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Fernández-Gualda MÁ, Ariza-Vega P, Galiano-Castillo N, Tovar-Martín I, Ortiz-Comino L, Lozano-Lozano M, Fernández-Lao C. PaiNEd app. Assessing central sensitization in survivors of breast cancer: A reliability study. Digit Health 2024; 10:20552076241260150. [PMID: 38882256 PMCID: PMC11179517 DOI: 10.1177/20552076241260150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/22/2024] [Indexed: 06/18/2024] Open
Abstract
Introduction Pain is a common adverse event in survivors of breast cancer (sBCs). As there is no gold standard to assess pain experience predominantly related to central sensitization (CS) symptoms, we designed the PaiNEd app, which includes an algorithm to report whether patients are under predominant CS pain mechanisms. Objective We aimed to assess the reliability of the PaiNEd app to estimate whether sBC pain experience is predominantly related to CS symptoms. Methods An observational, descriptive reliability design was employed to assess the inter- and intrarater reliability of the PaiNEd app. This app includes an algorithm that considers the number of painful body parts and some questionnaires related to pain, such as the Numeric Pain-Rating Scale, the Brief Pain Inventory, the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, and the Central Sensitization Inventory (CSI). Results A total of 21 sBCs with persistent pain were recruited. We observe a general trend of close agreement between the paper-based and app-based formats (ICCs ranged between 0.802 and 0.972; Cronbach's alpha ranged between 0.797 and 0.971). Test-retest reliabilities were moderate to excellent (ICCs ranged between 0.510 and 0.941; Cronbach's alpha ranged between 0.499 and 0.938). The agreement between the categorization of the CS algorithm and the CSI (cut-off point ≥ 40 for CS symptoms) was 95.24%. Conclusion The PaiNEd app emerges as a robust tool for evaluating pain experience predominantly related to CS and pain-related symptoms in sBCs. Its demonstrated reliability not only bolsters its utility but also signifies its potential as a valuable asset for healthcare professionals engaged in pain education programs.
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Affiliation(s)
- Miguel Ángel Fernández-Gualda
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
| | - Patrocinio Ariza-Vega
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, 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
| | - Noelia Galiano-Castillo
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
| | - Isabel Tovar-Martín
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Department of Radiation Oncology, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Lucía Ortiz-Comino
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
- Health Sciences Faculty (Melilla), University of Granada, Granada, Spain
| | - Mario Lozano-Lozano
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
| | - Carolina Fernández-Lao
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
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Calvache-Mateo A, Navas-Otero A, Heredia-Ciuró A, Matín-Núñez J, Torres-Sánchez I, López-López L, Valenza MC. Post-COVID Patients With New-Onset Chronic Pain 2 Years After Infection: Cross-Sectional Study. Pain Manag Nurs 2023; 24:528-534. [PMID: 37225540 PMCID: PMC10201348 DOI: 10.1016/j.pmn.2023.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/23/2023] [Accepted: 04/24/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Although pain is common in non-hospitalized post-COVID-19 syndrome, only a few studies have provided information on the pain experience of these patients. AIM To identify the clinical and psychosocial profile associated with pain in non-hospitalized patients with post-COVID-19 syndrome. METHOD In this study there were three groups: healthy control group, successfully recovered group, and post-COVID syndrome group. Pain-related clinical profile and pain-related psychosocial variables were collected. Pain-related clinical profile included: pain intensity and interference (Brief Pain Inventory), central sensitization (Central Sensitization Scale), insomnia severity (Insomnia Severity Index), and pain treatment. Pain-related psychosocial variables were: fear of movement and (re)injury (Tampa Scale for Kinesiophobia), catastrophizing (Pain Catastrophizing Scale), depression, anxiety and stress (Depression, Anxiety and Stress Scale), and fear-avoidance beliefs (Fear Avoidance Beliefs Questionnaire). RESULTS In all, 170 participants were included in the study (healthy control group n = 58, successfully recovered group n = 57, and post-COVID syndrome group n = 55). Post-COVID syndrome group obtained significantly worse punctuation in pain-related clinical profile and psychosocial variables than the other two groups (p < .05). CONCLUSIONS In conclusion, patients with post-COVID-19 syndrome have experienced high pain intensity and interference, central sensitization, increased insomnia severity, fear of movement, catastrophizing, fear-avoidance beliefs, depression, anxiety, and stress.
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Affiliation(s)
- Andrés Calvache-Mateo
- From the Physiotherapy Department, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Alba Navas-Otero
- From the Physiotherapy Department, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Alejandro Heredia-Ciuró
- From the Physiotherapy Department, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Javier Matín-Núñez
- From the Physiotherapy Department, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Irene Torres-Sánchez
- From the Physiotherapy Department, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Laura López-López
- From the Physiotherapy Department, Faculty of Health Sciences, University of Granada, Granada, Spain.
| | - Marie Carmen Valenza
- From the Physiotherapy Department, Faculty of Health Sciences, University of Granada, Granada, Spain
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Ordoñez-Mora LT, Rosero ID, Morales-Osorio MA, Guil R, Quintero Jordan G, Agudelo Jimenez JA, Gonzalez-Ruiz K, Avila-Valencia JC. NEUROCANTRIAL: study protocol for a randomised controlled trial of a pain neuroscience education programme in adults with cancer pain. BMJ Open 2023; 13:e071493. [PMID: 37758676 PMCID: PMC10537834 DOI: 10.1136/bmjopen-2022-071493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
INTRODUCTION Pain is the second most frequent symptom reported in patients with cancer among the main reasons for consultation. The incorporation of educational modalities in pain intervention processes has been suggested. This study aims to examine the efficacy of neuroscience pain education (PNE) in relation to pain, biopsychosocial variables and functional capacity in comparison with conventional treatment. It is hypothesised that an intervention based on PNE achieves better outcomes than conventional management, in terms of pain, biopsychosocial variables and functional capacity in adults with oncological pain. METHODS AND ANALYSIS This will be a single-blind, controlled clinical trial in which two groups will be compared using changes in pain as the primary measure. The first group will receive conventional treatment in addition to PNE, and participants will undergo an intervention of nine sessions (one session per week, for a total of 9 weeks), each lasting 30-40 min. Specifically, these sessions will teach biophysiological elements using metaphors that allow the adoption of these concepts related to pain. The second group will receive conventional treatment (pharmacological treatment). For this study, a sample size calculation was made based on the background, where 80 adults with oncological pain were required. An initial evaluation will be made to establish the baseline characteristics, and then, according to the randomisation, the assignment to the PNE group or the control group will be made and the two groups will be summoned again. Ten weeks later, for the intervention evaluation, the statistical analysis plan will be established by protocol and by intention-to-treat. ETHICS AND DISSEMINATION This protocol complies with all ethical considerations. The authors commit to presenting the study's results. This study was approved by the ethics committees of the Universidad Santiago de Cali, Clínica de Occidente/Angiografía de Occidente. The authors commit to presenting the study's results. TRIAL REGISTRATION NUMBER NCT05581784.
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Affiliation(s)
- Leidy Tatiana Ordoñez-Mora
- Doctorate in Applied Sciences, Universidad Santiago de Cali, Cali, Colombia
- Doctorate in Health Sciences, Universidad de Cadiz, Cadiz, Spain
| | - Ilem D Rosero
- Department of Health, Physiotherapy Program, Universidad Santiago de Cali, Cali, Colombia
| | - Marco Antonio Morales-Osorio
- Department of Health, Universidad de la Costa, Barranquilla, Colombia
- Department of Health, Universidad del Valle de Puebla, Puebla, Mexico
| | - Rocío Guil
- Department of Psychology, Universidad de Cádiz, Puerto Real, Spain
| | | | - Julian Alberto Agudelo Jimenez
- Grupo de investigación y Educación Clínica de Occidente GIECDO, Centro Medico Clinica de Occidente, Cali, Valle del Cauca, Colombia
| | | | - Juan Carlos Avila-Valencia
- Department of Health, Physiotherapy Program, Universidad Santiago de Cali, Cali, Colombia
- Grupo de investigación y Educación Clínica de Occidente GIECDO, Centro Medico Clinica de Occidente, Cali, Valle del Cauca, Colombia
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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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Roldán-Jiménez C, Martín-Martín J, Pajares B, Ribelles N, Alba E, Cuesta-Vargas AI. Factors associated with upper limb function in breast cancer survivors. PM R 2023; 15:151-156. [PMID: 34713595 DOI: 10.1002/pmrj.12731] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 09/24/2021] [Accepted: 10/25/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Breast cancer survivors may have side effects from treatment, such as impaired upper limb function after surgery, which may be affected by a range of factors. OBJECTIVE To analyze the association between upper limb function and strength, fear avoidance, and central sensitization symptoms among breast cancer survivors, and to explore how these variables are associated with upper limb function. DESIGN Validation cohort. SETTING Institutional practice at a public hospital. PATIENTS One hundred seventy-four breast cancer survivors who had been undergone surgery for a primary tumor. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE Upper limb function was measured by the Upper Limb Functional Index (ULFI-Sp). Independent outcomes were: handgrip strength, which was measured using a Jamar dynamometer on the dominant side; fear avoidance, measured using the Fear-Avoidance Components Scale (FACS-Sp); and central sensitization symptoms, which were measured using the Central Sensitisation Inventory (CSI-Sp). A linear regression model explaining the ULFI-Sp results was constructed with the variables. RESULTS The regression model was significant (F = 46.826; p < .0001), and explained 45% of the variance of the ULFI values. All variables showed strong associations with upper limb function. CONCLUSIONS Greater upper limb function is associated with higher grip strength, lower fear-avoidance behavior and fewer central sensitization symptoms among breast cancer survivors. These variables explained 45% of the upper limb function in the regression model, and concur with earlier research showing that factors such as central sensitization symptoms and kinesiophobia negatively affect upper limb function in such patients. Clinicians should therefore take into account strength, fear avoidance, and central sensitization symptoms when considering interventions aimed at improving upper limb function among breast cancer survivors.
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Affiliation(s)
- Cristina Roldán-Jiménez
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, Andalucía Tech., Málaga, Spain.,Instituto de Investigación Biomédica de Málaga (IBIMA), Grupo de Clinimetría (F-14), Málaga, Spain
| | - Jaime Martín-Martín
- Instituto de Investigación Biomédica de Málaga (IBIMA), Grupo de Clinimetría (F-14), Málaga, Spain.,Department of Human Anatomy, Legal Medicine and History of Science; Area of Legal Medicine, University of Málaga, Faculty of Medicine, Málaga, Spain
| | - Bella Pajares
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Nuria Ribelles
- Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Emilio Alba
- Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Antonio I Cuesta-Vargas
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, Andalucía Tech., Málaga, Spain.,Instituto de Investigación Biomédica de Málaga (IBIMA), Grupo de Clinimetría (F-14), Málaga, Spain.,School of Clinical Science, Faculty of Health Science, Queensland University Technology, Brisbane, Queensland, Australia
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6
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Nijs J, Lahousse A, Fernández-de-Las-Peñas C, Madeleine P, Fontaine C, Nishigami T, Desmedt C, Vanhoeij M, Mostaqim K, Cuesta-Vargas AI, Kapreli E, Bilika P, Polli A, Leysen L, Elma Ö, Roose E, Rheel E, Yılmaz ST, De Baets L, Huysmans E, Turk A, Saraçoğlu İ. Towards precision pain medicine for pain after cancer: the Cancer Pain Phenotyping Network multidisciplinary international guidelines for pain phenotyping using nociplastic pain criteria. Br J Anaesth 2023; 130:611-621. [PMID: 36702650 DOI: 10.1016/j.bja.2022.12.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/22/2022] [Accepted: 12/10/2022] [Indexed: 01/26/2023] Open
Abstract
Pain after cancer remains underestimated and undertreated. Precision medicine is a recent concept that refers to the ability to classify patients into subgroups that differ in their susceptibility to, biology, or prognosis of a particular disease, or in their response to a specific treatment, and thus to tailor treatment to the individual patient characteristics. Applying this to pain after cancer, the ability to classify post-cancer pain into the three major pain phenotypes (i.e. nociceptive, neuropathic, and nociplastic pain) and tailor pain treatment accordingly, is an emerging issue. This is especially relevant because available evidence suggests that nociplastic pain is present in an important subgroup of those patients experiencing post-cancer pain. The 2021 International Association for the Study of Pain (IASP) clinical criteria and grading system for nociplastic pain account for the need to identify and correctly classify patients according to the pain phenotype early in their treatment. These criteria are an important step towards precision pain medicine with great potential for the field of clinical oncology. Within this framework, the Cancer Pain Phenotyping (CANPPHE) Network, an international and interdisciplinary group of oncology clinicians and researchers from seven countries, applied the 2021 IASP clinical criteria for nociplastic pain to the growing population of those experiencing post-cancer pain. A manual is provided to allow clinicians to differentiate between predominant nociceptive, neuropathic, or nociplastic pain after cancer. A seven-step diagnostic approach is presented and illustrated using cases to enhance understanding and encourage effective implementation of this approach in clinical practice.
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Affiliation(s)
- Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium; Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Belgium; Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden.
| | - Astrid Lahousse
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium; Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Belgium; Research Foundation - Flanders (FWO), Brussels, Belgium; Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy (KIMA), Vrije Universiteit Brussel, 1090 Brussels, Belgium
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Alcorcón, Madrid, Spain
| | - Pascal Madeleine
- Sport Sciences - Performance & Technology, Department of Health Science & Technology, Aalborg University, Aalborg, Denmark
| | | | | | | | - Marian Vanhoeij
- Breast Clinic, University Hospital Brussels, Belgium; Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Belgium
| | - Kenza Mostaqim
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium
| | - Antonio I Cuesta-Vargas
- Cátedra de Fisioterapia, Universidad de Malaga, Andalucia Tech, Instituto de Investigacion Biomédica de Malaga (IBIMA) Grupo de Clinimetria (F-14), Malaga, Spain
| | - Eleni Kapreli
- Clinical Exercise Physiology & Rehabilitation Research Laboratory, Physiotherapy Department, Faculty of Health Sciences, University of Thessaly, Lamia, Greece
| | - Paraskevi Bilika
- Clinical Exercise Physiology & Rehabilitation Research Laboratory, Physiotherapy Department, Faculty of Health Sciences, University of Thessaly, Lamia, Greece
| | - Andrea Polli
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium; Research Foundation - Flanders (FWO), Brussels, Belgium; Laboratory of Clinical Epigenetics, Department of Public Health and Primary Care, Centre for Environment & Health, KU Leuven, Leuven, Belgium
| | - Laurence Leysen
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium
| | - Ömer Elma
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium
| | - Eva Roose
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium; Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy (KIMA), Vrije Universiteit Brussel, 1090 Brussels, Belgium; Universiteit Hasselt, REVAL, Agoralaan-gebouw A, 3590 Diepenbeek, Belgium
| | - Emma Rheel
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium; Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Sevilay Tümkaya Yılmaz
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium
| | - Liesbet De Baets
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium
| | - Eva Huysmans
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium; Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Belgium; Research Foundation - Flanders (FWO), Brussels, Belgium
| | - Ali Turk
- Kutahya Health Sciences University, Faculty of Medicine, Department of Radiation Oncology, Kütahya, Turkey
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de la Rosa-Díaz I, Barrero-Santiago L, Acosta-Ramírez P, Martín-Peces-Barba M, Iglesias-Hernández E, Plisset B, Lutinier N, Belzanne M, La Touche R, Grande-Alonso M. Cross-Sectional Comparative Study on Central Sensitization-Psychosocial Associated Comorbidities and Psychological Characteristics in Breast Cancer Survivors with Nociceptive Pain and Pain with Neuropathic Features and without Pain. Life (Basel) 2022; 12:life12091328. [PMID: 36143365 PMCID: PMC9505522 DOI: 10.3390/life12091328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/15/2022] [Accepted: 08/23/2022] [Indexed: 11/25/2022] Open
Abstract
Simple Summary Persistent pain after breast cancer treatment is still under research due to its complex and multifactorial underlying pathogenesis, including phycological factors. Further research is needed to elucidate more information about the factors that cause and perpetuate this pain. Thus, this study defined the influence of psychosocial and psychological factors on breast cancer survivors who report pain and those who do not. The psychosocial factors assessed were those that are associated with a central sensitization process, and the psychological factors were pain catastrophizing, fear of movement, anxiety and depression. Hence, the psychosocial symptom clusters were identified related to the clinical features of pain or to not reporting pain, which may encourage health clinicians to establish a customized biopsychosocial model focused on the management of pain-catastrophizing thoughts and fear of movement. Furthermore, anxiety and depression should be detected early by health professionals and referred to psychologists to be managed. Abstract The frequency of a high Central Sensitization Inventory (CSI) total score and the prevalence of pain have already been established among breast cancer survivors (BCS). However, the psychological factors’ influence based on the clinical features of pain is still unknown, as well as BCS characteristics with no pain. Thus, our main aim was to evaluate the presence of a high CSI total score in BCS with pain and compare it with BCS without pain and to evaluate the influence of psychosocial factors. A cross-sectional comparative study was designed to compare BCS with nociceptive pain (n = 19), pain with neuropathic features (n = 19) or no pain (n = 19), classified by the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS). CSI, pain catastrophizing, fear of movement, anxiety and depression symptoms were analyzed and compared among the three groups. The CSI total score was higher in both BCS pain groups compared to BCS without pain, but there were no statistical differences between the pain groups. The same observation was made when comparing pain catastrophizing. The neuropathic feature group showed greater levels of fear of movement, anxiety and depression compared to the no pain group. Thus, CS-psychosocial associated comorbidities and pain-catastrophizing thoughts were more prevalent among BCS with pain, regardless of the clinical features of pain. BCS with neuropathic pain features showed greater psychological disturbances.
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Affiliation(s)
- Irene de la Rosa-Díaz
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Calle Ganímedes, n° 11, 28023 Madrid, Spain
- Physical Therapist in Women’s Health Research Group, Department of Physical Therapy, University of Alcalá, Avenida de León, 3A, 28805 Madrid, Spain
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Calle Ganímedes, n° 11, 28023 Madrid, Spain
| | - Laura Barrero-Santiago
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Calle Ganímedes, n° 11, 28023 Madrid, Spain
| | - Paz Acosta-Ramírez
- Physical Therapy in Torrejón Hospital, Rehabilitation Department, Calle Mateo Inurria, 28850 Madrid, Spain
| | - Marina Martín-Peces-Barba
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Calle Ganímedes, n° 11, 28023 Madrid, Spain
| | - Esther Iglesias-Hernández
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Calle Ganímedes, n° 11, 28023 Madrid, Spain
| | - Bastien Plisset
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Calle Ganímedes, n° 11, 28023 Madrid, Spain
| | - Nicolás Lutinier
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Calle Ganímedes, n° 11, 28023 Madrid, Spain
| | - Margot Belzanne
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Calle Ganímedes, n° 11, 28023 Madrid, Spain
| | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Calle Ganímedes, n° 11, 28023 Madrid, Spain
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Calle Ganímedes, n° 11, 28023 Madrid, Spain
- Instituto de Dolor Craneofacial y Neuromusculoesquelético (INDCRAN), Calle Luisa Fernanda, n° 12, Bj Izq, 28023 Madrid, Spain
- Correspondence:
| | - Mónica Grande-Alonso
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Calle Ganímedes, n° 11, 28023 Madrid, Spain
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Calle Ganímedes, n° 11, 28023 Madrid, Spain
- Instituto de Rehabilitación Funcional La Salle, Aravaca, 28850 Madrid, Spain
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8
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Gutiérrez-Sánchez D, Pajares-Hachero BI, Trinidad-Fernández M, Escriche-Escuder A, Iglesias-Campos M, Bermejo-Pérez MJ, Alba-Conejo E, Roldán-Jiménez C, Cuesta-Vargas A. The Benefits of a Therapeutic Exercise and Educational Intervention Program on Central Sensitization Symptoms and Pain-Related Fear Avoidance in Breast Cancer Survivors. Pain Manag Nurs 2022; 23:467-472. [PMID: 35277360 DOI: 10.1016/j.pmn.2022.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 11/26/2021] [Accepted: 01/07/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Central sensitization symptoms and pain-related fear avoidance are two common problems in breast cancer survivors. Non-pharmacologic interventions such as therapeutic exercise and patient education can be effective in this population. AIMS This study aimed to: (1) analyze the benefits of a therapeutic exercise and educational program on central sensitization symptoms and pain-related fear avoidance in breast cancer survivors, and (2) explore the association between pain-related fear avoidance and central sensitization symptoms. DESIGN A single group pre-post intervention study was conducted. METHODS Patients were recruited from the service of Medical Oncology of the University Clinical Hospital Virgen de la Victoria, in Málaga (Spain). The intervention consisted of a therapeutic exercise and educational program that lasted 12 weeks, twice a week, for 1 hour. Two instruments were used: the Spanish version of the Central Sensitization Inventory and the Spanish Fear Avoidance Components Scale. RESULTS A total of 82 breast cancer survivors participated in the study. Pre-post change on Central Sensitization Inventory was statistically significant (p = .007). There was a trend towards a significant difference for the Spanish Fear Avoidance Components Scale (p = .062). There was a statistically significant correlation between pain-related fear avoidance and central sensitization symptoms (r = 0.536, p < .001). CONCLUSIONS The current study has provided preliminary evidence on the benefits of this intervention in pain-related fear avoidance and central sensitization symptoms in breast cancer survivors. The Spanish version of the Central Sensitization Inventory and the Spanish Fear Avoidance Components Scale demonstrated responsiveness to change.
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Affiliation(s)
- Daniel Gutiérrez-Sánchez
- Instituto de Investigación Biomédica de Málaga (IBIMA), Malaga, Spain; Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Málaga, Spain
| | | | - Manuel Trinidad-Fernández
- Instituto de Investigación Biomédica de Málaga (IBIMA), Malaga, Spain; Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, Andalucia Tech, Spain
| | - Adrian Escriche-Escuder
- Instituto de Investigación Biomédica de Málaga (IBIMA), Malaga, Spain; Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Málaga, Spain
| | - Marcos Iglesias-Campos
- Unidad de Gestión Clínica Intercentros de Oncología Médica. Hospitales Universitarios Regional y Virgen de la Victoria (IBIMA), Málaga
| | | | | | - Cristina Roldán-Jiménez
- Instituto de Investigación Biomédica de Málaga (IBIMA), Malaga, Spain; Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, Andalucia Tech, Spain.
| | - Antonio Cuesta-Vargas
- Instituto de Investigación Biomédica de Málaga (IBIMA), Malaga, Spain; Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, Andalucia Tech, Spain; School of Clinical Science, Faculty of Health Science, Queensland University Technology, Australia
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9
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Hurth A, Nijzink-Ter Steege J, Scheepbouwer P, Roose E, Lahousse A, Leysen L, Stas L, Kregel J, Salvat E, Nijs J. Assessment of Central Sensitization in Breast Cancer Survivors: Convergent Validity and Use of the Central Sensitization Inventory (CSI) and Its Short-Form as a Clustering Tool. Clin Pract 2021; 11:607-618. [PMID: 34563005 PMCID: PMC8482070 DOI: 10.3390/clinpract11030076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/18/2021] [Accepted: 08/31/2021] [Indexed: 01/22/2023] Open
Abstract
The Central Sensitization Inventory (CSI) measurement properties in patients having nonspecific, noncancer pain are well-established. However, studies examining the reliability and validity of either the CSI or the Central Sensitization Inventory short-form version (CSI-9) in breast cancer survivors (BCS) are scarce. The purpose was to evaluate convergent validity and internal consistency of the CSI and CSI-9. Additionally, the relevance of a new cluster calculator using the CSI was explored. The cross-sectional multi-center study included 65 BCS and 37 healthy volunteers. Patients filled out multiple questionnaires assessing pain, number of painful areas, anxiety, depression and quality of life. The relevance of a cluster calculator was explored by known-group comparisons and boxplot description. All hypotheses were formulated before data analysis. The majority of hypotheses on the correlations between the CSI or CSI-9 and other health outcomes were confirmed (22 out of 27). The CSI and CSI-9 have excellent (α = 0.92) and good (α = 0.86) internal consistency, respectively. The CSI cluster calculator might be an interesting tool to use to have a patient's overall condition snapshot. Generally, the study findings support the construct validity and internal consistency of the CSI, which underline the use of this self-reported instrument in BCS. The CSI-9 shows promising results, but should be further evaluated.
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Affiliation(s)
- Alban Hurth
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1050 Brussel, Belgium; (J.N.-T.S.); (P.S.); (E.R.); (A.L.); (L.L.)
- Institut de Formation en Masso-Kinésithérapie de Strasbourg, Université de Strasbourg, 67000 Strasbourg, France
| | - Jessica Nijzink-Ter Steege
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1050 Brussel, Belgium; (J.N.-T.S.); (P.S.); (E.R.); (A.L.); (L.L.)
| | - Pauline Scheepbouwer
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1050 Brussel, Belgium; (J.N.-T.S.); (P.S.); (E.R.); (A.L.); (L.L.)
| | - Eva Roose
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1050 Brussel, Belgium; (J.N.-T.S.); (P.S.); (E.R.); (A.L.); (L.L.)
| | - Astrid Lahousse
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1050 Brussel, Belgium; (J.N.-T.S.); (P.S.); (E.R.); (A.L.); (L.L.)
| | - Laurence Leysen
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1050 Brussel, Belgium; (J.N.-T.S.); (P.S.); (E.R.); (A.L.); (L.L.)
| | - Lara Stas
- Interfaculty Center for Data Processing and Statistics, Core Facility, Vrije Universiteit Brussel, 1050 Brussel, Belgium;
- Biostatistics and Medical Informatics Research Group, Faculty of Medicine and Pharmacy, Department of Public Health, Vrije Universiteit Brussel, 1050 Brussel, Belgium
| | - Jeroen Kregel
- Breederode Hogeschool, 3011 Rotterdam, The Netherlands;
| | - Eric Salvat
- Centre d’Evaluation et de Traitement de la Douleur, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France;
- Centre National de la Recherche Scientifique, Institut des Neurosciences Cellulaires et Intégratives, 67000 Strasbourg, France
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1050 Brussel, Belgium; (J.N.-T.S.); (P.S.); (E.R.); (A.L.); (L.L.)
- Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1090 Jette, Belgium
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
- Center for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
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