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Ramírez Medina CR, Feng M, Huang YT, Jenkins DA, Jani M. Machine learning identifies risk factors associated with long-term opioid use in fibromyalgia patients newly initiated on an opioid. RMD Open 2024; 10:e004232. [PMID: 38772680 PMCID: PMC11308899 DOI: 10.1136/rmdopen-2024-004232] [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: 02/16/2024] [Accepted: 04/29/2024] [Indexed: 05/23/2024] Open
Abstract
OBJECTIVES Fibromyalgia is frequently treated with opioids due to limited therapeutic options. Long-term opioid use is associated with several adverse outcomes. Identifying factors associated with long-term opioid use is the first step in developing targeted interventions. The aim of this study was to evaluate risk factors in fibromyalgia patients newly initiated on opioids using machine learning. METHODS A retrospective cohort study was conducted using a nationally representative primary care dataset from the UK, from the Clinical Research Practice Datalink. Fibromyalgia patients without prior cancer who were new opioid users were included. Logistic regression, a random forest model and Boruta feature selection were used to identify risk factors related to long-term opioid use. Adjusted ORs (aORs) and feature importance scores were calculated to gauge the strength of these associations. RESULTS In this study, 28 552 fibromyalgia patients initiating opioids were identified of which 7369 patients (26%) had long-term opioid use. High initial opioid dose (aOR: 31.96, mean decrease accuracy (MDA) 135), history of self-harm (aOR: 2.01, MDA 44), obesity (aOR: 2.43, MDA 36), high deprivation (aOR: 2.00, MDA 31) and substance use disorder (aOR: 2.08, MDA 25) were the factors most strongly associated with long-term use. CONCLUSIONS High dose of initial opioid prescription, a history of self-harm, obesity, high deprivation, substance use disorder and age were associated with long-term opioid use. This study underscores the importance of recognising these individual risk factors in fibromyalgia patients to better navigate the complexities of opioid use and facilitate patient-centred care.
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Affiliation(s)
- Carlos Raúl Ramírez Medina
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, The University of Manchester, Manchester, UK
| | - Mengyu Feng
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, The University of Manchester, Manchester, UK
| | - Yun-Ting Huang
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, The University of Manchester, Manchester, UK
| | - David A Jenkins
- Division of Informatics, Imaging and Data Science, The University of Manchester, Manchester, UK
| | - Meghna Jani
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, The University of Manchester, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Department of Rheumatology, Salford Royal Hospital, Northern Care Alliance, Salford, UK
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Baldi S, Pagliai G, Dinu M, Di Gloria L, Nannini G, Curini L, Pallecchi M, Russo E, Niccolai E, Danza G, Benedettelli S, Ballerini G, Colombini B, Bartolucci G, Ramazzotti M, Sofi F, Amedei A. Effect of ancient Khorasan wheat on gut microbiota, inflammation, and short-chain fatty acid production in patients with fibromyalgia. World J Gastroenterol 2022; 28:1965-1980. [PMID: 35664958 PMCID: PMC9150053 DOI: 10.3748/wjg.v28.i18.1965] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/19/2022] [Accepted: 03/27/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Fibromyalgia (FM) syndrome is mainly characterized by widespread pain, sleeping disorders, fatigue, and cognitive dysfunction. In many cases, gastrointestinal distress is also reported, suggesting the potential pathogenic role of the gut microbiota (GM). The GM is deeply influenced by several environmental factors, especially the diet, and recent findings highlighted significant symptom improvement in FM patients following various nutritional interventions such as vegetarian diet, low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyols based diets, gluten-free diet, and especially an ancient grain supplementation. In particular, a recent study reported that a replacement diet with ancient Khorasan wheat led to an overall improvement in symptom severity of FM patients.
AIM To examine the effects of ancient Khorasan wheat on the GM, inflammation, and short-chain fatty acid production in FM patients.
METHODS After a 2-wk run-in period, 20 FM patients were enrolled in this randomized, double-blind crossover trial. In detail, they were assigned to consume either Khorasan or control wheat products for 8 wk and then, following an 8-wk washout period, crossed. Before and after treatments, GM characterization was performed by 16S rRNA sequencing while the fecal molecular inflammatory response and the short-chain fatty acids (SCFAs) were respectively determined with the Luminex MAGPIX detection system and a mass chromatography-mass spectrometry method.
RESULTS The Khorasan wheat replacement diet, in comparison with the control wheat diet, had more positive effects on intestinal microbiota composition and on both the fecal immune and SCFAs profiles such as the significant increase of butyric acid levels (P = 0.054), candidatus Saccharibacteria (P = 9.95e-06) and Actinobacteria, and the reduction of Enterococcaceae (P = 4.97e-04). Moreover, the improvement of various FM symptoms along with the variation of some gut bacteria after the Khorasan wheat diet have been documented; in fact we reported positive correlations between Actinobacteria and both Tiredness Symptoms Scale (P < 0.001) and Functional Outcome of Sleep Questionnaire (P < 0.05) scores, between Verrucomicrobiae and both Widespread Pain Index (WPI) + Symptom Severity scale (SS) (P < 0.05) and WPI (P < 0.05) scores, between candidatus Saccharibacteria and SS score (P < 0.05), and between Bacteroidales and Sleep-Related and Safety Behaviour Questionnaire score (P < 0.05).
CONCLUSION The replacement diet based on ancient Khorasan wheat results in beneficial GM compositional and functional modifications that positively correlate with an improvement of FM symptomatology.
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Affiliation(s)
- Simone Baldi
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy
| | - Giuditta Pagliai
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy
- Unit of Clinical Nutrition, Careggi University Hospital, Florence 50134, Italy
| | - Monica Dinu
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy
- Unit of Clinical Nutrition, Careggi University Hospital, Florence 50134, Italy
| | - Leandro Di Gloria
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy
| | - Giulia Nannini
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy
| | - Lavinia Curini
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy
| | - Marco Pallecchi
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmaceutical and Nutraceutical Sciences, University of Florence, Sesto Fiorentino 50019, Italy
| | - Edda Russo
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy
| | - Elena Niccolai
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy
| | - Giovanna Danza
- Department of Biomedical, Experimental and Clinical Sciences “Mario Serio”, University of Florence, Florence 50134, Italy
| | - Stefano Benedettelli
- Department of Agriculture, Food, Environment and Forestry, University of Florence, Florence 50144, Italy
| | - Giovanna Ballerini
- Multidisciplinary Center for Pain Therapy, Reference Center for Fibromyalgia, Piero Palagi Hospital, USL Toscana Centro, Florence 50122, Italy
| | - Barbara Colombini
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy
| | - Gianluca Bartolucci
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmaceutical and Nutraceutical Sciences, University of Florence, Sesto Fiorentino 50019, Italy
| | - Matteo Ramazzotti
- Department of Biomedical, Experimental and Clinical Sciences “Mario Serio”, University of Florence, Florence 50134, Italy
| | - Francesco Sofi
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy
- Unit of Clinical Nutrition, Careggi University Hospital, Florence 50134, Italy
| | - Amedeo Amedei
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy
- SOD of Interdisciplinary Internal Medicine, Careggi University Hospital, Florence 50134, Italy
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3
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Cardenas-Rojas A, Castelo-Branco L, Pacheco-Barrios K, Shaikh ES, Uygur-Kucukseymen E, Giannoni-Luza S, Vasconcelos Felippe L, Gonzalez-Mego P, Luna-Cuadros MA, Gianlorenco ACL, Teixeira PE, Caumo W, Fregni F. Recruitment characteristics and non-adherence associated factors of fibromyalgia patients in a randomized clinical trial: A retrospective survival analysis. Contemp Clin Trials Commun 2021; 24:100860. [PMID: 34849424 PMCID: PMC8609141 DOI: 10.1016/j.conctc.2021.100860] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 10/08/2021] [Accepted: 11/09/2021] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Fibromyalgia is a complex pain condition that affects mostly women. Given the disease's lack of understanding, patients report poor adherence to medication and mistrust of medical services. This study aims to describe the recruitment characteristics and non-adherence associated factors of fibromyalgia patients to an RCT. METHODS We performed a retrospective longitudinal analysis with data from our ongoing RCT. We investigated characteristics of subjects recruited, consented, and randomized. Adherence was studied using survival analysis techniques, and its associated factors were identified using Cox proportional hazards regression model. RESULTS 524 subjects were contacted, 269 were eligible, 61 consented and 40 subjects were randomized. Thirty-eight percent were non-adherent to the protocol with a median of visits of five. The recruitment survey reported that 90% would likely participate in RCTs, 52% had previous participation, and 19% were aware of RCTs by their physicians. Some barriers were investigator-related (staff's friendliness and receiving the results of their trial participation) and center-related (privacy-confidentiality issues and the institution's reputation), without difference between adherent and non-adherent participants. We report significant factors for non-adherence as VAS anxiety score of 5 or more (5.3 HR, p = 0.01), Body Mass Index (BMI) (0.91 HR, p = 0.041) and Quality of Life (QoL) - Personal development subdomain (0.89 HR, p = 0.046). CONCLUSION Recruitment and adherence of fibromyalgia patients is a challenge; however, they seem eager to participate in RCTs. We recommend creating a comfortable, friendly and trusting environment to increase the recruitment rate. Higher anxiety, lower BMI and lower quality of life were associated with a higher attrition rate.
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Affiliation(s)
- Alejandra Cardenas-Rojas
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Luis Castelo-Branco
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Kevin Pacheco-Barrios
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru
| | - Emad Salman Shaikh
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Elif Uygur-Kucukseymen
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Stefano Giannoni-Luza
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Luna Vasconcelos Felippe
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Paola Gonzalez-Mego
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Maria Alejandra Luna-Cuadros
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Anna Carolyna Lepesteur Gianlorenco
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Physical Therapy, Federal University of Sao Carlos, Brazil
| | - Paulo E.P. Teixeira
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- MGH Institute of Health Professions, USA
| | - Wolnei Caumo
- Pain and Palliative Care Service at Clinical Hospital of Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Brazil
| | - Felipe Fregni
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Atzeni F, Alciati A, Salaffi F, Di Carlo M, Bazzichi L, Govoni M, Biasi G, Di Franco M, Mozzani F, Gremese E, Dagna L, Batticciotto A, Fischetti F, Giacomelli R, Guiducci S, Guggino G, Bentivegna M, Gerli R, Salvarani C, Bajocchi G, Ghini M, Iannone F, Giorgi V, Farah S, Bonazza S, Barbagli S, Gioia C, Marino NG, Capacci A, Cavalli G, Cappelli A, Carubbi F, Nacci F, Riccucci I, Cutolo M, Sinigaglia L, Sarzi-Puttini P. The association between body mass index and fibromyalgia severity: data from a cross-sectional survey of 2339 patients. Rheumatol Adv Pract 2021; 5:rkab015. [PMID: 34345760 PMCID: PMC8324026 DOI: 10.1093/rap/rkab015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 02/11/2021] [Indexed: 12/19/2022] Open
Abstract
Objective Various studies have shown that overweight and obesity are central features of FM, but the real impact of a high BMI on clinical severity in patients with FM is still controversial. The aim of this study was to analyse the relationships between BMI categories and measures of symptom severity and functional impairment using data from a Web-based registry of patients with FM. Methods Adult patients with an ACR 2010/2011 diagnosis of FM underwent a complete physical examination and laboratory tests and were asked to complete a package of questionnaires covering their sociodemographic and treatment details, in addition to the following disease-specific questionnaires: the revised Fibromyalgia Impact Questionnaire (FIQR), the modified Fibromyalgia Assessment Status questionnaire (ModFAS) and the Polysymptomatic Distress Scale (PDS). Results A total of 2339 patients were recruited and divided into two weight categories, underweight/normal (U/N, n = 1127, 48.2%) and overweight/obese (O/O, n = 1212, 51.8%). The total and subscales of FIQR, ModFAS and PSD scores were significantly higher in the O/O patients, as were all the mean scores of the individual FIQR items (P < 0.001 for all). Conclusion Our findings demonstrate that O/O patients with FM are significantly more impaired than U/N patients in all the symptomatological and functional domains as measured using the FIQR, ModFAS and PDS, thus suggesting that being O/O has an additional effect on symptoms and function.
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Affiliation(s)
- Fabiola Atzeni
- Rheumatology Unit, Department of Internal Medicine, University of Messina, Messina
| | - Alessandra Alciati
- Department of Clinical Neurosciences, Hermanas Hospitalarias, Villa San Benedetto Menni Hospital, Albese con Cassano, Humanitas Clinical and Research Center, Como, Milan, Rozzano
| | - Fausto Salaffi
- Rheumatology Clinic, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Jesi, Ancona
| | - Marco Di Carlo
- Rheumatology Clinic, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Jesi, Ancona
| | | | - Marcello Govoni
- Rheumatology, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliera-Universitaria S. Anna di Ferrara
| | - Giovanni Biasi
- Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena
| | - Manuela Di Franco
- Rheumatology Unit, Department of Internal Medicine, Anesthesiological and Cardiovascular Sciences, Policlinico Umberto I, Sapienza University of Rome
| | - Flavio Mozzani
- Internal Medicine and Rheumatology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma
| | - Elisa Gremese
- Rheumatology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome
| | - Lorenzo Dagna
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan
| | | | - Fabio Fischetti
- Unit of Rheumatology, Department of Medical, Surgery and Health Sciences, ASUGI and Clinical University, University of Trieste
| | - Roberto Giacomelli
- Clinical Unit of Rheumatology, School of Medicine, University of L'Aquila
| | - Serena Guiducci
- Division of Rheumatology AOUC, Department of Experimental and Clinical Medicine, University of Florence, Florence
| | - Giuliana Guggino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo
| | - Mario Bentivegna
- Integrated Reference Center of Rheumatology, Scicli Hospital, Ragusa
| | - Roberto Gerli
- Rheumatology Unit, Department of Medicine, University of Perugia, Perugia
| | - Carlo Salvarani
- University of Modena and Reggio Emilia, Azienda USL-IRCCS di Reggio Emilia
| | - Gianluigi Bajocchi
- Rheumatology Unit, S. Maria Hospital-USL, IRCCS Institute, Reggio Emilia
| | | | - Florenzo Iannone
- Rheumatology Unit, Department of Emergency Surgery and Organ Transplantations, University of Bari, Bari
| | - Valeria Giorgi
- Rheumatology Unit, Internal Medicine Department, ASST Fatebenefratelli-Sacco, Milan University School of Medicine, Milan
| | - Sonia Farah
- Rheumatology Clinic, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Jesi, Ancona
| | - Sara Bonazza
- Rheumatology, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliera-Universitaria S. Anna di Ferrara
| | - Stefano Barbagli
- Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena
| | - Chiara Gioia
- Rheumatology Unit, Department of Internal Medicine, Anesthesiological and Cardiovascular Sciences, Policlinico Umberto I, Sapienza University of Rome
| | - Noemi Giuliana Marino
- Internal Medicine and Rheumatology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma
| | - Annunziata Capacci
- Rheumatology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome
| | - Giulio Cavalli
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan
| | - Antonella Cappelli
- Rheumatology Unit, Internal Medicine Department, ASST Settelaghi, Varese
| | - Francesco Carubbi
- Clinical Unit of Rheumatology, School of Medicine, University of L'Aquila
| | - Francesca Nacci
- Division of Rheumatology AOUC, Department of Experimental and Clinical Medicine, University of Florence, Florence
| | - Ilenia Riccucci
- Rheumatology Unit, Department of Medicine, University of Perugia, Perugia
| | - Maurizio Cutolo
- Research Laboratory and Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, IRCCS San Martino, Genova
| | | | - Piercarlo Sarzi-Puttini
- Rheumatology Unit, Internal Medicine Department, ASST Fatebenefratelli-Sacco, Milan University School of Medicine, Milan
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Nijs J, Wijma AJ, Willaert W, Huysmans E, Mintken P, Smeets R, Goossens M, van Wilgen CP, Van Bogaert W, Louw A, Cleland J, Donaldson M. Integrating Motivational Interviewing in Pain Neuroscience Education for People With Chronic Pain: A Practical Guide for Clinicians. Phys Ther 2020; 100:846-859. [PMID: 31995191 DOI: 10.1093/ptj/pzaa021] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 07/07/2019] [Accepted: 10/06/2019] [Indexed: 12/28/2022]
Abstract
Pain neuroscience education (PNE) and motivational interviewing (MI) have been widely implemented and tested in the field of chronic pain management, and both strategies have been shown to be effective in the short term (small effect sizes) for the management of chronic pain. PNE uses contemporary pain science to educate patients about the biopsychosocial nature of the chronicity of their pain experience. The goal of PNE is to optimize patients' pain beliefs/perceptions to facilitate the acquisition of adaptive pain-coping strategies. MI, on the other hand, is a patient-centered communication style for eliciting and enhancing motivation for behavior change by shifting the patient away from a state of indecision or uncertainty. Conceptually, PNE and MI appear to be complementary interventions, with complementary rather than overlapping effects; MI primarily improves cognitive and behavioral awareness and, potentially, adherence to treatment principles, whereas PNE potentially increases pain knowledge/beliefs, awareness, and willingness to explore psychological factors that are potentially associated with pain. Therefore, combining PNE with MI might lead to improved outcomes with larger and longer-lasting effect sizes. The combined use of PNE and MI in patients having chronic pain is introduced here, along with a description of how clinicians might be able to integrate PNE and MI in the treatment of patients experiencing chronic pain. Clinical trials are needed to examine whether combining PNE with MI is superior to PNE or MI alone for improving pain and quality of life in patients having chronic pain.
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Affiliation(s)
- Jo Nijs
- Department of Physiotherapy, Faculty of Physical Education and Physiotherapy, Pain in Motion International Research Group, Vrije Universiteit Brussel, Building F-KIMA, Laarbeeklaan 103, BE-1090 Brussels, Belgium; and Department of Physical Medicine and Physiotherapy, Chronic Pain Rehabilitation, University Hospital Brussels, Brussels, Belgium
| | - Amarins J Wijma
- Department of Physiotherapy, Faculty of Physical Education and Physiotherapy, Pain in Motion International Research Group, Vrije Universiteit Brussel; Department of Physical Medicine and Physiotherapy, Chronic Pain Rehabilitation, University Hospital Brussels; and Transcare Pain, Transdisciplinary Treatment Center, Groningen, the Netherlands
| | - Ward Willaert
- Department of Physiotherapy, Faculty of Physical Education and Physiotherapy, Pain in Motion International Research Group,Vrije Universiteit Brussel; Department of Physical Medicine and Physiotherapy, Chronic Pain Rehabilitation, University Hospital Brussels; and Research Foundation-Flanders (FWO), Brussels, Belgium
| | - Eva Huysmans
- Department of Physiotherapy, Faculty of Physical Education and Physiotherapy, Pain in Motion International Research Group, Vrije Universiteit Brussel; Department of Physical Medicine and Physiotherapy, Chronic Pain Rehabilitation, University Hospital Brussels; Research Foundation-Flanders (FWO); and Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel
| | - Paul Mintken
- Department of Physical Therapy, School of Medicine, University of Colorado, Aurora, Colorado, and Wardenburg Health Center, University of Colorado, Boulder, Colorado
| | - Rob Smeets
- Research School CAPHRI, Maastricht University, Maastricht, the Netherlands, and CIR Revalidatie Eindhoven/Zwolle, Eindhoven/Zwolle, the Netherlands
| | - Mariëlle Goossens
- Research School CAPHRI, Maastricht University, and CIR Revalidatie Eindhoven/Zwolle
| | - C Paul van Wilgen
- Department of Physiotherapy, Faculty of Physical Education and Physiotherapy, Pain in Motion International Research Group, Vrije Universiteit Brussel; and Transcare Pain, Transdisciplinary Treatment Center
| | - Wouter Van Bogaert
- Department of Physiotherapy, Faculty of Physical Education and Physiotherapy, Pain in Motion International Research Group, Vrije Universiteit Brussel
| | - Adriaan Louw
- Department of Physical Therapy, International Spine and Pain Institute, Louisville, Kentucky
| | - Josh Cleland
- Department of Physical Therapy, Franklin Pierce University, Manchester, New Hampshire
| | - Megan Donaldson
- Physical Therapy Program, School of Medicine, Tufts University, Boston, Massachusetts
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6
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Olson KL, Mensinger JL. Weight-related stigma mediates the relationship between weight status and bodily pain: A conceptual model and call for further research. Body Image 2019; 30:159-164. [PMID: 31362217 PMCID: PMC6918660 DOI: 10.1016/j.bodyim.2019.07.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 07/15/2019] [Accepted: 07/15/2019] [Indexed: 10/26/2022]
Abstract
Women are disproportionately impacted by pain compared to men, highlighting the need to better understand factors that contribute to this gender disparity. Previous findings suggest weight-related stigma may be associated with pain among women attempting to lose weight. The goal of this study is to determine if experienced and/or internalized weight bias mediate the relationship between body mass index (BMI) and pain-related impairment in a large, community-based sample of women across the weight spectrum (N = 309; MAge = 56.5, SD = 14.5; MBMI = 28.5, SD = 7.1), and to evaluate whether this relationship differs for women with a pain condition. Analyses were performed using the Conditional-PROCESS Macro to examine the relationships between BMI, pain-related impairment, internalized and experienced weight-stigma, and the potentially moderating effect of pain-related conditions on these relationships. After adjusting for covariates, both experienced stigma and internalized weight stigma statistically mediated the BMI and pain-related impairment relationship; however, in the tests of moderated mediation, the indirect effect of internalized weight bias only held true for those without pain conditions. These findings offer a preliminary conceptual model and highlight the importance of pain research to include weight-related stigma.
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Affiliation(s)
- KayLoni L. Olson
- Weight Control and Diabetes Research Center, The Miriam Hospital, Providence RI,Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University
| | - Janell L. Mensinger
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia PA
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7
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Bjørklund G, Dadar M, Chirumbolo S, Aaseth J. Fibromyalgia and nutrition: Therapeutic possibilities? Biomed Pharmacother 2018; 103:531-538. [DOI: 10.1016/j.biopha.2018.04.056] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 04/07/2018] [Accepted: 04/09/2018] [Indexed: 12/25/2022] Open
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