle medicine program to address chronic musculoskeletal pain. PM R 2023; 15:761-771. [PMID: 35567523 PMCID: PMC9659670 DOI: 10.1002/pmrj.12847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 04/20/2022] [Accepted: 05/01/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Factors that motivate musculoskeletal patients to pursue an intensive, lifestyle medicine-based approach to care are poorly understood. OBJECTIVE To determine whether, compared to patients seeking musculoskeletal care through traditional pathways, patients who choose an intensive lifestyle medicine program for musculoskeletal pain endorse greater physical dysfunction, worse psychological health, and/or more biopsychosocial comorbidities. DESIGN Cross-sectional analysis of existing medical records from 2018 to 2021. SETTING Orthopedic department of one academic medical center. PATIENTS Fifty consecutive patients who enrolled in an intensive lifestyle medicine program to address a musculoskeletal condition. Comparison groups were the following: (1) 100 patients who presented for standard nonoperative musculoskeletal care, and (2) 100 patients who presented for operative evaluation by an orthopedic surgeon and qualified for joint arthroplasty. INTERVENTION Not applicable. MAIN OUTCOME MEASURES Primary outcomes were age-adjusted, between-group differences in Patient-Reported Outcomes Measurement Information System (PROMIS) physical and psychological health measures. Secondary outcomes were between-group differences in sociodemographic and medical history characteristics. RESULTS Patients who enrolled in the intensive lifestyle medicine program were more racially diverse (non-White race: lifestyle cohort 34% vs. comparison cohorts 16%-18%, p ≤ .029) and had a higher prevalence of obesity and diabetes than both comparison groups (mean body mass index: lifestyle cohort 37.6 kg/m2 vs. comparison cohorts 29.3-32.0, p < .001; diabetes prevalence: lifestyle cohort 32% vs. comparison cohorts 12%-16%, p ≤ .024). Compared to standard nonoperative patients, there were no clear between-group differences in PROMIS physical or psychological health scores. Compared to standard operative evaluation patients, patients in the lifestyle program reported worse anxiety but less pain interference (PROMIS Anxiety: B = 3.8 points [95% confidence interval, 0.1 to 7.4], p = .041; Pain interference: B = -3.6 [-6.0 to -1.2], p = .004). CONCLUSIONS Compared to musculoskeletal patients who sought care through traditional pathways, patients who chose an intensive lifestyle medicine pathway had a higher prevalence of metabolic comorbidities, but there was substantial overlap in patients' physical, psychological, and sociodemographic characteristics.
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Affiliation(s)
- Abby L Cheng
- Division of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | | | - Heidi Prather
- Department of Physiatry, Hospital for Special Surgery, Weill Cornell Medical College, New York City, New York, USA
| | - Barry A Hong
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Dana L Downs
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - John P Metzler
- Division of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Devyani M Hunt
- Division of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
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27
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Gholami Z, Faezi ST, Letafatkar A, Madreseh E. Pain neuroscience education, blended exercises and booster sessions as an effective therapy for pain, functional and psychological factors in patients with knee osteoarthritis: a study protocol for a single-blind randomised controlled trial with 2 2 factorial design during 6-month follow-up. BMJ Open 2023; 13:e070336. [PMID: 37173101 PMCID: PMC10186447 DOI: 10.1136/bmjopen-2022-070336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
INTRODUCTION This study aims to investigate whether a pain neuroscience education (PNE) combined with a blended exercises programme including aerobic, resistance, neuromuscular, breathing, stretching and balance exercises and diet education provides greater pain relief and improvement in functional and psychological factors than PNE and blended exercises alone and whether 'exercise booster sessions (EBS)' approach may improve outcomes and increase adherence in patients with knee osteoarthritis (KOA) (by telerehabilitation (TR)). METHODS AND ANALYSIS In this single-blind randomised controlled trial, 129 patients (both genders; age >40) diagnosed with KOA will be randomly assigned to one of the 22 treatment combinations as: (1) blended exercises alone (36 sessions over 12 weeks), (2) PNE alone (three sessions over 2 weeks), (3) combination of PNE with blended exercises (exercise three times a week for 12 weeks combined with three sessions of PNE) and (4) a control group. Outcome assessors will be blinded towards group allocation. The primary outcome variables are the visual analogue scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis index in knee osteoarthritis (WOMAC) score. Secondary outcomes include Pain Self-Efficacy Questionnaire (PSEQ), Depression, Anxiety and Stress Scale (DASS), Tampa Scale for Kinesiophobia (TSK), Short Falls Efficacy Scale International (FES-I), Pain Catastrophising Scale (PCS), Short Form Health Survey (SF-12) and Exercise Adherence Rating Scale (EARS), 30 s sit-to-stand test (30CST), Timed Up and Go (TUG), lower limbs' muscle strength and lower limb joints' active range of motion (AROM) will be performed at baseline, 3 and 6 months' postinterventions. The primary and secondary outcomes will assess at baseline, 3 months and 6 months postinterventions.The findings will be useful in establishing an effective treatment strategy covering multiple aspects behind KOA. The study protocol is conducted in clinical settings, thereby enhancing the possibility of future implementation of the treatments in the healthcare systems and self-care management. Results in comparison between groups will help to clarify the most effective of mixed-method TR (blended exercise, PNE, EBS with diet education) on more improvement in pain, functional and psychological factors in patients with KOA. This study will combine some of the most critical interventions, to be able to introduce a 'gold standard therapy' in the treatment of KOA. ETHICS AND DISSEMINATION The trial has been approved by the ethics committee for research involving human subjects of the Sport Sciences Research Institute of Iran (IR.SSRC.REC.1401.021). The study findings will be published in international peer-reviewed journals. TRIAL REGISTRATION NUMBER IRCTID: IRCT20220510054814N1.
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Affiliation(s)
- Zohreh Gholami
- Biomechanics and Sports Injuries, Kharazmi University - Karaj, Hesarak, Iran
| | | | - Amir Letafatkar
- Department of Biomechanics and Sport Injuries, Kharazmi University, Tehran, Iran
| | - Elham Madreseh
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
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28
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Bonanni R, Gino Grillo S, Cariati I, Tranquillo L, Iundusi R, Gasbarra E, Tancredi V, Tarantino U. Osteosarcopenia and Pain: Do We Have a Way Out? Biomedicines 2023; 11:biomedicines11051285. [PMID: 37238956 DOI: 10.3390/biomedicines11051285] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/21/2023] [Accepted: 04/23/2023] [Indexed: 05/28/2023] Open
Abstract
Osteosarcopenia (OSP) is a geriatric syndrome characterized by the coexistence of osteoporosis and sarcopenia and associated with an increased risk of fragility fractures, disability, and mortality. For patients with this syndrome, musculoskeletal pain represents the most significant challenge since, in addition to limiting the individual's functionality and promoting disability, it has a huge psychological burden involving anxiety, depression, and social withdrawal. Unfortunately, the molecular mechanisms involved in the development and persistence of pain in OSP have not yet been fully elucidated, although immune cells are known to play a key role in these processes. Indeed, they release several molecules that promote persistent inflammation and nociceptive stimulation, resulting in the gating of ion channels responsible for the generation and propagation of the noxious stimulus. The adoption of countermeasures to counteract the OSP progression and reduce the algic component appears to be necessary, providing patients with a better quality of life and greater adherence to treatment. In addition, the development of multimodal therapies, based on an interdisciplinary approach, appears to be crucial, combining the use of anti-osteoporotic drugs with an educational programme, regular physical activity, and proper nutrition to eliminate risk factors. Based on this evidence, we conducted a narrative review using the PubMed and Google Scholar search engines to summarize the current knowledge on the molecular mechanisms involved in the pain development in OSP and the potential countermeasures to be taken. The lack of studies addressing this topic highlights the need to conduct new research into the resolution of an ever-expanding social problem.
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Affiliation(s)
- Roberto Bonanni
- Department of Clinical Sciences and Translational Medicine, "Tor Vergata" University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Sonia Gino Grillo
- Department of Orthopaedics and Traumatology, "Policlinico Tor Vergata" Foundation, Viale Oxford 81, 00133 Rome, Italy
| | - Ida Cariati
- Department of Clinical Sciences and Translational Medicine, "Tor Vergata" University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Lucia Tranquillo
- Department of Orthopaedics and Traumatology, "Policlinico Tor Vergata" Foundation, Viale Oxford 81, 00133 Rome, Italy
| | - Riccardo Iundusi
- Department of Orthopaedics and Traumatology, "Policlinico Tor Vergata" Foundation, Viale Oxford 81, 00133 Rome, Italy
| | - Elena Gasbarra
- Department of Orthopaedics and Traumatology, "Policlinico Tor Vergata" Foundation, Viale Oxford 81, 00133 Rome, Italy
| | - Virginia Tancredi
- Department of Systems Medicine, "Tor Vergata" University of Rome, Via Montpellier 1, 00133 Rome, Italy
- Centre of Space Bio-Medicine, "Tor Vergata" University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Umberto Tarantino
- Department of Clinical Sciences and Translational Medicine, "Tor Vergata" University of Rome, Via Montpellier 1, 00133 Rome, Italy
- Department of Orthopaedics and Traumatology, "Policlinico Tor Vergata" Foundation, Viale Oxford 81, 00133 Rome, Italy
- Centre of Space Bio-Medicine, "Tor Vergata" University of Rome, Via Montpellier 1, 00133 Rome, Italy
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29
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Saracoglu I, Akin E. Reply to "Pain neuroscience education for fibromyalgia syndrome". Int J Rheum Dis 2023. [PMID: 36806658 DOI: 10.1111/1756-185x.14633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 02/11/2023] [Indexed: 02/23/2023]
Affiliation(s)
- Ismail Saracoglu
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Kutahya Health Sciences University, Kutahya, Turkey
| | - Esra Akin
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Kutahya Health Sciences University, Kutahya, Turkey
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30
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Purcell C, Duignan C, Fullen BM, Ryan S, Ward T, Caulfield B. Comprehensive assessment and classification of upper and lower limb pain in athletes: a scoping review. Br J Sports Med 2023; 57:535-542. [PMID: 36759138 DOI: 10.1136/bjsports-2022-106380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Upper and lower limb (peripheral) pain is prevalent in athletes. Contemporary research prioritises multidimensional pain assessment and classification. This study aims to review comprehensive athlete pain assessment practices against the reference standard (International Olympic Committee, IOC Athlete Pain framework), identifying trends and highlighting gaps. METHODS AND ANALYSIS Six databases were searched using a comprehensive search strategy. This review followed the Joanna Briggs Institute standardised methodology for scoping reviews and is reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Title and abstract, full-text screening and data charting were completed by two independent reviewers. INCLUSION CRITERIA Original research, systematic reviews and clinical practice guidelines reporting assessment or classification of pain in athletes of any age with chronic or acute peripheral pain in English on human participants from database inception. RESULTS 470 studies with 175 different pain assessment tools were mapped against the IOC Athlete Pain Framework. Papers included tools from neurophysiological (470/100%), biomechanical (425/90%), affective (103/22%), cognitive (59/13%) and socioenvironmental (182/39%) domains. Pain classification was included in 108 studies (23%). 4 studies (0.85%) defined pain. Athletes with physical disability were included in 13 (3%) studies and no studies included athletes with intellectual disabilities. Socioeconomic factors were addressed in 29 (6%) studies. DISCUSSION Neurophysiological and biomechanical domains are frequently addressed. Affective, socioenvironmental and cognitive tools are under-represented. Potential tools for use by researchers and clinicians are highlighted. Defining and classifying pain and determining predominant pain mechanisms is needed in both research and clinical practice. More work on underrepresented populations is needed. CONCLUSION This review informs researchers and clinicians working with athletes in pain how pain assessment and classification is currently conducted and highlights future priorities.
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Affiliation(s)
- Ciarán Purcell
- School of Public Health, Physiotherapy & Sport Science, University College Dublin, Dublin, Ireland .,Insight SFI Research Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - Ciara Duignan
- School of Public Health, Physiotherapy & Sport Science, University College Dublin, Dublin, Ireland.,Insight SFI Research Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - Brona M Fullen
- School of Public Health, Physiotherapy & Sport Science, University College Dublin, Dublin, Ireland
| | - Shiofra Ryan
- School of Public Health, Physiotherapy & Sport Science, University College Dublin, Dublin, Ireland.,Insight SFI Research Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - Tomas Ward
- Insight Centre for Data Analytics, School of Computing, Dublin City University, Dublin, Ireland
| | - Brian Caulfield
- School of Public Health, Physiotherapy & Sport Science, University College Dublin, Dublin, Ireland.,Insight SFI Research Centre for Data Analytics, University College Dublin, Dublin, Ireland
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31
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Meise R, Carvalho GF, Thiel C, Luedtke K. Additional effects of pain neuroscience education combined with physiotherapy on the headache frequency of adult patients with migraine: A randomized controlled trial. Cephalalgia 2023; 43:3331024221144781. [PMID: 36739510 DOI: 10.1177/03331024221144781] [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: 02/06/2023]
Abstract
Aim To assess the efficacy of pain neuroscience education combined with physiotherapy for the management of migraine.Background Physiotherapy can significantly reduce the frequency of migraine, but the evidence is based only on a few studies. Pain neuroscience education might pose a promising treatment, as it addresses migraine as a chronic pain disease.Methods In this non-blinded randomized controlled trial, migraine patients received physiotherapy + pain neuroscience education or physiotherapy alone, preceded by a three-month waiting period. Primary outcomes were frequency of headache (with and without migraine features), frequency of migraine and associated disability.Results Eighty-two participants were randomized and analyzed. Both groups showed a decrease of headache frequency (p = 0.02, d = 0.46) at post-treatment (physiotherapy: 0.77 days, 95%CI: -0.75 to 2.29 and physiotherapy + pain neuroscience education: 1.25 days, 95%CI: -0.05 to 2.55) and at follow-up (physiotherapy: 1.93, 95%CI: 0.07 to 3.78 and physiotherapy + pain neuroscience education: 3.48 days, 95%CI: 1.89 to 5.06), with no difference between groups (p = 0.26, d = 0.26). Migraine frequency was reduced significantly in the physiotherapy + pain neuroscience education group, and not in the physiotherapy group, at post-treatment (1.28 days, 95%CI: 0.34 to 2.22, p = 0.004) and follow-up (3.05 days, 95%CI: 1.98 to 5.06, p < 0.0001), with a difference between groups at follow-up (2.06 days, p = 0.003). Migraine-related disability decreased significantly in both groups (physiotherapy: 19.8, physiotherapy + pain neuroscience education: 24.0 points, p < 0.001, d = 1.15) at follow-up, with no difference between groups (p = 0.583). Secondary outcomes demonstrated a significant effect of time with no interaction between time and group. No harm or adverse events were observed during the study.Conclusion In comparison to physiotherapy alone, pain neuroscience education combined with physiotherapy can further reduce the frequency of migraine, but had no additional effect on general headache frequency or migraine-related disability.Trial Registration The study was pre-registered at the German Clinical Trials Register (DRKS00020804).
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Affiliation(s)
- Ruth Meise
- Institute of Health Sciences, Department of Physiotherapy, Pain and Exercise Research Luebeck, Universitaet zu Luebeck, Luebeck, Germany
| | - Gabriela Ferreira Carvalho
- Institute of Health Sciences, Department of Physiotherapy, Pain and Exercise Research Luebeck, Universitaet zu Luebeck, Luebeck, Germany
| | - Christian Thiel
- Department of Applied Health Sciences, Hochschule fuer Gesundheit (University of Applied Sciences), Bochum, Germany.,Faculty of Sports Science, Ruhr-University Bochum, Bochum, Germany
| | - Kerstin Luedtke
- Institute of Health Sciences, Department of Physiotherapy, Pain and Exercise Research Luebeck, Universitaet zu Luebeck, Luebeck, Germany
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Li X, Yin X, Feng H, Liao W, Zhao J, Su W, Fan Z, Wu S. Acupoint catgut embedding for chronic non-specific low back pain: A protocol of randomized controlled trial. Front Neurosci 2023; 17:1106051. [PMID: 36816104 PMCID: PMC9929453 DOI: 10.3389/fnins.2023.1106051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 01/09/2023] [Indexed: 02/04/2023] Open
Abstract
Chronic non-specific low back pain (CNLBP) is one of the leading causes of disability worldwide. Acupoint embedding (ACE) is widely used in China for the treatment of chronic non-specific low back pain, but there are no rigorous randomized controlled trials (RCTs) to confirm the effectiveness and safety of ACE for chronic non-specific low back pain. In this study, we design a single-center, single-blind, prospective RCT, with the aim of evaluating the efficacy and safety of ACE for CNLBP. 82 participants with CNLBP will be randomized in a 1:1 ratio into an ACE group and a sham ACE group. Participants will receive either ACE treatment or sham ACE treatment at once every 2 weeks, for an 8-week period, and followed by 6 months of follow-up. The primary outcome will be the change in visual analog scale (VAS) scores before and after treatment. Secondary outcomes will include the Oswestry Disability Index (ODI), the Roland Morris Disability Questionnaire (RMDQ) and the Short Form 36-Health Survey (SF-36). Adverse events that occur during the course of the trial will be recorded. Data will be analyzed according to a predefined statistical analysis plan. This study was approved by the medical ethics committee of Guangzhou Panyu Hospital of Chinese Medicine (202230). Written informed consent from patients is required. This trial is registered in the Chinese Clinical Trial Registry (ChiCTR2200059245). Trial results will be published in a peer-reviewed academic journal. Clinical trial registration https://www.chictr.org.cn, identifier ChiCTR2200059245.
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Affiliation(s)
- Xiaohui Li
- Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiuju Yin
- Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China,The Graduate School, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Haiyan Feng
- The Graduate School, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Wangbin Liao
- The Graduate School, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Jiayou Zhao
- Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wu Su
- Guangzhou Panyu Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zhiyong Fan
- Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China,Zhiyong Fan,
| | - Shan Wu
- Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China,*Correspondence: Shan Wu, ; orcid.org/0000-0002-7155-9464
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Effectiveness of a Primary Care Multidisciplinary Treatment for Patients with Chronic Pain Compared with Treatment as Usual. J Clin Med 2023; 12:jcm12030885. [PMID: 36769533 PMCID: PMC9918146 DOI: 10.3390/jcm12030885] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 01/16/2023] [Accepted: 01/20/2023] [Indexed: 01/24/2023] Open
Abstract
To manage chronic pain, multidisciplinary interventions have been increasingly deployed, mostly in secondary or tertiary care settings. Evidence on the effectiveness of multidisciplinary intervention within primary care is scarce. This study examined the effectiveness of a primary care multidisciplinary treatment for chronic pain compared with treatment as usual (TAU). The intervention consisted of pain neuroscience education and treatment by a GP, psychologist, and physiotherapist. Both groups filled out patient-reported outcome measures at baseline, 6 months, and 12 months. The results indicated there were no statistically significant differences for the primary outcomes of pain intensity, number of pain sites, and health-related quality of life (HR-QoL). There was a statistically significant difference in the secondary outcome perceived health change in favor of the intervention group. None of the other differences were statistically significant. A post-hoc analysis showed that there were statistically significant effects on patients' illness perceptions in favor of the intervention group. Based on the results, the findings do not support effectiveness of a low intensity outpatient multidisciplinary primary care treatment to treat chronic pain compared with TAU. However, as a result of several study limitations, it is considered unwarranted to conclude that multidisciplinary treatment in primary care is not valuable at all.
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McGrath RL, Shephard S, Chen YT. The Need for Transformational Change in Social Justice–Informed Physiotherapy. Physiother Can 2023. [DOI: 10.3138/ptc-2022-0108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Ryan L. McGrath
- From the: School of Allied Health, Exercise and Sport Sciences, Charles Sturt University, Albury, New South Wales, Australia
- Allied Health Education and Research Unit, Goulburn Valley Health, Shepparton, Victoria, Australia
| | - Sophie Shephard
- Vive Pain Rehabilitation, Wagga Wagga, New South Wales, Australia
| | - Yi-Tsung Chen
- Goulburn Valley Area Mental Health Service, Goulburn Valley Health, Shepparton, Victoria, Australia
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Karartı C, Basat HÇ, Özsoy İ, Özyurt F, Özsoy G, Kodak Mİ, Özüdoğru A, Uçar İ. Biopsychosocial Approach in Identifying Risk Factors of Kinesiophobia in Persons with Subacromial Pain Syndrome and Developing a Clinical Prediction Tool. Indian J Orthop 2023; 57:124-136. [PMID: 36660479 PMCID: PMC9789244 DOI: 10.1007/s43465-022-00781-7] [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: 03/22/2022] [Accepted: 11/15/2022] [Indexed: 11/27/2022]
Abstract
Introduction Although the negative effects of kinesiophobia on functional status in subacromial pain syndrome (SAPS) patients are clearly demonstrated, no study examines the risk factors of kinesiophobia in individuals with SAPS from a biopsychosocial perspective. The present study aims to determine the risk factors of kinesiophobia in individuals with SAPS using a biopsychosocial approach. This study also aims to explore the compounding effects of multiple associative risk factors by developing a clinical prediction tool to identify SAPS patients at higher risk for kinesiophobia. Materials and methods This cross-sectional study included 549 patients who were diagnosed with SAPS. The Tampa-Scale of Kinesiophobia (TSK) was used to assess kinesiophobia. Visual analog scale (VAS), The Shoulder Pain and Disability Index (SPADI), Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, the presence of metabolic syndrome, using any non-steroidal anti-inflammatory drugs, Pain Catastrophizing Scale (PCS), Illness Perception Questionnaire-revised (IPQ-R), Hospital Anxiety and Depression Scale (HADS), behavioral pattern of the patient, sociodemographic characteristics, and treatment expectancy were outcome measures. Results Thirteen significant risk factors of having kinesiophobia were: VASat rest (≥ 5.2), VASduring activity (≥ 7.1), DASH (≥ 72.1), presence of metabolic syndrome, PCShelplessness (≥ 16.1), IPQ-Rpersonal control (≤ 17.1), IPQ-Rtreatment control (≤ 16.3), HADSdepression (≥ 7.9), avoidance behavior type, being female, educational level (≤ high school), average hours of sleep (≤ 6.8), and treatment expectancy (≤ 6.6). The presence of seven or more risk factors increased the probability of having high level of kinesiophobia from 34.3 to 51%. Conclusions It seems necessary to address these factors, increase awareness of health practitioners and individuals. Level of evidence Level IV.
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Affiliation(s)
- Caner Karartı
- Department of Physiotherapy and Rehabilitation, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Hakkı Çağdaş Basat
- Department of Orthopedics and Traumatology, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - İsmail Özsoy
- Department of Physiotherapy and Rehabilitation, Selçuk University, Konya, Turkey
| | - Fatih Özyurt
- Department of Physiotherapy and Rehabilitation, Beykent University, Istanbul, Turkey
| | - Gülşah Özsoy
- Department of Physiotherapy and Rehabilitation, Selçuk University, Konya, Turkey
| | - Muhammed İhsan Kodak
- Department of Physiotherapy and Rehabilitation, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Anıl Özüdoğru
- Department of Physiotherapy and Rehabilitation, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - İlyas Uçar
- Department of Anatomy, Erciyes University, Kayseri, Turkey
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Adenis N, Gosselin K, Stetsenko N, Thevenon A. Clarification of the "pain neuroscience education" concept in the management of patients with persistent low back pain: A scoping review. J Back Musculoskelet Rehabil 2023; 36:995-1010. [PMID: 37458022 DOI: 10.3233/bmr-220370] [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: 07/18/2023]
Abstract
BACKGROUND Patient education is a recommended treatment strategy for persistent low back pain (PLBP). Pain neuroscience education (PNE) is an emerging concept with boundaries still unclear. OBJECTIVE To clarify the PNE concept and identify its key characteristics in PLBP management. METHODS A systematic search was conducted using the following databases: Pubmed, ScienceDirect, Google Scholar, Cochrane, and Pedro. INCLUSION CRITERIA publications in English or French on pain neuroscience education and chronic low back pain, educational books cited in white literature. Three reviewers independently selected eligible studies for final inclusion. Numerical analysis and narrative synthesis were carried out from the extracted data. RESULTS From 919 identified publications, 54 were selected. Ten educational resources were added. PNE refers to a theoretical framework, a specific educational intervention, and an overall care approach. It is characterized by the intention to help the patient reconceptualize their PLBP from a tissue injury marker to a protective, neurobiological perspective, and then to increase adherence to biopsychosocial rehabilitation and normalize cognitive-behavioral responses. Pain sciences concepts are presented with an optimization of learning strategies. CONCLUSION PNE stands out from other educational and cognitive behavioral approaches through its objective of changing the pain concept.
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Affiliation(s)
- Nicolas Adenis
- URePSSS University of Lille, Lille, France
- Physiotherapy Practice, Lille, France
| | | | | | - André Thevenon
- URePSSS University of Lille, Lille, France
- Pôle RRSS, Lille, France
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Pontes-Silva A. Fibromyalgia: Are we using the biopsychosocial model? Clin Exp Rheumatol 2023; 22:103235. [PMID: 36414221 DOI: 10.1016/j.autrev.2022.103235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 11/17/2022] [Indexed: 11/21/2022]
Affiliation(s)
- André Pontes-Silva
- Physical Therapy Post-Graduate Program, Physical Therapy Department, Federal University of São Carlos, São Carlos, SP, Brazil.
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Nogueira Carrer HC, Zanca GG, Haik MN. Clinical Assessment of Chronic Musculoskeletal Pain-A Framework Proposal Based on a Narrative Review of the Literature. Diagnostics (Basel) 2022; 13:diagnostics13010062. [PMID: 36611355 PMCID: PMC9818962 DOI: 10.3390/diagnostics13010062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/20/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022] Open
Abstract
The assessment of chronic musculoskeletal pain (CMP) is a challenge shared by several health professionals. Fragmented or incomplete assessment can cause deleterious consequences for the patient's function. The objective of this paper was to propose a framework for clinical assessment of CMP based on the current literature and following the conceptual model of the International Classification of Functioning and Health (ICF). We propose that the ICF rationale may help to guide the processes, acting as a moderator of the clinical assessment, since it changes the perspective used to obtain and interpret findings during anamnesis and physical examination. Additionally, updated specific knowledge about pain, including that of pain domains and mechanisms, along with effective patient-clinician communication may act as a mediator of CMP assessment. We conduct the readers through the steps of the clinical assessment of CMP using both the proposed moderator and mediators and present a clinical example of application. We suggest that the proposed framework may help clinicians to implement a CMP assessment based on the biopsychosocial model using a critical and updated rationale, potentially improving assessment outcomes, i.e., clinical diagnosis.
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Affiliation(s)
- Helen Cristina Nogueira Carrer
- Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos 13565-905, Brazil
- Interdisciplinary Center for Pain Care, Federal University of São Carlos (UFSCar), São Carlos 13565-905, Brazil
| | - Gisele Garcia Zanca
- Interdisciplinary Center for Pain Care, Federal University of São Carlos (UFSCar), São Carlos 13565-905, Brazil
- Department of Physical Therapy and Occupational Therapy, São Paulo State University (UNESP), Marília 17525-900, Brazil
| | - Melina Nevoeiro Haik
- Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos 13565-905, Brazil
- Interdisciplinary Center for Pain Care, Federal University of São Carlos (UFSCar), São Carlos 13565-905, Brazil
- Correspondence: ; Tel.: +55-16-3351-8341
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Igualada-Martinez P, Breslin E, Higgins D, Hainsworth A. Physiotherapy management of anorectal dysfunction. SEMINARS IN COLON AND RECTAL SURGERY 2022. [DOI: 10.1016/j.scrs.2022.100936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Pechincha Ribeiro L, Py Gonçalves Barreto R, Augusto Souza Fernandes R, Rezende Camargo P. What factors contribute to the Scapular Assistance Test result? A classification and regression tree approach. PLoS One 2022; 17:e0276662. [PMID: 36269769 PMCID: PMC9586338 DOI: 10.1371/journal.pone.0276662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 10/11/2022] [Indexed: 11/05/2022] Open
Abstract
The aim of this study was to determine predictive factors related to the Scapular Assistance Test in individuals with shoulder pain during arm elevation, and to analyze how these predictors interact in a nonlinear manner to discriminate the result of a positive and negative Scapular Assistance Test. Eighty-four individuals with shoulder pain with positive (n = 47, average age 38.4 years) and negative (n = 37, average age 37.8 years) Scapular Assistance Test completed the study. Demographic data, affected shoulder, pain duration, pain at rest, angular onset of pain, scapular dyskinesis, serratus anterior and lower trapezius muscle strength, Disabilities of Arm, Shoulder and Hand questionnaire and Pain Catastrophizing Scale were assessed in all participants. The Classification and Regression Tree analysis was used to determine which factors would predict the occurrence of a positive or negative Scapular Assistance Test and possible interactions among them. The resulting tree presented seven levels that combine the following variables: angular onset of pain, presence of scapular dyskinesis, pain catastrophizing, serratus anterior and lower trapezius muscle strength. The angular onset of pain during arm elevation was the main predictor of a positive Scapular Assistance Test selected by the Classification and Regression Tree. This study indicates that the Scapular Assistance Test result may be explained not only by biomechanical variables, but also by psychological factors. Disability of the upper limbs does not seem to contribute to the Scapular Assistance Test result.
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Affiliation(s)
- Larissa Pechincha Ribeiro
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Rodrigo Py Gonçalves Barreto
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, Brazil
| | | | - Paula Rezende Camargo
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, Brazil
- * E-mail:
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Siqueira-Campos VM, Fernandes LJH, de Deus JM, Conde DM. Parenting Styles, Mental Health, and Catastrophizing in Women with Chronic Pelvic Pain: A Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13347. [PMID: 36293927 PMCID: PMC9602934 DOI: 10.3390/ijerph192013347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023]
Abstract
Chronic pelvic pain (CPP) in women is a highly prevalent condition worldwide and requires multimodal treatment. Adverse childhood experiences have been associated with CPP in women, while allodynia and poor outcomes have been linked to pain catastrophizing in these patients. Pain perception has been associated with parenting style during childhood. The objective of this study was to investigate the association between parenting style, pain catastrophizing, anxiety, depression and CPP in women. A case-control study was conducted between May 2018 and August 2021 with 123 women with CPP and 123 pain-free controls. Questionnaires were used to collect participants' data. The association between parenting style and CPP was assessed using multiple logistic regression, with odds ratios (OR) and 95% confidence intervals (CI) being calculated. The correlation between catastrophizing, pain intensity, pain duration, anxiety, depression, and parenting style in women with CPP was assessed using Spearman's rank correlation coefficient (r). A higher frequency of low maternal care (60.7% versus 45.2%; p = 0.026), anxiety (79.7% versus 56.9%; p < 0.001), depression (73.2% versus 56.1%; p = 0.008) and physical violence (31.7% versus 14.6%; p = 0.003) was found in the CPP group compared to the controls. There was no association between parenting style and CPP in the adjusted analysis. A positive correlation was found between catastrophizing and pain intensity (r = 0.342; p < 0.001), anxiety (r = 0.271; p = 0.002), depression (r = 0.272; p = 0.002), and maternal overprotection (r = 0.185; p = 0.046). A negative correlation was found between anxiety and maternal (r = -0.184; p = 0.047) and paternal (r = -0.286; p = 0.006) care and between depression and maternal (r = -0.219; p = 0.018) and paternal (r = -0.234; p = 0.026) care. The present results suggest a significant but weak association of parenting style with pain catastrophizing, the mental health of women with CPP, and the way in which they experience pain.
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Dereli M, Kahraman T, France CR. Cross-Cultural Adaptation and Psychometric Validation of the Turkish Version of Pain Resilience Scale. Eval Health Prof 2022; 46:140-151. [PMID: 36148877 DOI: 10.1177/01632787221127377] [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: 11/17/2022]
Abstract
The Pain Resilience Scale (PRS) is a useful tool that evaluates behavioral engagement and adaptively regulates cognitions and emotions despite the pain. This study aimed to translate the PRS to Turkish and investigate its psychometric properties. The Turkish version of PRS was completed online by 332 healthy adults, and a subset of 105 respondents was re-assessed after 7-14 days. The reliability of the adapted measure was evaluated in terms of internal consistency, relative, and absolute test-retest reliability. Validity was evaluated in terms of structural, construct, and known-group validity using positive and negative psychological scales. The Turkish version of PRS has a three-factor structure and its cumulative variance is 78.06%. The total PRS score and its subscales correlated positively with pain self-efficacy, general resilience, and quality of life, and negatively with pain catastrophizing, kinesiophobia, anxiety, depression, and disability. The PRS scores were significantly higher in those with high general resilience (p < 0.001). The PRS had high internal consistency and test-retest reliability. Standard Error of Measurement (SEM) and Minimum Detectable Difference (MDD) were calculated as 2.9 and 8.0, respectively. The Turkish version of PRS is a reliable and valid instrument for measuring pain resilience in terms of behavioral perseverance and cognitive positivity.
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Affiliation(s)
- Muge Dereli
- Department of Therapy and Rehabilitation, Aydin Vocational School of Health Services, 52943Aydin Adnan Menderes University, Aydin, Turkey.,Department of Physiotherapy and Rehabilitation, Graduate School of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
| | - Turhan Kahraman
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, 226844Izmir Katip Celebi University, Izmir, Turkey
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Moens M, Alliet W, Billot M, De Smedt A, Flamée P, Vanhonacker D, Roulaud M, Rigoard P, Goudman L. Goals, Expectations, and the Definition of Success for Neuromodulation for Pain According to Representatives of Neuromodulation Device Manufacturers. J Pers Med 2022; 12:jpm12091457. [PMID: 36143243 PMCID: PMC9500654 DOI: 10.3390/jpm12091457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/03/2022] [Accepted: 09/04/2022] [Indexed: 11/19/2022] Open
Abstract
Representatives of neuromodulation device manufacturers are expected to facilitate the relationship between patients and healthcare providers. Nevertheless, the goals, expectations, and definition of success for neuromodulation for pain have not yet been explored. Representatives present at the 2nd Joint Congress of the INS European Chapters in September 2021 completed a survey to ascertain their opinions about the goals to achieve with neuromodulation, the factors that they expect to change, and their definition of success for neuromodulation. In total, 39 representatives completed the survey. To provide excellent service for patients (22.4%), to become a trusted partner for physicians (21.5%), and to provide excellent service for physicians (20.7%) were the highest ranked goals. The most frequently reported factors that were expected to change were pain intensity (23.1%), patient satisfaction (19.7%), mobility/functioning (14.5%), and capacity to return to work (13.7%). Within the definitions of success, increased quality of life of the patient was stated in 21% of the definitions, closely followed by pain control (19.3%) and happiness/patient satisfaction (15.8%). The goals of representatives of neuromodulation device manufacturers seem to focus on ensuring a good relationship with physicians on the one hand and providing good service towards patients on the other hand, whereby pain control, quality of life, and patient satisfaction seem to be important for company representatives.
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Affiliation(s)
- Maarten Moens
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
- Department of Radiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
- STIMULUS Consortium (reSearch and TeachIng neuroModULation Uz bruSsel), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - William Alliet
- Department of Anesthesiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Maxime Billot
- PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, 86021 Poitiers, France
| | - Ann De Smedt
- STIMULUS Consortium (reSearch and TeachIng neuroModULation Uz bruSsel), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Department of Physical Medicine and Rehabilitation, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Panagiotis Flamée
- Department of Anesthesiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Domien Vanhonacker
- Department of Anesthesiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Manuel Roulaud
- PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, 86021 Poitiers, France
| | - Philippe Rigoard
- PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, 86021 Poitiers, France
- Department of Spine Surgery & Neuromodulation, Poitiers University Hospital, 86021 Poitiers, France
- Pprime Institute UPR 3346, CNRS, ISAE-ENSMA, University of Poitiers, 86360 Chasseneuil-du-Poitou, France
| | - Lisa Goudman
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
- STIMULUS Consortium (reSearch and TeachIng neuroModULation Uz bruSsel), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Research Foundation—Flanders (FWO), 1090 Brussels, Belgium
- Correspondence: ; Tel.: +32-2477-5514
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Apaydin Cirik V, Bulut E, Aksoy B, Yalçin Cömert HS, Pate JW. The concept of pain inventory for children: The reliability and validity study of the Turkish version. J Pediatr Nurs 2022; 66:111-119. [PMID: 35709634 DOI: 10.1016/j.pedn.2022.05.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND PURPOSE Pain experiences in childhood are very likely to be reflected in adulthood. The early evaluation of the concept of pain in children may eventually lead to. better patient outcomes in the future. Therefore, we aimed to culturally and developmentally adapt the Concept of Pain Inventory for Children (COPI) for Turkish children. METHODS This descriptive, correlational study was conducted with 239 post-operative children aged 8-12 years between June and December 2021. The research adhered to COSMIN guidelines. The data were collected using a descriptive information form and the COPI. Factor analysis, Cronbach's alpha, and item-total score analysis were used for the data analysis. RESULTS The resulting unidimensional scale consists of 12 items in Turkish. The scale explained 65% of the total variance. The exploratory factor analysis showed that the factor loadings of items ranged from 0.64 to 0.91. The confirmatory factor analysis showed that the factor loadings of items ranged from 0.66 to 0.92. Goodness of fit indexes were found to be as follows: Normed Fit Index >0.90; Incremental Fit Index >0.90; Comparative Fit Index >0.90; and the Root Mean Square Error of Approximation <0.08. The total Cronbach's alpha coefficient of the scale was 0.78 (reliable). CONCLUSIONS The 12-item Turkish translation of the COPI was deemed valid and reliable in 8-12-year-old children in a post-operative setting. PRACTICE IMPLICATIONS Evaluation of children's pain concepts during childhood may contribute to the identification of conceptual gaps for pain science education.
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Affiliation(s)
- Vildan Apaydin Cirik
- Karamanoğlu Mehmetbey University, Faculty of Health Sciences, Department of Midwifery, Child Health Nursing, Karaman, Turkey.
| | - Elif Bulut
- Karadeniz Technical University, Faculty of Health Sciences, Child Health Nursing Department, Trabzon, Turkey.
| | - Bahar Aksoy
- Gumushane University, Faculty of Health Sciences, Child Health Nursing Department, Gumushane, Turkey.
| | | | - Joshua W Pate
- Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia.
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Subialka JA, Smith K, Signorino JA, Young JL, Rhon DI, Rentmeester C. What do patients referred to physical therapy for a musculoskeletal condition expect? A qualitative assessment. Musculoskelet Sci Pract 2022; 59:102543. [PMID: 35334352 DOI: 10.1016/j.msksp.2022.102543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/15/2022] [Accepted: 03/03/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Patient expectations related to physical therapy outcomes are commonly collected through surveys and close-ended questionnaires. These methods may not optimally capture patients' expectations for physical therapy, especially in the patients' own words. Louis Gifford identified four questions attempting to guide clinicians' understanding of patients' expectations for physical therapy. However, a qualitative assessment mapping the expectations that patients have prior to starting physical therapy appears to be undocumented. OBJECTIVES The aim of this study was to determine patient expectations prior to beginning physical therapy for individuals with musculoskeletal conditions. DESIGN Qualitative analysis with structured interviews and open-ended participant responses. METHODS Twenty-five people (18 female, 7 male; mean age: 47.04 years) were interviewed prior to their initial physical therapy evaluation using a pragmatic approach rooted in phenomenology. Data were transcribed, coded, and thematized using qualitative data analysis software. RESULTS Outcome, education, exercise, evaluation, and cause of pain were key themes expressed by participants. Participants appear to want to better understand their symptoms, how they can improve symptoms, what the clinician will do, and how long they will attend physical therapy. Many participants were not certain where physical therapy fit within their overall healthcare plan, and perceptions of manual therapy were vague. CONCLUSIONS These identified themes highlight what patients may expect from a physical therapy experience and clinicians should work to identify and satisfy each patient's individual expectations to optimize outcomes.
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Affiliation(s)
- Josh A Subialka
- Bellin College, Doctor of Science in Physical Therapy Program, 3201 Eaton Rd, Green Bay, WI, 54311, USA; Doctor of Physical Therapy Program, College of Health Sciences, Midwestern University, Glendale, AZ, USA.
| | - Kristin Smith
- Bellin College, Doctor of Science in Physical Therapy Program, 3201 Eaton Rd, Green Bay, WI, 54311, USA
| | - Joseph A Signorino
- Bellin College, Doctor of Science in Physical Therapy Program, 3201 Eaton Rd, Green Bay, WI, 54311, USA; Doctor of Physical Therapy Program, Shenandoah University, Winchester, VA, USA
| | - Jodi L Young
- Bellin College, Doctor of Science in Physical Therapy Program, 3201 Eaton Rd, Green Bay, WI, 54311, USA
| | - Daniel I Rhon
- Bellin College, Doctor of Science in Physical Therapy Program, 3201 Eaton Rd, Green Bay, WI, 54311, USA
| | - Casey Rentmeester
- Bellin College, Doctor of Science in Physical Therapy Program, 3201 Eaton Rd, Green Bay, WI, 54311, USA
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Zahid M, Unal E, Özdemir Işık Ö, Oksuz S, Karakaya J, Erguney Cefle A. The reliability, validity, and responsiveness of Cognitive Exercise Therapy Approach-Biopsychosocial Questionnaire for patients with fibromyalgia. Int J Rheum Dis 2022; 25:685-691. [PMID: 35505570 DOI: 10.1111/1756-185x.14325] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/07/2022] [Accepted: 04/17/2022] [Indexed: 01/03/2023]
Abstract
AIM Although the importance of biopsychosocial models for chronic diseases is emphasized nowadays, the lack of assessment tools to meet this need draws attention. This study was planned to assess the validity, reliability, and responsiveness of the Cognitive Exercise Therapy Approach-Biopsychosocial Questionnaire (BETY-BQ) in patients with fibromyalgia. METHOD Hospital Anxiety and Depression Scale (HADS), Mindful Attention Awareness Scale, Health Assessment Questionnaire, the Fibromyalgia Impact Questionnaire, and Short-Form 36 (SF-36) were used for the validity of BETY-BQ. For the reliability study, evaluations were repeated at 1-week intervals and for the responsiveness, the same scales were applied to patients under medical treatment at 3-month intervals. RESULTS The correlations of BETY-BQ with the other scales were found to be moderate to high (respectively r = .591, P < .001 and r = .441, P < .001; r = -.419, P < .001; r = .617, P < .001; r = .722, P < .001; r = -.580 and -.374, P = .001 and P < .001) and with SF-36 sub-parameters were found to be weak-moderate. The test-retest method was used for reliability, and the correlation between the responses was very high (r = .901, P < .001). The intraclass correlation coefficient (ICC) was found to be high (ICC = 0.899, P < .001). Cronbach's alpha (α) value was found to be .947. In the correlation analysis of time-dependent changes, BETY-BQ correlated weakly with other scales and moderately correlated with HADS (HADS-anxiety r = .489, P = .006, HADS-depression r = .500, P = .005). CONCLUSIONS BETY-BQ was presented in the literature as a valid, reliable, and sensitive scale that can be used both in the biopsychosocial evaluation and as an easily understood, practical scale that can be answered in a short time in the practices of healthcare professionals.
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Affiliation(s)
| | - Edibe Unal
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Özlem Özdemir Işık
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Kocaeli University Hospital, Kocaeli, Turkey
| | - Sevim Oksuz
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Eastern Mediterranean University, Famagusta, Turkey
| | - Jale Karakaya
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ayse Erguney Cefle
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Kocaeli University Hospital, Kocaeli, Turkey
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Lou J, Pourkazemi F, Mackenzie L. Exploring the experiences of individuals living with persistent pain using a visual art diary. Br J Occup Ther 2022. [DOI: 10.1177/03080226221079239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Persistent pain significantly impacts daily living. Visual arts interventions can have positive outcomes, but little is known about benefits for people with persistent pain. This study aimed to explore participant experiences of utilising visual art in expressing and managing their persistent pain experience through a visual diary. Method As part of a small exploratory study nested in a larger project, participants with a history of persistent pain were recruited from a local pain management clinic. Six participants with persistent pain attended five weekly intervention sessions involving art observation, creation and discussion, at the Art Gallery of NSW. Participants explored their ideas about their pain experience through artmaking using visual and written data from self-reported pain diaries. Thematic analysis was used. Results Analysis of five diaries was conducted. Visual and written expressions of the pain experience varied. Colour was used by participants to represent ideas and emotions. Capital letters were used to convey tone, or emphasis. Three main themes emerged from the written and visual data: ‘The lived experience of pain’, ‘The powerful drive for growth beyond change itself’ and ‘Personal values and perceptions guiding daily living and decision-making’. Conclusion This study provides insights into the potential benefits of using visual arts to help manage persistent pain experiences and improve health outcomes.
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Affiliation(s)
- Jasmine Lou
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Fereshteh Pourkazemi
- Discipline of Physiotherapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
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Conventional Cervical Exercises Compared with a Mixed-Reality-Based Game in Asymptomatic Subjects: An Exploratory Crossover Pilot Study. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12073657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Mixed reality presents itself as a potential technological tool for the management of people with musculoskeletal disorders, without having as many adverse side effects as immersive virtual reality. The objective of this study was to explore the possibilities of a mixed-reality game, performing task-oriented cervical exercises compared to conventional therapeutic exercises in sensorimotor outcome measures in asymptomatic subjects. A randomized crossover pilot study was performed with two intervention groups: a mixed-reality group (MRG) and a conventional exercise group (CEG). The cervical joint position error test (CJPET) and deep cervical flexor endurance test (DCFET) were measured as sensorimotor outcomes. Statistically significant differences were found in the pre–post comparison in the DCFET for both groups (MRG: t = −3.87, p < 0.01; CEG: t = −4.01, p < 0.01) and in the extension of the CJPET for the MRG (t = 3.50, p < 0.01). The rest of the measurements showed no significant differences comparing both groups pre- and postintervention (p > 0.05). Mixed reality has apparently the same positive effects as conventional exercises in sensorimotor outcomes in asymptomatic subjects. These results could help in future studies with mixed virtual reality in the management of people with musculoskeletal disorders.
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Pomarensky M, Macedo L, Carlesso LC. Management of Chronic Musculoskeletal Pain Through a Biopsychosocial Lens. J Athl Train 2022; 57:312-318. [PMID: 35439311 PMCID: PMC9020600 DOI: 10.4085/1062-6050-0521.20] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Chronic musculoskeletal pain continues to constitute a rising cost and burden on individuals and society on a global level, thus driving the demand for improved management strategies. The biopsychosocial model has long been a recommended approach to help manage chronic pain, with its consideration of the person and his or her experiences, psychosocial context, and societal considerations. However, the biomedical model continues to be the basis of athletic therapy and athletic training programs and therefore clinical practice. For more than 30 years, psychosocial factors have been identified in the literature as outcome predictors relating to chronic pain, including (but not limited to) catastrophizing, fear avoidance, and self-efficacy. Physical assessment strategies such as validated outcome measures can be used by the athletic therapist and athletic trainer to determine the presence or severity (or both) of nonbiogenic pain. Knowledge of these predictors and strategies allows the athletic therapist and athletic trainer to frame the use of exercise (eg, graded exposure), manual therapy, and therapeutic modalities in the appropriate way to improve clinical outcomes. Through changes in educational curricula content, such as those recommended by the International Association for the Study of Pain, athletic therapists and athletic trainers can develop profession-specific knowledge and skills that will enhance their clinical practice and enable them to better assist those living with chronic musculoskeletal pain conditions.
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Medeiros P, Medeiros AC, Coimbra JPC, de Paiva Teixeira LEP, Salgado-Rohner CJ, da Silva JA, Coimbra NC, de Freitas RL. Physical, Emotional, and Social Pain During COVID-19 Pandemic-Related Social Isolation. TRENDS IN PSYCHOLOGY 2022. [PMCID: PMC8886700 DOI: 10.1007/s43076-022-00149-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The socio-emotional condition during the COVID-19 pandemic subsidises the (re)modulation of interactive neural circuits underlying risk assessment behaviour at the physical, emotional, and social levels. Experiences of social isolation, exclusion, or affective loss are generally considered some of the most “painful” things that people endure. The threats of social disconnection are processed by some of the same neural structures that process basic threats to survival. The lack of social connection can be “painful” due to an overlap in the neural circuitry responsible for both physical and emotional pain related to feelings of social rejection. Indeed, many of us go to great lengths to avoid situations that may engender these experiences. Accordingly, this work focuses on pandemic times; the somatisation mentioned above seeks the interconnection and/or interdependence between neural systems related to emotional and cognitive processes such that a person involved in an aversive social environment becomes aware of himself, others, and the threatening situation experienced and takes steps to avoid daily psychological and neuropsychiatric effects. Social distancing during isolation evokes the formation of social distress, increasing the intensity of learned fear that people acquire, consequently enhancing emotional and social pain.
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Affiliation(s)
- Priscila Medeiros
- Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, São Paulo, Ribeirão Preto 14049-900 Brazil
- Laboratory of Neurosciences of Pain & Emotions and Multi-User Centre of Neuroelectrophysiology, Department of Surgery and Anatomy, Ribeirão Preto Medical School of the University of São Paulo, Av. Bandeirantes, 3900, São Paulo, Ribeirão Preto 14049-900 Brazil
| | - Ana Carolina Medeiros
- Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, São Paulo, Ribeirão Preto 14049-900 Brazil
- Laboratory of Neurosciences of Pain & Emotions and Multi-User Centre of Neuroelectrophysiology, Department of Surgery and Anatomy, Ribeirão Preto Medical School of the University of São Paulo, Av. Bandeirantes, 3900, São Paulo, Ribeirão Preto 14049-900 Brazil
- Behavioural Neurosciences Institute (INeC), Av. do Café, 2450, São Paulo, Ribeirão Preto 14050-220 Brazil
| | - Jade Pisssamiglio Cysne Coimbra
- Pontificial Catholic University of Campinas (PUC-Campinas), Prof Dr Euryclides de Jesus Zerbini Str., 1516, Parque Rural Fazenda Santa Cândida, Campinas, São Paulo, 13087-571 Brazil
| | | | - Carlos José Salgado-Rohner
- NeuroSmart Lab, International School of Economics and Administrative Sciences, Universidad de La Sabana, Chia, Colombia
| | - José Aparecido da Silva
- Laboratory of Psychophysics, Perception, Psychometrics, and Pain, Department of Psychology, Ribeirão Preto School of Philosophy, Sciences and Literature of the University of São Paulo (FFCLRP-USP), São Paulo, Ribeirão Preto 14049-901 Brazil
| | - Norberto Cysne Coimbra
- Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, São Paulo, Ribeirão Preto 14049-900 Brazil
- Behavioural Neurosciences Institute (INeC), Av. do Café, 2450, São Paulo, Ribeirão Preto 14050-220 Brazil
| | - Renato Leonardo de Freitas
- Laboratory of Neurosciences of Pain & Emotions and Multi-User Centre of Neuroelectrophysiology, Department of Surgery and Anatomy, Ribeirão Preto Medical School of the University of São Paulo, Av. Bandeirantes, 3900, São Paulo, Ribeirão Preto 14049-900 Brazil
- Behavioural Neurosciences Institute (INeC), Av. do Café, 2450, São Paulo, Ribeirão Preto 14050-220 Brazil
- Biomedical Sciences Institute, Federal University of Alfenas (UNIFAL-MG), Gabriel Monteiro da Silva Str., 700, Alfenas, Minas Gerais 37130-000 Brazil
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