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Chang P, Amaral LJ, Asher A, Clauw D, Jones B, Thompson P, Warner AS. A perspective on a precision approach to pain in cancer; moving beyond opioid therapy. Disabil Rehabil 2024; 46:2174-2183. [PMID: 37194659 DOI: 10.1080/09638288.2023.2212916] [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: 09/11/2022] [Accepted: 05/07/2023] [Indexed: 05/18/2023]
Abstract
PURPOSE Cancer-related pain is primarily treated with opioids which while effective can add significant patient burden due to side effects, associated stigma, and timely access. The purpose of this perspective discussion is to argue for a precision approach to pain in cancer based on a biopsychosocial and spiritual model which we argue can offer a higher quality of life while limiting opioid use. CONCLUSIONS Pain in cancer represents a heterogenous process with multiple contributing and modulating factors. Specific characterization of pain as either nociceptive, neuropathic, nociplastic, or mixed can allow for targeted treatments. Additional assessment of biopsychosocial and spiritual issues can elucidate further points of targeted intervention which can lead to overall greater pain control.
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Affiliation(s)
- Philip Chang
- Philip Chang - Cedars Sinai Medical Center, Los Angeles, CA
| | | | - Arash Asher
- Arash Asher - Cedars Sinai Medical Center, Los Angeles, CA
| | | | - Bronwen Jones
- Bronwen Jones - Cedars Sinai Medical Center, Los Angeles, CA
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Artacho-Cordón F, Salinas-Asensio MDM, Galiano-Castillo N, Ocón-Hernández O, Peinado FM, Mundo-López A, Lozano-Lozano M, Álvarez-Salvago F, Arroyo-Morales M, Fernández-Lao C, Cantarero-Villanueva I. Effect of a Multimodal Supervised Therapeutic Exercise Program on Quality of Life, Pain, and Lumbopelvic Impairments in Women With Endometriosis Unresponsive to Conventional Therapy: A Randomized Controlled Trial. Arch Phys Med Rehabil 2023; 104:1785-1795. [PMID: 37467936 DOI: 10.1016/j.apmr.2023.06.020] [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: 12/29/2022] [Revised: 06/22/2023] [Accepted: 06/29/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of "Physio-EndEA", a multimodal nine-week supervised exercise intervention, on quality of life, pain, and lumbopelvic impairments in women with endometriosis unresponsive to conventional therapy. DESIGN Parallel-group randomized controlled trial. Outcomes were measured at baseline, post-intervention, and at 1 year. SETTING Two Public University Hospitals. PARTICIPANTS This trial included 31 women with endometriosis (N=31) randomly allocated to "Physio-EndEA" group (n=16) or control group (n=15). Four participants dropped out of the study for causes unrelated to the intervention. INTERVENTIONS The "Physio-EndEA" program consisted of a 1-week lumbopelvic stabilization learning phase followed by an 8-week phase of stretching, aerobic, and resistance exercises focused on the lumbopelvic area. It was sequentially instructed and supervised by a trained physiotherapist (with volume and intensity progression) and adapted daily to the potential of each participant. Control group received the usual treatment stipulated by their gynecologist. MAIN OUTCOME MEASURES The primary outcome was quality of life. Secondary outcomes were pain intensity, pressure pain thresholds, pain-related catastrophic thoughts, abdominal and back strength, lumbopelvic stability, and muscle architecture. RESULTS Adherence rate was 90.6% and mean (±standard deviation) satisfaction was 9.44±0.73 out of 10. No remarkable health problems were reported during the trial. In comparison with controls, the quality of life was improved post-intervention and at 1 year in the Physio-EndEA group with large effect sizes (d>0.80). This group also evidenced: a reduced intensity of dyspareunia, catastrophic thoughts; an increase in pelvic, lumbar, and distal pressure pain thresholds; increases in abdominal and back strength and lumbopelvic stability; and increased thickness of transversus abdominis (right side) and width of lumbar multifidus (left side). CONCLUSION A 9-week program of multimodal supervised therapeutic exercise is a feasible and effective intervention to improve QoL in women with endometriosis. This program also offers benefits in terms of pain/sensitization and lumbopelvic impairments.
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Affiliation(s)
- Francisco Artacho-Cordón
- Department of Radiology and Physical Medicine, University of Granada, Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | | | - Noelia Galiano-Castillo
- Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; Department of Physiotherapy, University of Granada. Granada, Spain; Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Olga Ocón-Hernández
- Gynaecology and Obstetrics Unit, "San Cecilio" University Hospital, Granada, Spain
| | | | | | - Mario Lozano-Lozano
- Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; Department of Physiotherapy, University of Granada. Granada, Spain; Sport and Health University Research Institute (iMUDS), Granada, Spain
| | | | - Manuel Arroyo-Morales
- Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; Department of Physiotherapy, University of Granada. Granada, Spain; Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Carolina Fernández-Lao
- Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; Department of Physiotherapy, University of Granada. Granada, Spain; Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Irene Cantarero-Villanueva
- Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; Department of Physiotherapy, University of Granada. Granada, Spain; Sport and Health University Research Institute (iMUDS), Granada, Spain
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Plinsinga ML, Singh B, Rose GL, Clifford B, Bailey TG, Spence RR, Turner J, Coppieters MW, McCarthy AL, Hayes SC. The Effect of Exercise on Pain in People with Cancer: A Systematic Review with Meta-analysis. Sports Med 2023; 53:1737-1752. [PMID: 37213049 PMCID: PMC10432370 DOI: 10.1007/s40279-023-01862-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2023] [Indexed: 05/23/2023]
Abstract
INTRODUCTION Cancer-related pain is common and undertreated. Exercise is known to have a pain-relieving effect in non-cancer pain. OBJECTIVES This systematic review aimed to evaluate (1) the effect of exercise on cancer-related pain in all cancers, and (2) whether the effect of exercise differed according to exercise mode, degree of supervision, intervention duration and timing (during or after cancer treatment), pain types, measurement tool and cancer type. METHODS Electronic searches were undertaken in six databases to identify exercise studies evaluating pain in people with cancer, published prior to 11 January 2023. All stages of screening and data extraction were conducted independently by two authors. The Cochrane risk of bias tool for randomised trials (RoB 2) was used and overall strength of evidence was assessed using the GRADE approach. Meta-analyses were performed overall and by study design, exercise intervention and pain characteristics. RESULTS In total, 71 studies reported in 74 papers were eligible for inclusion. The overall meta-analysis included 5877 participants and showed reductions in pain favouring exercise (standardised mean difference - 0.45; 95% confidence interval - 0.62, - 0.28). For most (> 82%) of the subgroup analyses, the direction of effect favoured exercise compared with usual care, with effect sizes ranging from small to large (median effect size - 0.35; range - 0.03 to - 1.17). The overall strength of evidence for the effect of exercise on cancer-related pain was very low. CONCLUSION The findings provide support that exercise participation does not worsen cancer-related pain and that it may be beneficial. Better pain categorisation and inclusion of more diverse cancer populations in future research would improve understanding of the extent of benefit and to whom. PROSPERO REGISTRATION NUMBER CRD42021266826.
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Affiliation(s)
- Melanie Louise Plinsinga
- School of Health Sciences and Social Work, Menzies Health Institute Queensland, Griffith University, Brisbane and Gold Coast, Australia.
| | - Ben Singh
- Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, Australia
| | - Grace Laura Rose
- School of Nursing, Midwifery and Social Work, The University of Queensland, and Mater Research Institute, Brisbane, Australia
| | - Briana Clifford
- School of Nursing, Midwifery and Social Work, The University of Queensland, and Mater Research Institute, Brisbane, Australia
- School of Health Sciences, University of New South Wales, Sydney, Australia
| | - Tom George Bailey
- School of Nursing, Midwifery and Social Work, The University of Queensland, and Mater Research Institute, Brisbane, Australia
| | - Rosalind Renee Spence
- School of Health Sciences and Social Work, Menzies Health Institute Queensland, Griffith University, Brisbane and Gold Coast, Australia
| | - Jemma Turner
- School of Health Sciences and Social Work, Menzies Health Institute Queensland, Griffith University, Brisbane and Gold Coast, Australia
| | - Michel Willem Coppieters
- School of Health Sciences and Social Work, Menzies Health Institute Queensland, Griffith University, Brisbane and Gold Coast, Australia
- Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences-Musculoskeletal Health Program, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Alexandra Leigh McCarthy
- School of Nursing, Midwifery and Social Work, The University of Queensland, and Mater Research Institute, Brisbane, Australia
| | - Sandra Christine Hayes
- School of Health Sciences and Social Work, Menzies Health Institute Queensland, Griffith University, Brisbane and Gold Coast, Australia
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Fernández-Gualda MÁ, Ariza-Vega P, Lozano-Lozano M, Cantarero-Villanueva I, Martín-Martín L, Castro-Martín E, Arroyo-Morales M, Tovar-Martín I, Lopez-Garzon M, Postigo-Martin P, González-Santos Á, Artacho-Cordón F, Ortiz-Comino L, Galiano-Castillo N, Fernández-Lao C. Persistent pain management in an oncology population through pain neuroscience education, a multimodal program: PaiNEd randomized clinical trial protocol. PLoS One 2023; 18:e0290096. [PMID: 37582097 PMCID: PMC10426993 DOI: 10.1371/journal.pone.0290096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 06/27/2023] [Indexed: 08/17/2023] Open
Abstract
INTRODUCTION Pain is one of the most persistent symptoms after cancer treatment. The central nervous system can erroneously stay in its alarm phase, altering the pain experience of patients who have cancer. Pain neuroscience education (PNE) with multimodal approaches may benefit these patients. OBJECTIVE This protocol aims to determine the effectiveness of a PNE tool on pain, physical function and quality of life, as a supplement to a multimodal rehabilitation (MR) program in patients who had breast cancer (BC). METHODS An 8-week double-blinded randomized controlled trial will be conducted, including 72 participants who had BC and who have persistent pain, randomized into three groups: PNE program + MR program, traditional biomedical information + MR program and control group. The PNE program will include educational content that participants will learn through a mobile app and the MR program will include a concurrent exercise program and manual therapy. The primary outcome will be the perceived pain assessed using the Visual Analogue Scale and secondary outcomes are others related to pain, physical function and quality of life. All outcomes will be evaluated at baseline, at the end of the intervention and 6 months after the end of intervention. DISCUSSION The proposed study may help BC patients with persistent pain improve their pain experience, quality of life and provide for more adaptive pain-coping strategies. This protocol could propose an action guide to implement different integral approaches for the treatment of sequelae. This treatment option could be offered to this patient profile and it could be easily implemented in the healthcare systems due to its low costs. TRIAL REGISTRATION ClinicalTrials.gov, NCT04877860. (February18, 2022).
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Affiliation(s)
- Miguel Ángel Fernández-Gualda
- Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
| | - Patrocinio Ariza-Vega
- Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
- Department of Physical and Sport Education, PA-HELP "Physical Activity for HEaLth Promotion" Research Group, Faculty of Sports Sciences, University of Granada, Granada, Spain
| | - Mario Lozano-Lozano
- Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
| | - Irene Cantarero-Villanueva
- Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
| | - Lydia Martín-Martín
- Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
| | - Eduardo Castro-Martín
- Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
| | - Manuel Arroyo-Morales
- Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
| | - Isabel Tovar-Martín
- Radiation Oncology Department, Virgen de las Nieves University Hospital, Granada, Spain
| | - Maria Lopez-Garzon
- Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
| | - Paula Postigo-Martin
- Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
| | - Ángela González-Santos
- Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
| | - Francisco Artacho-Cordón
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
- Department of Radiology and Physical Medicine, University of Granada, Granada, Spain
| | - Lucía Ortiz-Comino
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
- Health Sciences Faculty (Melilla), University of Granada, Granada, Spain
| | - Noelia Galiano-Castillo
- Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
| | - Carolina Fernández-Lao
- Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
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Cuthbert C, Twomey R, Bansal M, Rana B, Dhruva T, Livingston V, Daun JT, Culos-Reed SN. The role of exercise for pain management in adults living with and beyond cancer: a systematic review and meta-analysis. Support Care Cancer 2023; 31:254. [PMID: 37039883 PMCID: PMC10088810 DOI: 10.1007/s00520-023-07716-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 03/28/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND Pain is a common side effect of cancer or cancer treatment that negatively impacts biopsychosocial wellbeing and quality of life. Exercise is a potential intervention to manage pain that is safe and has multiple benefits. The objective was to determine the role of exercise in cancer pain management. METHODS We completed a systematic review and meta-analysis of exercise interventions in adults with any type or stage of cancer by searching Ovid MEDLINE®, Embase, APA PsycInfo, the Cochrane Central Register of Controlled Trials, CINAHL, and SPORTDiscus. We included experimental and quasi-experimental designs where pain was measured as an outcome. Data synthesis included narrative and tabular summary. A meta-analysis was performed on studies powered to detect the effect of exercise on pain. Study quality was evaluated using the Cochrane risk of bias tool and certainty of evidence was evaluated using the GRADE tool. RESULTS Seventy-six studies were included. Studies were predominantly conducted in breast cancer and exercise usually included a combination of aerobic and strength training. Ten studies were included in the meta-analysis demonstrating a significant effect for exercise in decreasing pain (estimated average standard mean difference (SMD) was g = - 0.73 (95% CI: - 1.16 to - 0.30)); however, the overall effect prediction interval was large. Overall risk of bias for most studies was rated as some concerns and the grading of evidence certainty was low. CONCLUSION There are limitations in the evidence for exercise to manage cancer-related pain. Further research is needed to understand the role of exercise in a multimodal pain management strategy.
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Affiliation(s)
- Colleen Cuthbert
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada.
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | - Rosie Twomey
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Mannat Bansal
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Benny Rana
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Tana Dhruva
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | | | - Julia T Daun
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - S Nicole Culos-Reed
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Alberta Health Services, Calgary, AB, Canada
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6
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Artacho-Cordón F, Lorenzo Hernando E, Pereira Sánchez A, Quintas-Marquès L. Conceptos actuales en dolor y endometriosis: diagnóstico y manejo del dolor pélvico crónico. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2023. [DOI: 10.1016/j.gine.2023.100843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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7
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Song JS, Yamada Y, Kataoka R, Wong V, Spitz RW, Bell ZW, Loenneke JP. Training-induced hypoalgesia and its potential underlying mechanisms. Neurosci Biobehav Rev 2022; 141:104858. [PMID: 36096206 DOI: 10.1016/j.neubiorev.2022.104858] [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: 06/20/2022] [Revised: 08/25/2022] [Accepted: 09/02/2022] [Indexed: 11/25/2022]
Abstract
It is well-established that a single bout of exercise can reduce pain sensitivity (i.e., exercise-induced hypoalgesia) in healthy individuals. However, exercise-induced hypoalgesia is often impaired in individuals with chronic pain. This might suggest that repeated bouts of exercise (i.e., exercise training) are needed in order to induce a reduction in pain sensitivity (i.e., training-induced hypoalgesia) among individuals with chronic pain, given that a single bout of exercise seems to be insufficient to alter pain. However, the effect of repeated bouts of exercise on pain sensitivity and its underlying mechanisms remain poorly understood. Therefore, the purpose of this review was to provide an overview of the existing literature on training-induced hypoalgesia, as well as discuss potential mechanisms of training-induced hypoalgesia and offer considerations for future research. Existing literature suggests that training interventions may induce hypoalgesic adaptations potentially driven by central nervous system and immune system factors. However, the limited number of randomized controlled trials available, along with the lack of understanding of underlying mechanisms, provides a rationale for future research.
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Affiliation(s)
- Jun Seob Song
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, MS, USA
| | - Yujiro Yamada
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, MS, USA
| | - Ryo Kataoka
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, MS, USA
| | - Vickie Wong
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, MS, USA
| | - Robert W Spitz
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, MS, USA
| | - Zachary W Bell
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, MS, USA
| | - Jeremy P Loenneke
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, MS, USA.
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Amirsasan R, Akbarzadeh M, Akbarzadeh S. Exercise and colorectal cancer: prevention and molecular mechanisms. Cancer Cell Int 2022; 22:247. [PMID: 35945569 PMCID: PMC9361674 DOI: 10.1186/s12935-022-02670-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 08/02/2022] [Indexed: 12/16/2022] Open
Abstract
Exercise and physical activity have been shown to be strongly associated with a decreased incidence rate of various chronic diseases especially numerous human malignancies. A huge number of clinical trials and meta-analysis have demonstrated that exercise is significantly effective in lowering the risk of colorectal cancer. In addition, it is suggested as an effective therapeutic modality against this cancer type. Therefore, in this review, we will review comprehensibly the effects of exercise in preventing, treating, and alleviating the adverse effects of conventional therapeutic options in colorectal cancer. Moreover, the possible mechanisms underlying the positive effects of exercise and physical activity in colorectal cancer, including regulation of inflammation, apoptosis, growth factor axis, immunity, epigenetic, etc. will be also discussed. Exercise is an effective post-treatment management program in colorectal cancer survivals Exercise improves muscle strength, cardiorespiratory fitness, emotional distress, physical activity, fatigue, and sleep quality in colorectal patients undergoing chemotherapy Targeting and modulating insulin-like growth factor (IGF) system, inflammation, apoptosis, immunity, epigenetic, Leptin and Ghrelin, and signaling pathways are major underlying mechanisms for preventive effects of exercise in colorectal cancer
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Affiliation(s)
- Ramin Amirsasan
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tabriz, Tabriz, Iran
| | - Maryam Akbarzadeh
- Department of Biology, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
| | - Shabnam Akbarzadeh
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tabriz, Tabriz, Iran.
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9
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del Mar Salinas-Asensio M, Ocón-Hernández O, Mundo-López A, Fernández-Lao C, Peinado FM, Padilla-Vinuesa C, Álvarez-Salvago F, Postigo-Martín P, Lozano-Lozano M, Lara-Ramos A, Arroyo-Morales M, Cantarero-Villanueva I, Artacho-Cordón F. 'Physio-EndEA' Study: A Randomized, Parallel-Group Controlled Trial to Evaluate the Effect of a Supervised and Adapted Therapeutic Exercise Program to Improve Quality of Life in Symptomatic Women Diagnosed with Endometriosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031738. [PMID: 35162761 PMCID: PMC8834829 DOI: 10.3390/ijerph19031738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/18/2022] [Accepted: 01/30/2022] [Indexed: 11/16/2022]
Abstract
Aim: The ‘Physio-EndEA’ study aims to explore the potential benefits of a therapeutic exercise program (focused on lumbopelvic stabilization and tolerance to exertion) on the health-related quality of life (HRQoL) of symptomatic endometriosis women. Design: The present study will use a parallel-group randomized controlled trial design. Methods: A total of 22 symptomatic endometriosis women will be randomized 1:1 to the Physio-EndEA or usual care groups. The ‘Physio-EndEA’ program will consist of a one-week lumbopelvic stabilization learning phase followed by an eight-week phase of stretching, aerobic and resistance exercises focused on the lumbopelvic area that will be sequentially instructed and supervised by a trained physiotherapist (with volume and intensity progression) and adapted daily to the potential of each participant. The primary outcome measure is HRQoL. The secondary outcome measures included clinician-reported outcomes (pressure pain thresholds, muscle thickness and strength, flexibility, body balance and cardiorespiratory fitness) and patient-reported outcomes (pain intensity, physical fitness, chronic fatigue, sexual function, gastrointestinal function and sleep quality). Discussion: Findings of this study will help to identify cost-effective non-pharmacological options (such as this exercise-based intervention) that may contribute to the improvement of HRQoL in symptomatic endometriosis women.
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Affiliation(s)
- María del Mar Salinas-Asensio
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain; (C.F.-L.); (P.P.-M.); (M.L.-L.); (M.A.-M.); (I.C.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
- Correspondence: (M.d.M.S.-A.); (F.A.-C.)
| | - Olga Ocón-Hernández
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- Gynaecology and Obstetrics Unit, ‘San Cecilio’ University Hospital, E-18016 Granada, Spain
| | | | - Carolina Fernández-Lao
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain; (C.F.-L.); (P.P.-M.); (M.L.-L.); (M.A.-M.); (I.C.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
| | - Francisco M. Peinado
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
| | - Carmen Padilla-Vinuesa
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- Gynaecology and Obstetrics Unit, ‘San Cecilio’ University Hospital, E-18016 Granada, Spain
| | | | - Paula Postigo-Martín
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain; (C.F.-L.); (P.P.-M.); (M.L.-L.); (M.A.-M.); (I.C.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
| | - Mario Lozano-Lozano
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain; (C.F.-L.); (P.P.-M.); (M.L.-L.); (M.A.-M.); (I.C.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
| | - Ana Lara-Ramos
- Gynaecology and Obstetrics Unit, ‘Virgen de las Nieves’ University Hospital, E-18012 Granada, Spain;
| | - Manuel Arroyo-Morales
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain; (C.F.-L.); (P.P.-M.); (M.L.-L.); (M.A.-M.); (I.C.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
| | - Irene Cantarero-Villanueva
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain; (C.F.-L.); (P.P.-M.); (M.L.-L.); (M.A.-M.); (I.C.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
| | - Francisco Artacho-Cordón
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
- Department of Radiology and Physical Medicine, University of Granada, E-18016 Granada, Spain
- CIBER Epidemiology and Public Health (CIBERESP), E-28029 Madrid, Spain
- Correspondence: (M.d.M.S.-A.); (F.A.-C.)
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10
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Lopez-Garzon M, Postigo-Martin P, González-Santos Á, Arroyo-Morales M, Achalandabaso-Ochoa A, Férnández-Pérez AM, Cantarero-Villanueva I. Colorectal cancer pain upon diagnosis and after treatment: a cross-sectional comparison with healthy matched controls. Support Care Cancer 2022; 30:3573-3584. [PMID: 35028719 PMCID: PMC8857146 DOI: 10.1007/s00520-022-06803-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 12/31/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND The current study sought to explore whether cancer pain (CP) already exists in patients at colorectal cancer (CRC) diagnosis before treatment compared with patients with colorectal cancer (CRC) after treatment and a healthy matched control group. The study also sought to examine whether factors related to physical health status could enhance pain processes. METHODS An observational cross-sectional study was conducted following the STROBE checklist. Twenty-nine newly diagnosed and forty post-treatment patients with CRC and 40 healthy age/sex-matched controls were included for comparison. Pain, local muscle function, and body composition outcomes were assessed by a physiotherapist with > 3 years of experience. ANCOVA and Kruskal-Wallis tests were performed, with Bonferroni and Dunn-Bonferroni post hoc analyses and Cohen's d and Hedge's effect size, as appropriate. RESULTS The analysis detected lower values of pressure pain threshold (PPT) points, the PPT index, and abdominal strength and higher values of self-reported abdominal pain in newly diagnosed patients, with even more marked results observed in the post-treatment patients, where lower lean mass and skeletal muscle index values were also found than those in the healthy matched controls (p < 0.05). In the post-treatment and healthy matched control groups, positive associations were observed between the PPT lumbar dominant side points and abdominal isometric strength and lean mass, and negative associations were observed between the lumbar dominant side points and body fat (p < 0.05). CONCLUSION Upon diagnosis, patients with CRC already show signs of hyperalgesia and central sensitization and deteriorated physical conditions and body composition, and this state could be aggravated by subsequent treatments.
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Affiliation(s)
- Maria Lopez-Garzon
- 'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria Ibs, University of Granada, Granada, Spain.,Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria Ibs, GRANADA, Granada, Spain
| | - Paula Postigo-Martin
- 'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria Ibs, University of Granada, Granada, Spain. .,Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain. .,Instituto de Investigación Biosanitaria Ibs, GRANADA, Granada, Spain.
| | - Ángela González-Santos
- 'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria Ibs, University of Granada, Granada, Spain.,Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria Ibs, GRANADA, Granada, Spain
| | - Manuel Arroyo-Morales
- 'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria Ibs, University of Granada, Granada, Spain.,Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria Ibs, GRANADA, Granada, Spain.,Unit of Excellence On Exercise and Health (UCEES), University of Granada, Granada, Spain
| | | | | | - Irene Cantarero-Villanueva
- 'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria Ibs, University of Granada, Granada, Spain.,Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria Ibs, GRANADA, Granada, Spain.,Unit of Excellence On Exercise and Health (UCEES), University of Granada, Granada, Spain
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11
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Effect of Physical Therapy Modalities on Quality of Life of Head and Neck Cancer Survivors: A Systematic Review with Meta-Analysis. J Clin Med 2021; 10:jcm10204696. [PMID: 34682818 PMCID: PMC8539984 DOI: 10.3390/jcm10204696] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/05/2021] [Accepted: 10/11/2021] [Indexed: 12/16/2022] Open
Abstract
The objective was to describe the effectiveness of different physical therapy modalities to improve Quality of Life (QoL) in Head and Neck Cancer (HNC) survivors. PubMed, Scopus, Web of Science, CINAHL and Cochrane Library were searched for randomized clinical controlled trials published until 30 April 2020. Risk of bias assessment and meta-analysis were conducted using the Cochrane tools. A total of 251 records were retrieved, and 10 met the inclusion criteria. Interventions whose parameters focus on a 12-week exercise programs of aerobic activity (walking) or Progressive Resistance Training (PRT) for the whole body are effective and safe modalities improving QoL in HNC survivors. Electrophysical agents did not show significant results between groups. As for the assessment of methodological quality, 4 of the 10 articles included had a high risk of overall bias. Only five articles provided sufficient information to conduct a meta-analysis for exercise program intervention on QoL, showing a tendency in favor of intervention group, even when the global results did not show statistically significant improvements (pooled Cohen's d 0.15; 95% CI: -0.25 to 0.54; I2 45.87%; p heterogeneity = 0.10). The present review and meta-analysis identified meaningful benefits of exercise on QoL of HNC survivors; this has been confirmed in a meta-analysis. This review adds evidence supporting exercise interventions on Head and Neck Cancer population whose opportunities for successful recovery after medical treatment are more limited.
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12
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Martin-Perez AJ, Fernández-González M, Postigo-Martin P, Sampedro Pilegaard M, Fernández-Lao C, Castro-Martín E, Martín-Martín L, Lozano-Lozano M. Effectiveness of Antalgic Therapies in Patients with Vertebral Bone Metastasis: A Protocol for a Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083991. [PMID: 33920146 PMCID: PMC8069127 DOI: 10.3390/ijerph18083991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/05/2021] [Accepted: 04/08/2021] [Indexed: 12/02/2022]
Abstract
There is no systematic review that has identified existing studies evaluating the pharmacological and non-pharmacological intervention for pain management in patients with bone metastasis. To fill this gap in the literature, this systematic review with meta-analysis aims to evaluate the effectiveness of different antalgic therapies (pharmacological and non-pharmacological) in the improvement of pain of these patients. To this end, this protocol has been written according to the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) and registered in PROSPERO (CRD42020135762). A systematic search will be carried out in four international databases: Medline (Via PubMed), Web of Science, Cochrane Library and SCOPUS, to select the randomized controlled clinical trials. The Risk of Bias Tool developed by Cochrane will be used to assess the risk of bias and the quality of the identified studies. A narrative synthesis will be used to describe and compare the studies, and after the data extraction, random effects model and a subgroup analyses will be performed according to the type of intervention, if possible. This protocol aims to generate a systematic review that compiles and synthesizes the best and most recent evidence on the treatment of pain derived from vertebral metastasis.
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Affiliation(s)
- Antonio Jose Martin-Perez
- Department of Internal Medicine, San Cecilio University Hospital, Hospital Universitario San Cecilio, 18016 Granada, Spain;
- Clinical Medicine and Public Health Doctoral Studies, University of Granada, 18010 Granada, Spain
| | - María Fernández-González
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18010 Granada, Spain;
| | - Paula Postigo-Martin
- Biohealth Research Institute in Granada (ibs.GRANADA), 18016 Granada, Spain; (P.P.-M.); (C.F.-L.); (E.C.-M.); (M.L.-L.)
- Sport and Health University Research Institute (iMUDS), “Cuídate” Support Unit for Oncology Patients (UAPO-Cuíate), 18010 Granada, Spain
| | - Marc Sampedro Pilegaard
- Occupational Science and Occupational Therapy, The Research Unit for User Perspectives and Community-Based Interventions, Department of Public Health, University of Southern Denmark, 5230 Odense, Denmark;
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, 5000 Odense, Denmark
| | - Carolina Fernández-Lao
- Biohealth Research Institute in Granada (ibs.GRANADA), 18016 Granada, Spain; (P.P.-M.); (C.F.-L.); (E.C.-M.); (M.L.-L.)
- Sport and Health University Research Institute (iMUDS), “Cuídate” Support Unit for Oncology Patients (UAPO-Cuíate), 18010 Granada, Spain
| | - Eduardo Castro-Martín
- Biohealth Research Institute in Granada (ibs.GRANADA), 18016 Granada, Spain; (P.P.-M.); (C.F.-L.); (E.C.-M.); (M.L.-L.)
- Sport and Health University Research Institute (iMUDS), “Cuídate” Support Unit for Oncology Patients (UAPO-Cuíate), 18010 Granada, Spain
| | - Lydia Martín-Martín
- Biohealth Research Institute in Granada (ibs.GRANADA), 18016 Granada, Spain; (P.P.-M.); (C.F.-L.); (E.C.-M.); (M.L.-L.)
- Sport and Health University Research Institute (iMUDS), “Cuídate” Support Unit for Oncology Patients (UAPO-Cuíate), 18010 Granada, Spain
- Correspondence: ; Tel.: +34-958249004
| | - Mario Lozano-Lozano
- Biohealth Research Institute in Granada (ibs.GRANADA), 18016 Granada, Spain; (P.P.-M.); (C.F.-L.); (E.C.-M.); (M.L.-L.)
- Sport and Health University Research Institute (iMUDS), “Cuídate” Support Unit for Oncology Patients (UAPO-Cuíate), 18010 Granada, Spain
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13
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Lozano-Lozano M, Martín-Martín L, Galiano-Castillo N, Fernández-Lao C, Cantarero-Villanueva I, López-Barajas IB, Arroyo-Morales M. Mobile health and supervised rehabilitation versus mobile health alone in breast cancer survivors: Randomized controlled trial. Ann Phys Rehabil Med 2019; 63:316-324. [PMID: 31454561 DOI: 10.1016/j.rehab.2019.07.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/29/2019] [Accepted: 07/29/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Survival rates in cancer are increasing exponentially, with a corresponding increase/influence in disability-adjusted life-years. Efforts should be made to explore the optimal balance between unsupervised/distance-based and supervised/onsite approaches to cancer care. OBJECTIVE This study aimed to compare the clinical efficacy of the BENECA mobile Health (mHealth) lifestyle application combined with a supervised rehabilitation program (BENECA and supervised rehabilitation) versus the BENECA mHealth lifestyle application alone on quality of life (QoL) and functional outcomes of breast cancer survivors. METHODS This randomized controlled trial included 80 survivors of breast cancer diagnosed at stage I-IIIA, who completed adjuvant therapy and were overweight or obese at diagnosis. Participants were randomly allocated (ratio 1:1, 3 waves) to BENECA mHealth and rehabilitation for 2months (n=40) or BENECA mHealth and usual care (BENECA mHealth alone; n=40). Participants completed a questionnaire at baseline (T1), 8-weeks post-intervention (T2) and 6-month follow-up (T3). The primary outcome was QoL assessed with the EORT QLQ-C30. Secondary outcomes included upper-limb functionality and body composition. Statistical (between-group analyses of covariance) and clinical effects were analyzed by intention to treat. RESULTS Both groups showed improved outcomes, but global QoL was significantly better with BENECA mHealth and rehabilitation than BENECA mHealth alone (mean difference, 12.76; 95% confidence interval 4.85; 20.67; P=0.004), with a moderate-to-large effect size (d=72). The proportion of participants reporting reliable clinical improvement on global QoL at T2 was higher with BENECA mHealth and rehabilitation than BENECA mHealth alone (57.5% vs 26.3%, P=0.008). Improvement in subjective and objective upper-limb functionality was also higher with BENECA mHealth and rehabilitation. CONCLUSIONS The BENECA mHealth lifestyle application with a supervised rehabilitation program had a statistically and clinically significant effect on QoL and upper-limb functionality in breast cancer survivors and is a unique and important promising new approach.
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Affiliation(s)
- Mario Lozano-Lozano
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain
| | - Lydia Martín-Martín
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain
| | - Noelia Galiano-Castillo
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain.
| | - Carolina Fernández-Lao
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain
| | - Irene Cantarero-Villanueva
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain
| | | | - Manuel Arroyo-Morales
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain
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Gulati A. Precision Pain Medicine: Can We Deliver Targeted Pain Therapies for the Oncologic Patient in the 21st Century? PAIN MEDICINE 2019; 18:1207-1208. [PMID: 28431079 DOI: 10.1093/pm/pnx082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Amitabh Gulati
- Weill Cornell Pain Medicine Fellowship, Department of Anesthesia and Critical Care, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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15
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Acupuncture for Back Pain in Colon Cancer: A Case Report. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2017. [DOI: 10.5812/ijcm.15087] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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