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Amajjar I, Vergauwen K, Willigenburg NW, Ham SJ, Smeets RJEM. Pain and fatigue in adult patients with multiple osteochondromas: The Netherlands. PLoS One 2024; 19:e0305640. [PMID: 39018287 PMCID: PMC11253920 DOI: 10.1371/journal.pone.0305640] [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: 12/18/2023] [Accepted: 06/03/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Multiple Osteochondromas (MO) is a rare genetic disorder characterised by the presence of numerous benign bone tumours, known as osteochondromas. Within the spectrum of debilitating symptoms associated with MO, pain is recognized as a major problem. Interestingly, our clinical observations suggest that fatigue is also a significant concern but has merely been touched upon in MO literature. This study aims to (1) assess the level of pain and fatigue in adult patients with MO; (2) compare fatigue in MO to healthy subjects and patients with Rheumatoid Arthritis (RA); (3) identify associated variables for pain and fatigue in patients with MO. METHODS In this cross-sectional study, 353 adult MO patients completed a survey with validated questionnaires on pain, fatigue and psychosocial factors. Pain and fatigue were assessed with the Numeric Rating Scale (NRS), and fatigue was also measured with the Checklist Individual Strength (CIS). Fatigue (CIS) was compared with reference scores of healthy subjects and patients with RA, using a one-sample t-test. Multiple linear regression models for pain and fatigue were developed using a-priori selected independent variables based on a theoretical framework (ICF-model). RESULTS Pain was reported by 87.8% (NRS = 3.19±2.6) and fatigue by 90.4% (NRS = 4.1±2.6) of patients with MO. Fatigue scores for MO (CIS = 84.1±15.3) were significantly higher (p<0.001) compared to reference scores of healthy subjects and patients with RA. The multivariable analysis for pain provided a final regression model with six variables (R2 = 0.445, p<0.001) of which fear avoidance beliefs and fatigue had the strongest association. For the fatigue models NRS (R2 = 0.455, p<0.001) and CIS (R2 = 0.233, p<0.001), the strongest associations were found with anxiety and depression respectively. CONCLUSIONS Pain and fatigue are highly prevalent in patients with MO. Fatigue is significantly higher compared to healthy subjects and patients with RA. Several variables associated with pain and fatigue have been identified that could help improve multidisciplinary treatment plans.
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Affiliation(s)
- Ihsane Amajjar
- Department of Orthopaedic Surgery, OLVG, Amsterdam, The Netherlands
- Department of Rehabilitation Medicine, CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Kuni Vergauwen
- Department of Rehabilitation Medicine, CAPHRI, Maastricht University, Maastricht, The Netherlands
- Department of Health Care, AP University College, Antwerp, Belgium
- MOVANT, Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerp, Belgium
- Pain in Motion International Research Group, Brussels, Belgium
| | | | - S. John Ham
- Department of Orthopaedic Surgery, OLVG, Amsterdam, The Netherlands
| | - Rob J. E. M. Smeets
- Department of Health Care, AP University College, Antwerp, Belgium
- Pain in Motion International Research Group, Brussels, Belgium
- Clinics in Rehabilitation, Eindhoven, The Netherlands
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2
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Baroni A, Fregna G, Lamberti N, Manfredini F, Straudi S. Fatigue can influence the development of late-onset pain in post-COVID-19 syndrome: An observational study. Eur J Pain 2024; 28:901-912. [PMID: 38155562 DOI: 10.1002/ejp.2228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 12/12/2023] [Accepted: 12/18/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Late-onset pain is frequent following COVID-19, and many pathogenetic mechanisms have been proposed. Identifying the main features of patients may help in designing tailored rehabilitative interventions. METHODS We enrolled post-COVID-19 patients with an increase in pain intensity of two points on the COVID-19 Yorkshire Rehabilitation Scale (C19-YRS) at 52 weeks compared to the pre-COVID-19 condition. All subjects were retrospectively monitored at 12, 26, and 52 weeks. A specific pain assessment was performed to determine the characteristics and mechanisms of pain. Catastrophizing, kinesiophobia, and other psychological symptoms were evaluated. The pressure pain threshold (PPT) and temporal summation (TS) were measured and compared in age- and sex-matched healthy controls to analyse pain characteristics. RESULTS A total of 67 patients were recruited, with 20 of them presenting an increase in pain at 52 weeks. Subjects of the two subgroups were similar in demographic and clinical characteristics at baseline; significant differences in fatigue, anxiety, mobility, ability to perform daily activities, and general health perception were recorded at 26 weeks. Fatigue significantly predicted pain onset (β = 0.54, p = 0.002). Sixteen different body regions were identified as painful, with a pain intensity of 6.0 ± 1.9. Most of the samples did not show neuropathic or nociplastic mechanisms. No differences in PPT and TS were recorded between patients and healthy controls. CONCLUSIONS Almost one out of three patients hospitalized for COVID-19 developed pain 1 year later, and fatigue seems responsible for chronicity. An overlapping of conditions may explain late-onset post-COVID-19 pain, and a comprehensive approach must be considered for patient management. SIGNIFICANCE Late-onset pain is frequent in post-COVID-19 syndrome and an overlapping of different mechanisms seems to be responsible for its development. Among many predisposing factors, fatigue in the months before seems to be one of the primary causes of pain one year following infection and its management may help to identify new strategies for prevention and treatment of late-onset pain.
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Affiliation(s)
- A Baroni
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
- Department of Neuroscience and Rehabilitation, Ferrara University Hospital, Ferrara, Italy
| | - G Fregna
- Doctoral Program in Translational Neurosciences and Neurotechnologies, University of Ferrara, Ferrara, Italy
| | - N Lamberti
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - F Manfredini
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
- Department of Neuroscience and Rehabilitation, Ferrara University Hospital, Ferrara, Italy
| | - S Straudi
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
- Department of Neuroscience and Rehabilitation, Ferrara University Hospital, Ferrara, Italy
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3
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Yamada K, Adams H, Ellis T, Clark R, Sully C, Lariviere C, Sullivan MJ. The temporal relation between pain and fatigue in individuals receiving treatment for chronic musculoskeletal pain. BMC Musculoskelet Disord 2022; 23:219. [PMID: 35260111 PMCID: PMC8905765 DOI: 10.1186/s12891-022-05162-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 02/25/2022] [Indexed: 11/23/2022] Open
Abstract
Background Numerous investigations have revealed significant relations between pain and fatigue in individuals with persistent pain conditions. However, the direction of influence between pain and fatigue remains unclear. Shortcomings of design and analytic approaches used in previous research limit the nature of conclusions that can be drawn about possible causal or directional relations between pain and fatigue. The present study investigated the temporal relation between changes in pain and changes in fatigue in individuals with musculoskeletal pain enrolled in a 10-week behavioral activation intervention. On the basis of previous findings, it was hypothesized that analyses would support a bi-directional relation between pain and fatigue. Methods The study sample consisted of 104 individuals with chronic musculoskeletal pain participating in a 10-week standardized rehabilitation intervention. Measures of pain intensity and fatigue were completed pre-, mid-, and post-treatment. The three-wave data panel permitted examination of the direction of influence between pain and fatigue through the course of the intervention. A random-intercept cross-lagged panel model (RI-CLPM) was used to examine the temporal relation between pain and fatigue. Results Consistent with previous research, cross-sectional analyses of pre-treatment data revealed significant correlations between measures of pain and fatigue. Significant reductions in pain and fatigue were observed through the course of treatment (d = 0.33 and d = 0.66, p < .001, respectively). RI-CLPM revealed that pain severity predicted later fatigue (pre to mid-treatment standardized path coefficient (β) = 0.55, p = 0.02; mid to post-treatment β = 0.36, p = 0.001); however, fatigue did not predict later pain severity. Conclusions Discussion addresses the processes that might underlie the temporal relation between pain and fatigue. Clinical implications of the findings are also discussed.
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Affiliation(s)
- Keiko Yamada
- Department of Psychology, McGill University, 2001 McGill College, QC, H3A 1G1, Montreal, Canada.,Department of Anesthesiology and Pain Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Heather Adams
- University Centre for Research and Disability, Halifax, Nova Scotia, Canada
| | - Tamra Ellis
- Centre for Rehabilitation and Health, Toronto, ON, Canada
| | - Robyn Clark
- Kootenay Health Services, Nelson, BC, Canada
| | - Craig Sully
- Kootenay Health Services, Nelson, BC, Canada
| | - Christian Lariviere
- l'Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montreal, QC, Canada
| | - Michael Jl Sullivan
- Department of Psychology, McGill University, 2001 McGill College, QC, H3A 1G1, Montreal, Canada.
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4
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Løke D, Løvstad M, Andelic N, Andersson S, Ystrom E, Vassend O. The role of pain and psychological distress in fatigue: a co-twin and within-person analysis of confounding and causal relations. Health Psychol Behav Med 2022; 10:160-179. [PMID: 35173998 PMCID: PMC8843118 DOI: 10.1080/21642850.2022.2033121] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Daniel Løke
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen-Bjornemyr, Norway
| | - Marianne Løvstad
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen-Bjornemyr, Norway
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Nada Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Center for Habilitation and Rehabilitation Models and Services (CHARM), University of Oslo, Oslo, Norway
| | - Stein Andersson
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Psychosomatic and CL Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Eivind Ystrom
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Olav Vassend
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
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Teh WL, Liu J, Satghare P, Samari E, Mok YM, Subramaniam M. Depressive symptoms and health-related quality of life in a heterogeneous psychiatric sample: conditional indirect effects of pain severity and interference. BMC Psychiatry 2021; 21:470. [PMID: 34579684 PMCID: PMC8474842 DOI: 10.1186/s12888-021-03470-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 09/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Few studies have examined clinically relevant mechanisms that underlie the association between two important indices of recovery- depression severity and health-related quality of life (HRQOL) in psychiatric outpatients. This study aimed to explicate the roles of pain interference and pain severity as mediating and moderating mechanisms in the relationship between depressive symptoms and HRQOL. METHODS Data from 290 outpatients diagnosed with schizophrenia (n = 102), depressive (n = 98), and anxiety (n = 90) disorders were examined. Participants completed a set of questionnaires that queried their sociodemographic statuses, current pain severity and interference levels, depression severity levels, and HRQOL. Subsequently, mediation and moderation analyses were conducted. RESULTS Analyses revealed that pain interference fully mediated the relationship between depressive symptoms and physical (34% of the total effect) but not mental HRQOL. At high pain levels (+ 1 SD from mean), depressive symptoms may interfere with physical quality of life through pain interference, but this was not present at low pain levels (- 1 SD from mean). CONCLUSIONS Prolonged pain symptoms could negatively influence psychiatric recovery beyond the physical aspect of HRQOL. These results thus imply a need to detect and manage severe physical pain complaints at the acute stage in psychiatric outpatients.
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Affiliation(s)
- Wen Lin Teh
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Jianlin Liu
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Pratika Satghare
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Ellaisha Samari
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Yee Ming Mok
- Department of Mood and Anxiety, Institute of Mental Health, Singapore, 539747, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
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Juengst SB, Terhorst L, Nabasny A, Wallace T, Weaver JA, Osborne CL, Burns SP, Wright B, Wen PS, Kew CLN, Morris J. Use of mHealth Technology for Patient-Reported Outcomes in Community-Dwelling Adults with Acquired Brain Injuries: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2173. [PMID: 33672183 PMCID: PMC7926536 DOI: 10.3390/ijerph18042173] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/16/2021] [Accepted: 02/18/2021] [Indexed: 11/26/2022]
Abstract
The purpose of our scoping review was to describe the current use of mHealth technology for long-term assessment of patient-reported outcomes in community-dwelling individuals with acquired brain injury (ABI). Following PRISMA guidelines, we conducted a scoping review of literature meeting these criteria: (1) civilians or military veterans, all ages; (2) self-reported or caregiver-reported outcomes assessed via mobile device in the community (not exclusively clinic/hospital); (3) published in English; (4) published in 2015-2019. We searched Ovid MEDLINE(R) < 1946 to 16 August 2019, MEDLINE InProcess, EPub, Embase, and PsycINFO databases for articles. Thirteen manuscripts representing 12 distinct studies were organized by type of ABI [traumatic brain injury (TBI) and stroke] to extract outcomes, mHealth technology used, design, and inclusion of ecological momentary assessment (EMA). Outcomes included post-concussive, depressive, and affective symptoms, fatigue, daily activities, stroke risk factors, and cognitive exertion. Overall, collecting patient-reported outcomes via mHealth was feasible and acceptable in the chronic ABI population. Studies consistently showed advantage for using EMA despite variability in EMA timing/schedules. To ensure best clinical measurement, research on post-ABI outcomes should consider EMA designs (versus single time-point assessments) that provide the best timing schedules for their respective aims and outcomes and that leverage mHealth for data collection.
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Affiliation(s)
- Shannon B. Juengst
- UT Southwestern Medical Center, Department of Physical Medicine & Rehabilitation, Dallas, TX 75390, USA; (A.N.); (C.L.O.); (B.W.); (C.-L.N.K.)
- UT Southwestern Medical Center, Department of Applied Clinical Research, Dallas, TX 75390, USA
| | - Lauren Terhorst
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA 15219, USA;
| | - Andrew Nabasny
- UT Southwestern Medical Center, Department of Physical Medicine & Rehabilitation, Dallas, TX 75390, USA; (A.N.); (C.L.O.); (B.W.); (C.-L.N.K.)
- UT Southwestern Medical Center, Department of Applied Clinical Research, Dallas, TX 75390, USA
| | | | - Jennifer A. Weaver
- Department of Clinical Research & Leadership, George Washington University, Washington, DC 20006, USA;
| | - Candice L. Osborne
- UT Southwestern Medical Center, Department of Physical Medicine & Rehabilitation, Dallas, TX 75390, USA; (A.N.); (C.L.O.); (B.W.); (C.-L.N.K.)
| | - Suzanne Perea Burns
- School of Occupational Therapy, Texas Woman’s University, Denton, TX 76204, USA;
| | - Brittany Wright
- UT Southwestern Medical Center, Department of Physical Medicine & Rehabilitation, Dallas, TX 75390, USA; (A.N.); (C.L.O.); (B.W.); (C.-L.N.K.)
- UT Southwestern Medical Center, Department of Applied Clinical Research, Dallas, TX 75390, USA
| | - Pey-Shan Wen
- Department of Occupational Therapy, Georgia State University, Atlanta, GA 30303, USA;
| | - Chung-Lin Novelle Kew
- UT Southwestern Medical Center, Department of Physical Medicine & Rehabilitation, Dallas, TX 75390, USA; (A.N.); (C.L.O.); (B.W.); (C.-L.N.K.)
- UT Southwestern Medical Center, Department of Applied Clinical Research, Dallas, TX 75390, USA
| | - John Morris
- Shepherd Center, Atlanta, GA 30309, USA; (T.W.); (J.M.)
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Greenspan LS, Alley L, Rice SPM, Olson R. Exploring biopsychosocial correlates of pain, pain management strategies, and risk for opioid misuse among home care workers in Washington State. Home Health Care Serv Q 2020; 40:54-74. [PMID: 32972327 DOI: 10.1080/01621424.2020.1810191] [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: 02/07/2023]
Abstract
Home care workers (HCWs) are at high risk for musculoskeletal pain and injury, and they are an important population for pain management research and intervention. The purpose of this study was to gather novel data on HCWs' work characteristics, pain experiences, pain management strategies, and risk for opioid misuse. A survey invitation was e-mailed to a random sub-sample of HCWs in Washington State, and 421 responded. Over half (54.2%) reported chronic or currently elevated pain. Pharmacological pain management strategies were used by 67.3% of all respondents with 4.8% reporting prescription opioid use. Biopsychosocial factors like injuries, interpersonal conflict, financial strain, and anxiety were associated with increased opioid misuse risk. Multimodal primary and secondary interventions are recommended to improve HCWs' pain management.
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Affiliation(s)
- Leah S Greenspan
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University , Portland, Oregon, USA
| | - Lindsey Alley
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University , Portland, Oregon, USA
| | - Sean P M Rice
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University , Portland, Oregon, USA
| | - Ryan Olson
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University , Portland, Oregon, USA.,School of Public Health, Oregon Health & Science University and Portland State University , Portland, Oregon, USA.,Department of Psychology, Portland State University , Portland, Oregon, USA
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8
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Ramos AK, Carvajal-Suarez M, Trinidad N, Michaud TL, Grimm B, LeVan T, Siahpush M. A Cross-sectional Study of Gender-related Differences in Reporting Fatigue and Pain among Latino/A Migrant Farmworkers. J Agromedicine 2020; 25:319-329. [PMID: 31941431 DOI: 10.1080/1059924x.2020.1713272] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: Migrant farmworkers face many hardships in both their working and living environments including dangerous and demanding tasks, long hours, and inadequate rest. This study sought to explore gender differences in the reporting of fatigue and pain and to identify predictors of fatigue and pain among migrant farmworkers in Nebraska (n = 241). Methods: Bivariate tests were used to assess associations among study variables. Linear and generalized linear mixed effect models were used to assess gender as a predictor of fatigue and pain respectively while controlling for covariates. Results: Females reported significantly higher levels of fatigue (M score = 15.5, SD = 6.1 compared to M score = 12.8, SD = 4.3) than their male counterparts. Females were also more likely to report pain (56.9% of females compared to 36.3% of males). Being female, pain, hours of sleep, and job demands were significant predictors of fatigue. Fatigue and job-related injury were the only significant predictors of pain. Conclusions: There are gender-related disparities in the reporting of fatigue and pain among Latino/a migrant farmworkers. Extra precautions need to be taken to protect worker health and safety and reduce fatigue, particularly for female workers. Implications for employers, supervisors, and healthcare providers are discussed.
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Affiliation(s)
- Athena K Ramos
- Department of Health Promotion, Center for Reducing Health Disparities, College of Public Health, 984340 Nebraska Medical Center , Omaha, NE, USA
| | - Marcela Carvajal-Suarez
- Center for Reducing Health Disparities, College of Public Health, 984340 Nebraska Medical Center, University of Nebraska Medical Center , Omaha, NE, USA
| | - Natalia Trinidad
- Center for Reducing Health Disparities, College of Public Health, 984340 Nebraska Medical Center, University of Nebraska Medical Center , Omaha, NE, USA
| | - Tzeyu L Michaud
- Center for Reducing Health Disparities, College of Public Health, 984340 Nebraska Medical Center, University of Nebraska Medical Center , Omaha, NE, USA
| | - Brandon Grimm
- Department of Health Promotion, College of Public Health, 984365 Nebraska Medical Center, University of Nebraska Medical Center , Omaha, NE, USA
| | - Tricia LeVan
- Department of Epidemiology, College of Public Health, 984395 Nebraska Medical Center, University of Nebraska Medical Center , Omaha, NE, USA
| | - Mohammad Siahpush
- Department of Health Promotion, College of Public Health, 984365 Nebraska Medical Center, University of Nebraska Medical Center , Omaha, NE, USA
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Reply. Pain 2018; 159:1179-1180. [DOI: 10.1097/j.pain.0000000000001195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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