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Ramírez-Maestre C, Esteve R, López-Martínez AE, Jensen MP, Miró J, de la Vega R. The Impairment and Functioning Inventory Revised-English version: A validation study in individuals with disabilities and bothersome pain. PM R 2021; 14:818-827. [PMID: 34181318 DOI: 10.1002/pmrj.12659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/14/2021] [Accepted: 06/11/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Despite the relevance of daily function in individuals with chronic pain, few questionnaires have been designed to assess this domain in individuals with musculoskeletal pain. In addition, the Impairment and Functioning Inventory-Revised (IFI-R) is the only instrument that assesses perceived decreases in levels of daily activity after the onset of pain. OBJECTIVE To evaluate the psychometric properties of the English version of the IFI-R. DESIGN Cross-sectional study. SETTING A database of individuals with medical conditions commonly associated with chronic pain maintained by the University of Washington. PATIENTS A total of 470 individuals with chronic pain. METHODS Factorial validity was analyzed by conducting a confirmatory factor analysis via structural equation modeling. Internal consistency was evaluated by calculating Cronbach's α coefficients. Convergent validity was assessed by calculating Pearson correlation coefficients between the two scales of the IFI-R and the Patient Reported Outcome Measurement Information System (PROMIS) Pain Interference Scale. Criterion validity was analyzed by regression analysis via structural equation modeling. MAIN OUTCOME MEASURES The English version of the IFI-R (IFI-R-EV) for individuals with chronic pain. RESULTS The IFI-R-EV consists of 30 items with two related subscales: The Daily Function subscale (α = .86). and the Impairment subscale (α = .89). A significant correlation was found between these subscales and a measure of pain interference (r's = - .33, and .35 respectively; p's < .01). We also found statistically significant associations (p < .05) between daily function and depression (β = -.14) and pain intensity (β = -.13), between impairment and depression (β = .14) and pain intensity (β = .16), and between daily function and pain acceptance (β = .14). CONCLUSIONS The findings indicate that the IFI-R-EV provides valid and reliable measures of daily function and impairment in English-speaking individuals with a disability and chronic pain. These results are consistent with those obtained with the Spanish version.
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Affiliation(s)
- Carmen Ramírez-Maestre
- Faculty of Psychology, Andalucía Tech. Campus de Teatinos, Universidad de Málaga, Málaga, Spain.,Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
| | - Rosa Esteve
- Faculty of Psychology, Andalucía Tech. Campus de Teatinos, Universidad de Málaga, Málaga, Spain.,Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
| | - Alicia E López-Martínez
- Faculty of Psychology, Andalucía Tech. Campus de Teatinos, Universidad de Málaga, Málaga, Spain.,Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Jordi Miró
- Department of Psychology, Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment (CRAMC), Universitat Rovira i Virgili, Catalonia, Spain.,Institut d'Investigació Sanitària Pere Virgili, Catalonia, Spain
| | - Rocío de la Vega
- Faculty of Psychology, Andalucía Tech. Campus de Teatinos, Universidad de Málaga, Málaga, Spain
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Van Meulenbroek T, Huijnen I, Stappers N, Engelbert R, Verbunt J. Generalized joint hypermobility and perceived harmfulness in healthy adolescents; impact on muscle strength, motor performance and physical activity level. Physiother Theory Pract 2020; 37:1438-1447. [PMID: 31908174 DOI: 10.1080/09593985.2019.1709231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objective: The first aim of this study was to determine whether adolescents with asymptomatic Generalized Joint Hypermobility (GJH) have a lower level of physical functioning (physical activity level, muscle strength and performance) compared to non-hypermobile controls. Secondly, to evaluate whether the negative impact of perceived harmfulness on physical functioning was more pronounced in adolescents with asymptomatic GJH.Methods: Cross-sectional study. Sixty-two healthy adolescents (mean age 16.8, range 12-21) participated. Hypermobility (Beighton score), perceived harmfulness (PHODA-youth) and muscle strength (dynamometry), motor performance (Single-Leg-Hop-for-Distance) and physical activity level (PAL) (accelerometry) were measured. Hierarchical regression analyses were used to study differences in physical functioning and perceived harmfulness between asymptomatic GJH and non-hypermobile controls.Results: Asymptomatic GJH was associated with increased knee extensor muscle strength (peak torque/body weight; PT/BW), controlled for age and gender (dominant leg; ß = 0.29; p = .02). No other associations between asymptomatic GJH and muscle strength, motor performance and PAL were found. Perceived harmfulness was not more pronounced in adolescents with asymptomatic GJH.Conclusions: Adolescents with asymptomatic GJH had increased knee extensor muscle strength compared to non-hypermobile controls. No other differences in the level of physical functioning was found and the negative impact of perceived harmfulness was not more pronounced in adolescents with asymptomatic GJH.
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Affiliation(s)
- Thijs Van Meulenbroek
- Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, Netherlands.,Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, Netherlands
| | - Ivan Huijnen
- Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, Netherlands.,Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, Netherlands
| | - Nicole Stappers
- Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, Netherlands
| | - Raoul Engelbert
- ACHIEVE, Center for Applied Research, Faculty of Health, University of Applied Sciences Amsterdam, Amsterdam, Netherlands.,Department of Rehabilitation, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands.,Department of Pediatrics, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Jeanine Verbunt
- Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, Netherlands.,Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, Netherlands
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Verbrugghe J, Agten A, O Eijnde B, Olivieri E, Huybrechts X, Seelen H, Vandenabeele F, Timmermans A. Feasibility of high intensity training in nonspecific chronic low back pain: A clinical trial. J Back Musculoskelet Rehabil 2018. [PMID: 29526840 DOI: 10.3233/bmr-170810] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Although low to moderate intensity exercise therapy is a predominant part of rehabilitation in nonspecific chronic low back pain (NSCLBP), effect sizes are small and optimal exercise modalities/intensities are unclear. Conversely, effects of high intensity training have not yet been investigated in this population. OBJECTIVE The aim of this study is to investigate the feasibility of high intensity training (HIT) and to explore the magnitude of the effects of a HIT program on exercise capacity and disease related outcome measures compared to conventional therapy for persons with NSCLBP. METHODS In this non-randomized controlled feasibility study, treatment satisfaction, adherence, disability, pain, physical activity, body composition, exercise capacity and self-reported motivation, were assessed in persons with NSCLBP, before (PRE) and after (POST) 6 weeks (12 sessions, 1.5 hours/session, 2 x/week) of high intensity cardiovascular (100% VO2Max) and high load resistance (80% 1RM) training (HIT, n= 10) and compared to average intensity/load (60% VO2max) conventional physical therapy (CON, n= 10). RESULTS At PRE, CON and HIT did not differ, except for gender ratio and lean mass. Compared to CON, HIT retained motivation to rehabilitate better (HIT: +3%; CON: -25%) and had higher therapy adherence (+16%) during the study course. No adverse events were noted in both groups. Whereas disability reduced in both groups (HIT: -10.4%; CON: -8.3%), peak workload (+7.0%), time to exhaustion (+9.5%), and activity level (+5.6%) only improved in HIT. CONCLUSIONS High intensity exercise therapy appears to be a feasible rehabilitation approach in NSCLBP. Outcomes improved following the HIT protocol, warranting the investigation of its effectiveness in future large scale RCT studies.
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Affiliation(s)
- Jonas Verbrugghe
- Hasselt University, REVAL - Rehabilitation Research Center, BIOMED, Hasselt, Belgium
| | - Anouk Agten
- Hasselt University, REVAL - Rehabilitation Research Center, BIOMED, Hasselt, Belgium
| | - Bert O Eijnde
- Hasselt University, REVAL - Rehabilitation Research Center, BIOMED, Hasselt, Belgium
| | - Enzo Olivieri
- Department of Rehabilitation and Physical Medicine, Jessa Ziekenhuis, Hasselt, Belgium
| | - Xavier Huybrechts
- Department of Rehabilitation and Physical Medicine, Jessa Ziekenhuis, Hasselt, Belgium
| | - Henk Seelen
- Adelante - Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands
| | - Frank Vandenabeele
- Hasselt University, REVAL - Rehabilitation Research Center, BIOMED, Hasselt, Belgium
| | - Annick Timmermans
- Hasselt University, REVAL - Rehabilitation Research Center, BIOMED, Hasselt, Belgium
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Oliveira CB, Franco MR, Maher CG, Christine Lin CW, Morelhão PK, Araújo AC, Negrão Filho RF, Pinto RZ. Physical Activity Interventions for Increasing Objectively Measured Physical Activity Levels in Patients With Chronic Musculoskeletal Pain: A Systematic Review. Arthritis Care Res (Hoboken) 2017; 68:1832-1842. [PMID: 27111744 DOI: 10.1002/acr.22919] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 03/11/2016] [Accepted: 04/19/2016] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To investigate whether physical activity interventions increase objectively measured physical activity levels of patients with chronic musculoskeletal pain (e.g., osteoarthritis, low back pain) compared to no/minimal intervention. METHODS We performed a systematic review with meta-analysis searching the Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, SportDiscus, and Physiotherapy Evidence Database (PEDro) databases, and the main clinical trials registries. Quasirandomized or randomized controlled trials investigating the effect of physical activity interventions on objectively measured physical activity levels (e.g., using accelerometers or pedometers) of patients with chronic musculoskeletal pain compared with no/minimal intervention were considered eligible. Analyses were conducted separately for short-term (≤3 months), intermediate (>3 months and <12 months), and long-term (≥12 months) followups. Pooled effects were calculated using the standardized mean difference (SMD), and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used in summary conclusions. RESULTS Eight published trials and 6 registered trials were included. For the short-term followup, pooling of 6 trials showed no significant effect (SMD 0.34, 95% confidence interval -0.09, 0.77) between a physical activity intervention and no/minimal intervention. Similarly nonsignificant results were found for the intermediate and long-term followups. The overall evidence according to the GRADE approach was classified as low quality. CONCLUSION Our findings suggest that physical activity-based interventions may lead to little or no difference in objectively measured physical activity levels of patients with chronic musculoskeletal pain compared with no/minimal interventions. Given the number of registered trials, the pooled effect found in this review is likely to change once the results of these trials become available.
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Affiliation(s)
- Crystian B Oliveira
- Faculdade de Ciências e Tecnologia, UNESP, Universidade Estadual Paulista, Presidente Prudente, São Paulo, Brazil
| | - Marcia R Franco
- Faculdade de Ciências e Tecnologia, UNESP, Universidade Estadual Paulista, Presidente Prudente, São Paulo, Brazil
| | - Christopher G Maher
- George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia
| | - Chung-Wei Christine Lin
- George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia
| | - Priscila K Morelhão
- Faculdade de Ciências e Tecnologia, UNESP, Universidade Estadual Paulista, Presidente Prudente, São Paulo, Brazil
| | | | - Ruben F Negrão Filho
- Faculdade de Ciências e Tecnologia, UNESP, Universidade Estadual Paulista, Presidente Prudente, São Paulo, Brazil
| | - Rafael Z Pinto
- Faculdade de Ciências e Tecnologia, UNESP, Universidade Estadual Paulista, Presidente Prudente, São Paulo, Brazil, and George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia
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Adams P, Murnane EL, Elfenbein M, Wethington E, Gay G. Supporting the Self-Management of Chronic Pain Conditions with Tailored Momentary Self-Assessments. PROCEEDINGS OF THE SIGCHI CONFERENCE ON HUMAN FACTORS IN COMPUTING SYSTEMS. CHI CONFERENCE 2017; 2017:1065-1077. [PMID: 30310887 PMCID: PMC6176683 DOI: 10.1145/3025453.3025832] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
To better support the self-management of chronic pain, this paper investigates how those living with the condition prefer to self-assess their pain levels using smartphones. Our work consists of three stages: design ideation and review, an in-lab user study with 10 participants resulting in nine candidate interfaces, and a 3 week field trial of two further honed measures with 12 participants. This research firstly yields a better understanding of participants' strong and sometimes contrasting preferences regarding their self-assessment of pain intensity. We additionally contribute two novel interfaces that support accurate, quick, and repeated use along with other participant-valued interactions (e.g., familiar, relatable, and highly usable). In particular, we focus on designing tailored measures that both enhance respondent motivation as well as minimize the difficulty of meaningful self-assessment by supporting the cog-nitive effort in translating a subjective experience into a single numerical value.
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Affiliation(s)
| | | | | | | | - Geri Gay
- Information Science, Cornell University
- Communication, Cornell University
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Vergauwen K, Huijnen IP, Depuydt A, Van Regenmortel J, Meeus M. Measuring the physical activity level and pattern in daily life in persons with chronic fatigue syndrome/myalgic encephalomyelitis: a systematic review. PHYSICAL THERAPY REVIEWS 2017. [DOI: 10.1080/10833196.2017.1300624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Kuni Vergauwen
- Division of Occupational Therapy, Department of Health and Social Care, Artesis Plantijn University College Antwerp , Antwerp, Belgium
- Faculty of Medicine and Health Sciences, Department of Occupational Therapy, Ghent University , Ghent, Belgium
- Pain in Motion Research Group , Belgium
| | - Ivan P.J. Huijnen
- Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University , Maastricht, The Netherlands
- Adelante Centre of Expertise in Rehabilitation and Audiology , Hoensbroek, The Netherlands
- Department of Rehabilitation Medicine, Academic Hospital Maastricht , Maastricht, The Netherlands
| | - Astrid Depuydt
- Faculty of Medicine and Health Sciences, Department of Occupational Therapy, Ghent University , Ghent, Belgium
| | - Jasmine Van Regenmortel
- Faculty of Medicine and Health Sciences, Department of Occupational Therapy, Ghent University , Ghent, Belgium
| | - Mira Meeus
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, Ghent University , Ghent, Belgium
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp , Antwerp, Belgium
- Pain in Motion Research Group , Belgium
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Change Narratives That Elude Quantification: A Mixed-Methods Analysis of How People with Chronic Pain Perceive Pain Rehabilitation. Pain Res Manag 2017; 2016:9570581. [PMID: 28070161 PMCID: PMC5192338 DOI: 10.1155/2016/9570581] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 10/27/2016] [Indexed: 11/17/2022]
Abstract
Chronic pain negatively impacts health, well-being, and social participation. Effective rehabilitation often hinges on long-term changes in pain-related perceptions and behaviors. However, there are important gaps in understanding how patients perceive these changes. The present pilot study addresses this gap by using qualitative and quantitative methodologies to explore how patients perceive and experience changes in function, participation, and pain-related factors following a chronic pain rehabilitation program. A mixed-method design was used in which the core method was qualitative. Descriptive quantitative data was used to further characterize the sample. Semistructured interviews were conducted 1-6 months following treatment completion. Questionnaires were administered before and after treatment and at follow-up. Interview data was analyzed thematically. Participants' individual descriptive data was compared to established cut-scores and criteria for change. A major theme of personal growth emerged in the qualitative analysis. Participants also discussed the factors that facilitated personal growth and the ongoing challenges to this growth. The quantitative data revealed limited improvement on measures of pain, disability, catastrophizing, and depression. These findings suggest that, despite limited improvement on treatment-related questionnaires, patients can experience an important and enduring sense of personal growth. Clinical and theoretical implications are discussed.
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Andrews NE, Strong J, Meredith PJ, Fleming JA. The relationship between overactivity and opioid use in chronic pain: a 5-day observational study. Pain 2016; 157:466-474. [PMID: 26458090 DOI: 10.1097/j.pain.0000000000000384] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
With increasing concerns about the potential harm of long-term opioid therapy, there is a need for the development and implementation of alternative treatment strategies for patients with chronic pain who have been using opioids for a prolonged period of time. Based on the findings from a recent qualitative investigation that suggested there may be a bidirectional association between opioid reliance and habitual overactivity behaviour (activity engagement that significantly exacerbates pain), this study was designed to quantitatively investigate the association between opioid use and habitual overactivity over a 5-day period in a group of chronic pain patients. Participants provided a list of their prescribed pain medication, completed a self-report measure of habitual overactivity, and then commenced 5 days of data collection. Data collection required participants to wear an activity monitor and to complete a diary that detailed their daily activities and the time at which they took medication. Individuals reporting higher levels of habitual overactivity were more likely to be prescribed opioids. In addition, higher levels of habitual overactivity were associated with more frequent pro re nata ("as needed") opioid use over the 5 days, and with a discrepancy between the prescribed and actual oral morphine-equivalent daily dose, where more medication was taken than was prescribed. There was no predominant context for pro re nata use. The results of this study support the idea that habitual overactivity behaviour may play a role in the development of reliance on opioid medication and that such an association may provide a potential treatment target for opioid therapy rationalisation.
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Affiliation(s)
- Nicole Emma Andrews
- Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Queensland, Australia Department of Occupational Therapy, The Royal Brisbane and Women's Hospital, Queensland, Australia The Professor Tess Cramond Multidisciplinary Pain Centre, The Royal Brisbane and Women's Hospital, Queensland, Australia
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Differences in the course of daily activity level between persons with and without chronic pain. Am J Phys Med Rehabil 2015; 94:101-9; quiz 110-3. [PMID: 25299522 DOI: 10.1097/phm.0000000000000206] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to determine differences in (the course of) daily activity level between persons with and persons without chronic pain. DESIGN A total of 18 participants with chronic pain and 19 age-matched healthy controls wore an accelerometer for 7 days, of which two weekdays were taken for analysis. Average movement intensity, peak movement intensity, and postures were compared between the persons with and persons without chronic pain over the day. The course of daily activities was analyzed by comparing the activity in the morning, afternoon, and evening. RESULTS The participants with chronic pain spent significantly more time in lying and less time in sitting and standing. Total step count showed a trend (P = 0.07) to be lower in participants with chronic pain. Participants with chronic pain showed lower average movement intensity and peak movement intensity (P < 0.01) over the whole day. No differences were found in the course of daily activity between the two groups in both average movement intensity and peak movement intensity. CONCLUSIONS Persons with and persons without chronic pain differed in daily activity level with regard to average movement intensity, peak movement intensity, and postures. No differences were found in the course of daily activity between the two groups.
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Paraschiv-Ionescu A, Buchser E, Aminian K. Unraveling dynamics of human physical activity patterns in chronic pain conditions. Sci Rep 2014; 3:2019. [PMID: 23779003 PMCID: PMC6504837 DOI: 10.1038/srep02019] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Accepted: 05/30/2013] [Indexed: 11/12/2022] Open
Abstract
Chronic pain is a complex disabling experience that negatively affects the cognitive, affective and physical functions as well as behavior. Although the interaction between chronic pain and physical functioning is a well-accepted paradigm in clinical research, the understanding of how pain affects individuals' daily life behavior remains a challenging task. Here we develop a methodological framework allowing to objectively document disruptive pain related interferences on real-life physical activity. The results reveal that meaningful information is contained in the temporal dynamics of activity patterns and an analytical model based on the theory of bivariate point processes can be used to describe physical activity behavior. The model parameters capture the dynamic interdependence between periods and events and determine a ‘signature’ of activity pattern. The study is likely to contribute to the clinical understanding of complex pain/disease-related behaviors and establish a unified mathematical framework to quantify the complex dynamics of various human activities.
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Affiliation(s)
- Anisoara Paraschiv-Ionescu
- Laboratory of Movement Analysis and Measurement, Ecole Polytechnique Federale de Lausanne (EPFL), Switzerland
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