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Keyaerts S, Godderis L, Vanden Abeele V, Daenen L. Identifying pain profiles in employees including work-related factors and pain perceptions: a cross-sectional study in Belgian companies. BMJ Open 2024; 14:e082804. [PMID: 39134443 PMCID: PMC11331899 DOI: 10.1136/bmjopen-2023-082804] [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: 12/04/2023] [Accepted: 07/26/2024] [Indexed: 08/21/2024] Open
Abstract
OBJECTIVES Studies usually investigate a limited number or a predefined combinations of risk factors for sickness absence in employees with pain. We examined frequently occurring combinations across a wide range of work-related factors and pain perceptions. DESIGN Cross-sectional study. SETTING Belgian companies that are under supervision of IDEWE, an external service for prevention and protection at work. PARTICIPANTS In total, 249 employees experiencing pain for at least 6 weeks were included and filled out an online survey. OUTCOMES Latent profile analysis was used to differentiate profiles of work-related factors (physical demands, workload, social support and autonomy) and pain perceptions (catastrophising, fear-avoidance beliefs and pain acceptance). Subsequently, profiles were compared on sociodemographics (age, gender, level of education, work arrangement, duration of complaints, multisite pain and sickness absence in the previous year) and predictors of sickness absence (behavioural intention and perceived behavioural control). RESULTS Four profiles were identified. Profile 1 (38.2%) had favourable scores and profile 4 (14.9%) unfavourable scores across all indicators. Profile 2 (33.3%) had relatively high physical demands, moderate autonomy levels and favourable scores on the other indicators. Profile 3 (13.7%) showed relatively low physical demands, moderate autonomy levels, but unfavourable scores on the other indicators. Predictors of profiles were age (OR 0.93 and 95% CI (0.89 to 0.98)), level of education (OR 0.28 and 95% CI (0.1 to 0.79)) and duration of sickness absence in the previous year (OR 2.29 and 95% CI (0.89 to 5.88)). Significant differences were observed in behavioural intention (χ2=8.92, p=0.030) and perceived behavioural control (χ2=12.37, p=0.006) across the four profiles. CONCLUSION This study highlights the significance of considering the interplay between work-related factors and pain perceptions in employees. Unfavourable scores on a single work factor might not translate into maladaptive pain perceptions or subsequent sickness absence, if mitigating factors are in place. Special attention must be devoted to employees dealing with unfavourable working conditions along with maladaptive pain perceptions. In this context, social support emerges as an important factor influencing sickness absence.
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Affiliation(s)
- Stijn Keyaerts
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Knowledge Information and Research Center, Group Idewe, Leuven, Belgium
| | - Lode Godderis
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Knowledge Information and Research Center, Group Idewe, Leuven, Belgium
| | | | - Liesbeth Daenen
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Knowledge Information and Research Center, Group Idewe, Leuven, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, VU Brussels, Brussels, Belgium
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Sharif-Nia H, Froelicher ES, Shafighi AH, Osborne JW, Fatehi R, Nowrozi P, Mohammadi B. The persian version of the fear-avoidance beliefs questionnaire among iranian post-surgery patients: a translation and psychometrics. BMC Psychol 2024; 12:390. [PMID: 39010142 PMCID: PMC11247876 DOI: 10.1186/s40359-024-01884-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 07/02/2024] [Indexed: 07/17/2024] Open
Abstract
INTRODUCTION Fear-avoidance beliefs (FAB) play a crucial role in the treatment outcomes of post-surgery patients. These beliefs can lead to activity avoidance, increased pain, and decreased quality of life. Therefore, accurately measuring these beliefs in Iranian patients is of significant importance. The Fear-Avoidance Belief Questionnaire (FABQ) is a patient-reported questionnaire that evaluates individuals' FAB. Since the validity and reliability of the Persian version of FABQ (FABQ-P) have not been assessed based on the Iranian population and sociocultural contexts, the current study has been implemented to determine the reliability and validity of the FABQ-P among Iranian post-operative patients by translation and psychometric properties. METHODS This methodological study conducted in 2023, a sample of 400 patients who had undergone surgery were selected using a convenience sampling method. The scale used in the study was translated and its psychometric properties were evaluated through network analysis and assessments of construct validity (including exploratory and confirmatory factor analysis), convergent validity, and discriminant validity. Additionally, the study assessed the internal consistency of the scale. RESULTS The MLEFA results with Promax and Kaiser Normalization rotation yielded two factors explaining 57.91% of the variance, encompassing 13 items. Also, the model was approved by CFA. Convergent and discriminant validity have been confirmed through the following criteria: Average Variance Extracted (AVE) exceeding 0.5, Composite Reliability (CR) surpassing 0.7, and Heterotrait-Monotrait Ratio of Correlations (HTMT) equating to 0.597. As for reliability, Cronbach's alpha, composite reliability (CR), and MaxR for all constructs were greater than 0.7, demonstrating good internal consistency. CONCLUSION As demonstrated by the results, the FABQ-P has a satisfactory level of reliability along with authentic validity according to the sociocultural contexts of Iranian post-operative patients.
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Affiliation(s)
- Hamid Sharif-Nia
- Psychosomatic Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Nursing, Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Erika Sivarajan Froelicher
- Department of Physiological Nursing, School of Nursing, Department of Epidemiology & Biostatistics, School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Amir Hossein Shafighi
- Department of Nursing, Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran.
| | | | - Reza Fatehi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Poorya Nowrozi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Bita Mohammadi
- Master of Nursing, Hospital Nurse 17 Shahrivar Amol, Mazandaran University of Medical Sciences, Sari, Iran
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Tamale BN, Ssekamatte T, Isunju JB, Nalugya A, Mukasa MM, Tigaiza A, Nakalembe D, Kansiime WK, Kimbugwe C, Mselle JS, Mugambe RK. Work-related musculoskeletal disorders among desludging operators in Uganda. BMC Musculoskelet Disord 2024; 25:461. [PMID: 38872154 PMCID: PMC11170829 DOI: 10.1186/s12891-024-07564-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 06/03/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Despite the limited evidence, desludging operators remain at a heightened risk of work-related musculoskeletal disorders (WMSDs). This study established the prevalence and predictors of WMSDs among desludging operators in Uganda. METHODS A digitalized structured questionnaire was used to collect cross-sectional data on musculoskeletal disorders and routine workplace activities from 303 desludging operators in 11 cities in Uganda. These cities were purposively selected based on the presence of a fecal sludge treatment plant or wastewater treatment plant. The Nordic Musculoskeletal Questionnaire (NMQ) was used to assess WMSDs. Simple random sampling with replacements was used to select respondents. Data were analyzed using STATA version 15.0. Modified Poisson Regression was used to measure the strength of association between the independent variables and WMSDs. RESULTS A total of 303 study participants were interviewed (97.7% response rate). The average age of the respondents was 34.0 years (SD ± 9.8). The prevalence of WMSDs among desludging operators was 29.7%. The body parts affected by MSDs were; the elbow for 4.6% (14/303), shoulder for 5.0% (15/303), and wrist/hand for 6.3% (19/303) of the respondents. At multivariable analysis, after controlling for age, desludging operators' ability to influence the availability of equipment needed to do their work (APR = 0.45, 95% CI: 0.20-0.99), and feeling that everything done was an effort (APR = 1.70, 95% CI: 1.01-2.87) were significantly associated with WMSDs. CONCLUSION The prevalence of WMSDs was high among desludging operators in Uganda. Desludging operators' ability to influence the availability of equipment needed to do their work and frequency of feeling that everything done was an effort were significantly associated with WMSDs. Interventions should focus on ensuring adequate provision of ergonomic equipment and promoting practices that reduce the physical strain associated with desludging tasks. Additionally, comprehensive training programs addressing proper lifting techniques and posture awareness could significantly mitigate the risk of WMSDs among desludging-operators.
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Affiliation(s)
- Bridget Nagawa Tamale
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda.
| | - Tonny Ssekamatte
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Aisha Nalugya
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Mujjabi Martin Mukasa
- Department of Urban Water and Sewerage Services, Ministry of Water and Environment, Kampala, Uganda
| | - Arnold Tigaiza
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Doreen Nakalembe
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Winnifred K Kansiime
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | | | | | - Richard K Mugambe
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
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Mansfield M, Thacker M, Taylor JL, Bannister K, Spahr N, Jong ST, Smith T. The association between psychosocial factors and mental health symptoms in cervical spine pain with or without radiculopathy on health outcomes: a systematic review. BMC Musculoskelet Disord 2023; 24:235. [PMID: 36978016 PMCID: PMC10045438 DOI: 10.1186/s12891-023-06343-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Neck pain, with or without radiculopathy, can have significant negative effects on physical and mental wellbeing. Mental health symptoms are known to worsen prognosis across a range of musculoskeletal conditions. Understanding the association between mental health symptoms and health outcomes in this population has not been established. Our aim was to systematically review the association between psychosocial factors and/or mental health symptoms on health outcomes in adults with neck pain, with or without radiculopathy. METHODS A systematic review of published and unpublished literature databases was completed. Studies reporting mental health symptoms and health outcomes in adults with neck pain with or without radiculopathy were included. Due to significant clinical heterogeneity, a narrative synthesis was completed. Each outcome was assessed using GRADE. RESULTS Twenty-three studies were included (N = 21,968 participants). Sixteen studies assessed neck pain only (N = 17,604 participants); seven studies assessed neck pain with radiculopathy (N = 4,364 participants). Depressive symptoms were associated with poorer health outcomes in people with neck pain and neck pain with radiculopathy. These findings were from seven low-quality studies, and an additional six studies reported no association. Low-quality evidence reported that distress and anxiety symptoms were associated with poorer health outcomes in people with neck pain and radiculopathy and very low-quality evidence showed this in people with neck pain only. Stress and higher job strain were negatively associated with poorer health outcomes measured by the presence of pain in two studies of very low quality. CONCLUSIONS Across a small number of highly heterogenous, low quality studies mental health symptoms are negatively associated with health outcomes in people with neck pain with radiculopathy and neck pain without radiculopathy. Clinicians should continue to utilise robust clinical reasoning when assessing the complex factors impacting a person's presentation with neck pain with or without radiculopathy. PROSPERO REGISTRATION NUMBER CRD42020169497.
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Affiliation(s)
- Michael Mansfield
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ, UK.
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Mick Thacker
- School of Physiotherapy, Royal College of Surgeons Ireland, 123 St Stephen's Green, Dublin 2, Ireland
| | - Joseph L Taylor
- Wolfson Centre of Age Related Diseases, Institute of Psychiatry, Psychology and Neuroscience, Central Modulation of Pain, King's College London, London, SE1 1UL, UK
| | - Kirsty Bannister
- Wolfson Centre of Age Related Diseases, Institute of Psychiatry, Psychology and Neuroscience, Central Modulation of Pain, King's College London, London, SE1 1UL, UK
| | - Nicolas Spahr
- Physiotherapy Department, Guy's and St Thomas Hospital NHS Foundation Trust, St Thomas Hospital, Westminster Bridge Road, London, UK
| | - Stephanie T Jong
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ, UK
| | - Toby Smith
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ, UK
- Warwick Medical School, University of Warwick, Coventry, UK
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Fear-Avoidance Behavior and Sickness Absence in Patients with Work-Related Musculoskeletal Disorders. ACTA ACUST UNITED AC 2020; 56:medicina56120646. [PMID: 33255875 PMCID: PMC7760519 DOI: 10.3390/medicina56120646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/23/2020] [Accepted: 11/23/2020] [Indexed: 11/25/2022]
Abstract
(1) Background and objectives: The purpose of this work is to determine the association of fear-avoidance attitudes with sickness absence status, its duration and disability in a work accident context. (2) Materials and Methods: This is a descriptive observational design, conducting the study in two occupational insurance provider clinics with patients with nonspecific low back and neck pain during the study period. Clinical variables were the Fear Avoidance Questionnaire, Roland Morris Disability Questionnaire, Neck Disability Index, Numerical Pain Scale; sociodemographic variables were sex, age, occupational, educational level, sickness absence status, and duration in days of absence from work. Multiple logistic and linear regressions were used to explore the association between variables. (3) Results: Fear-avoidance behavior is related to sickness absence status (OR = 1.048, p = 0.007), and the physical activity dimension (OR = 1.098, p = 0.013) is more relevant than the work dimension (OR = 1.056, p = 0.028). The duration of sickness absence is related to higher values on the fear-avoidance behavior scale in its global dimension (b = 0.84, p = 0.003, r = 0.327), and the results of the physical activity dimension (B = 1.37, p = 0.035, r = 0.236) were more relevant than the work dimension (B = 1.21, p = 0.003, r = 0.324). Fear-avoidance behavior is related to disability in both dimensions (B = 0.912, p ˂ 0.001, r = 0.505). (4) Conclusions: Fear-avoidance behaviors may influence the typification of sickness absence status, its duration both in its physical activity and work dimension, and its disability reported with higher values than in other healthcare contexts.
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ZAMRI EN, HOE VCW, MOY FM. Predictors of low back pain among secondary school teachers in Malaysia: a longitudinal study. INDUSTRIAL HEALTH 2020; 58:254-264. [PMID: 31666460 PMCID: PMC7286713 DOI: 10.2486/indhealth.2019-0106] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Low back pain (LBP) is prevalent among workers both in developed and developing countries. School teachers represent a high proportion of the working population in Malaysia. However, there is a lack of longitudinal study on predictors and course of LBP among teachers. Therefore, this study aimed to determine the predictors and course of LBP among secondary school teachers. Longitudinal data of 701 teachers in Selangor, Malaysia were collected from May 2015 to October 2016. Associations between predictors and LBP were analysed using logistic regression and reported as odds ratio (OR) and 95% confidence interval (CI). At 12-month of follow-up, 44% (95%CI: 40.6%, 48.0%) of the participants reported having LBP. In the regression model that included all risk factors, only LBP at baseline (OR 10.43, 95%CI: 6.19, 17.58) was associated with LBP at 12-month follow-up. When LBP at baseline was removed from the model, anxiety symptom (OR 2.51, 95%CI: 1.19, 5.30) and lifting heavy weights (OR 4.16, 95%CI: 1.40, 12.30) were found to be significantly associated with LBP at 12-month follow-up. In conclusion, issues on anxiety and lifting heavy weights should be addressed to reduce the occurrence of LBP despite the presence of health condition itself (LBP at baseline).
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Affiliation(s)
- Eva Nabiha ZAMRI
- Centre for Epidemiology and Evidence-Based Practice,
Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya,
Malaysia
- Cluster of Lifestyle Science, Advanced of Medical &
Dental Institute, Malaysia
| | - Victor Chee Wai HOE
- Centre for Epidemiology and Evidence-Based Practice,
Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya,
Malaysia
- Centre for Occupational and Environmental Health-UM,
Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya,
Malaysia
| | - Foong Ming MOY
- Centre for Epidemiology and Evidence-Based Practice,
Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya,
Malaysia
- *To whom correspondence should be addressed. E-mail:
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7
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Storm V. [Fear avoidance beliefs, pain-related self-efficacy, and subjective work ability among back pain patients : A pilot study with voluntary subjects]. Schmerz 2019; 33:312-319. [PMID: 31041528 DOI: 10.1007/s00482-019-0371-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Work-related fear avoidance beliefs play an important role when considering subjective work ability among people with back pain. Pain-related self-efficacy is known as a predictor for physical activity and subjective work ability. OBJECTIVES The present longitudinal study aims to investigate the relationships between work-related fear avoidance beliefs, pain-related self-efficacy, and subjective work ability among back pain patients. MATERIALS AND METHODS A total of 93 people with back pain (M = 35.58 years, SD = 13.45; range: 18-69) were assessed at baseline and 4 weeks later. Of the participants, 54.83% (n = 51) were female. Data analysis was performed with SPSS 25 using descriptive statistics and multiple regression methods. RESULTS Work-related fear avoidance beliefs were negatively related with subjective work ability at baseline. Pain-related self-efficacy moderated this relationship. The relationship was stronger at low and medium levels of pain-related self-efficacy. The moderation effect was not found when considering subjective work ability after 4 weeks. CONCLUSION Work-related fear avoidance beliefs among back pain patients seem to be important for subjective work ability in the short term. This especially holds true when patients have low self-efficacy beliefs. The investigated constructs should be emphasized in the patient-centered therapy. Longitudinal studies with larger samples and more frequent follow-ups should be investigated in future studies.
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Affiliation(s)
- Vera Storm
- Institut für Sportwissenschaften, Abteilung Sportpsychologie, Universität Münster, Horstmarer Landweg 62b, 48149, Münster, Deutschland.
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Al Adal S, Pourkazemi F, Mackey M, Hiller CE. The Prevalence of Pain in People With Chronic Ankle Instability: A Systematic Review. J Athl Train 2019; 54:662-670. [PMID: 31184959 DOI: 10.4085/1062-6050-531-17] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To identify the prevalence of pain in people with chronic ankle instability (CAI) and how pain is related to the impairments of CAI. DATA SOURCES We searched the databases of AMED, CINAHL, EMBASE, MEDLINE, PubMed, Scopus, SPORTDiscus, and Web of Science from inception to March 2017. STUDY SELECTION Eligible studies were peer-reviewed research in which investigators reported the presence of ankle pain or assessed the effects of pain on impairments in participants with CAI. Age and language were not restricted. Studies that included only surgical interventions were excluded. DATA EXTRACTION Studies identified by the search strategy were screened according to the eligibility criteria, and 2 independent reviewers extracted the data. Outcome measurements were (1) pain ratings using measures such as a visual analog scale and (2) other residual impairments, such as feelings of weakness, giving way, or deficits in functional performance. DATA SYNTHESIS Of the 5907 records identified through the database search, 14 studies were included in this review. All authors assessed ankle pain by self-report questionnaires or physical examination, or both. Pain was self-reported by 23% to 79% of participants and present on physical examination in 25% to 75% of participants, depending on the test applied. Among these studies, the highest reported pain level was 4.9 on the 11-point visual analog scale. Studies were heterogeneous for pain measures, participant groups, interventions, and follow-up periods. The relationship between pain and the structural and functional impairments associated with CAI was not investigated in the included studies. CONCLUSIONS Pain was present in a large proportion of people who had CAI, but pain levels were low. Information about the effects of pain was not reported, so researchers should examine the association between pain and function, balance, or other activities in people with CAI.
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Affiliation(s)
- Saeed Al Adal
- Faculty of Health Sciences, University of Sydney, Australia
| | | | - Martin Mackey
- Faculty of Health Sciences, University of Sydney, Australia
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Edmond SL, Enriquez CS, Millner MH, Nasri-Heir C, Heir GM. Is there an association between fear avoidance beliefs, and pain and disability in patients with orofacial pain? J Oral Rehabil 2017; 44:426-433. [PMID: 28295505 DOI: 10.1111/joor.12503] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2017] [Indexed: 11/29/2022]
Abstract
Numerous psychosocial factors have been shown to contribute to the development and perpetuation of orofacial pain. One well-recognized model for explaining the link between psychosocial factors and chronic pain is the fear avoidance model. To date, this proposed link has not been studied in subjects with orofacial pain. During the initial evaluation of subjects with orofacial pain, we collected data on fear avoidance beliefs using the Fear Avoidance Beliefs Questionnaire, and disability and pain. At between 6 and 8 weeks follow-up, we re-collected these data, as well as data addressing subjects' perceived change in their condition. Data were analyzed using correlation coefficients and linear regression. Fear avoidance beliefs at intake were inversely correlated with intake disability, There were no significant associations between fear avoidance beliefs at initial evaluation or in changes in fear avoidance beliefs during the 6-8 weeks follow-up period; and changes in disability, pain or perceived change in condition at 6-8 weeks follow-up. Of note, fear avoidance beliefs increased over the follow-up period, despite improvements in all outcome measures. There was insufficient evidence to suggest that high levels of fear avoidance beliefs at initial evaluation are associated with higher levels of disability or pain at intake, or with change in disability, pain or perceived change in condition at 6-8 weeks follow-up. Similarly, there was insufficient evidence to suggest that changes in fear avoidance beliefs during treatment are associated with any of these outcome measures.
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Affiliation(s)
- S L Edmond
- School of Health Professions, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - C S Enriquez
- School of Health Sciences, Stockton University, Galloway, NJ, USA
| | - M H Millner
- School of Health Professions, Rutgers, The State University of New Jersey, Newark, NJ, USA.,Professional Physical Therapy and Training, LLC, Madison, NJ, USA
| | - C Nasri-Heir
- Department of Diagnostic Sciences, Rutgers, School of Dental Medicine Center for Temporomandibular Disorders and Orofacial Pain, The State University of New Jersey, Newark, NJ, USA
| | - G M Heir
- Department of Diagnostic Sciences, Rutgers, School of Dental Medicine Center for Temporomandibular Disorders and Orofacial Pain, The State University of New Jersey, Newark, NJ, USA
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Jordon MK, Beattie PF, D'Urso S, Scriven S. Spinal manipulation does not affect pressure pain thresholds in the absence of neuromodulators: a randomized controlled trial. J Man Manip Ther 2016; 25:172-181. [PMID: 28912629 DOI: 10.1080/10669817.2016.1230352] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Measurement of pressure pain threshold (PPT) is a way to determine one of the many potential treatment effects of spinal manipulative therapy. OBJECTIVE To determine how multiple spinal manipulations administered in a single-session affected PPTs at local and distal sites in asymptomatic individuals. METHODS Participants were randomly assigned into one of three groups: Group one (n = 18) received a lumbar manipulation followed by a cervical manipulation. Group two (n = 17) received a cervical manipulation followed by a lumbar manipulation. The control group (n = 19) received two bouts of five minutes of rest. At baseline and after each intervention or rest period, each participant's PPTs were obtained using a handheld algometer. The PPTs were tested bilaterally over the lateral epicondyles of the humerus and over the mid-bellies of the upper trapezius, lumbar paraspinal, and the tibialis anterior muscles. This study was registered with ClinicalTrials.gov, and its Identifier is NCT02828501. RESULTS Repeated-measures ANOVAs and Kruskal-Wallis tests showed no significant within- or between-group differences in PPT. Within-group effect sizes in the changes of PPT ranged from -.48 at the left paraspinal muscles to .24 at the left lateral humeral epicondyle. Statistical power to detect significant differences at α of 0.05 was calculated to be 0.94. CONCLUSIONS This study suggests that in young adults who do not have current or recent symptoms of spinal pain, multiple within-session treatments of cervical and lumbar spinal manipulation fail to influence PPTs. Changes in PPT that are observed in symptomatic individuals are likely to be primarily influenced by pain-related neuromodulators rather than by an isolated, mechanical effect of spinal manipulation.
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Affiliation(s)
- Max K Jordon
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Paul F Beattie
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Sarah D'Urso
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Sarah Scriven
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Myhre K, Lau B, Marchand GH, Leivseth G, Bautz-Holter E, Røe C. Demand, Control and Support at Work Among Sick-Listed Patients with Neck or Back Pain: A Prospective Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2016; 26:183-194. [PMID: 26286432 DOI: 10.1007/s10926-015-9602-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Purpose The main aim of this study was to assess changes in perceived demand, control and support at work of neck and back pain patients over 1 year. We also hypothesised that perceived changes in demand, control and support at work were associated with clinical improvement, reduced fear-avoidance beliefs and successful return to work. Methods Four hundred and five sick-listed patients referred to secondary care with neck or back pain were originally included in an interventional study. Of these, two hundred and twenty-six patients reported perceived psychosocial work factors at both baseline and 1-year follow-up, and they were later included in this prospective study. Changes in demand, control and support dimensions were measured by a total of nine variables. Results At the group level, no significant differences were found among the measured subscales. At the individual level, the regression analyses showed that decreases in fear-avoidance beliefs about work were consistently related to decreases in demand and increases in control, whereas decreases in disability, anxiety and depression were related to increases in support subscales. Conclusions The perception of demand, control and support appear to be stable over 1 year in patients with neck and back pain, despite marked improvement in pain and disability. Disability, anxiety, depression and fear-avoidance beliefs about work were significantly associated with the perception of the work environment, whereas neck and back pain were not.
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Affiliation(s)
- Kjersti Myhre
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ulleval, Nydalen, P.O. Box 4956, 0424, Oslo, Norway.
| | - Bjørn Lau
- National Institute of Occupational Health, Oslo, Norway
- Lovisenberg Hospital, Oslo, Norway
| | - Gunn Hege Marchand
- Faculty of Medicine, Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gunnar Leivseth
- Faculty of Medicine, Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
| | - Erik Bautz-Holter
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ulleval, Nydalen, P.O. Box 4956, 0424, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Cecilie Røe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ulleval, Nydalen, P.O. Box 4956, 0424, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
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12
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Øyeflaten I, Opsahl J, Eriksen HR, Braathen TN, Lie SA, Brage S, Ihlebæk CM, Breivik K. Subjective health complaints, functional ability, fear avoidance beliefs, and days on sickness benefits after work rehabilitation - a mediation model. BMC Musculoskelet Disord 2016; 17:225. [PMID: 27215825 PMCID: PMC4878022 DOI: 10.1186/s12891-016-1084-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Accepted: 05/17/2016] [Indexed: 12/04/2022] Open
Abstract
Background Long-term sick leave and withdrawal from working life is a concern in western countries. In Norway, comprehensive inpatient work rehabilitation may be offered to sick listed individuals at risk of long-term absence from work. Knowledge about prognostic factors for work outcomes after long-term sick leave and work rehabilitation is still limited. The aim of this study was to test a mediation model for various hypothesized biopsychosocial predictors of continued sick leave after inpatient work rehabilitation. Methods One thousand one hundred fifty-five participants on long-term sick leave from eight different work rehabilitation clinics answered comprehensive questionnaires at arrival to the clinic, and were followed with official register data on sickness benefits for 3 years. Structural equation models were conducted, with days on sickness benefits after work rehabilitation as the outcome. Results Fear avoidance beliefs for work mediated the relation between both musculoskeletal complaints and education on days on sickness benefits after work rehabilitation. The relation between musculoskeletal complaints and fear avoidance beliefs for work was furthermore fully mediated by poor physical function. Previous sick leave had a strong independent effect on continued sick leave after work rehabilitation. Fear avoidance beliefs for work did not mediate the small effect of pseudoneurological complaints on continued sick leave. Poor coping/interaction ability was neither related to continued sick leave nor fear avoidance beliefs for work. Conclusions The mediation model was partly supported by the data, and provides some possible new insight into how fear avoidance beliefs for work and functional ability may intervene with subjective health complaints and days on sickness benefits after work rehabilitation.
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Affiliation(s)
- Irene Øyeflaten
- National Centre for Occupational Rehabilitation, Haddlandsvegen 20, NO-3864, Rauland, Norway. .,Uni Research Health, Bergen, Norway.
| | | | - Hege R Eriksen
- Uni Research Health, Bergen, Norway.,Department of Sport and Physical Activity, Bergen University College, Bergen, Norway
| | - Tore Norendal Braathen
- National Centre for Occupational Rehabilitation, Haddlandsvegen 20, NO-3864, Rauland, Norway.,Faculty of Health and Social Studies, Telemark University College, Porsgrunn, Norway
| | - Stein Atle Lie
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Søren Brage
- The Directorate of Labour and Welfare, Oslo, Norway
| | - Camilla M Ihlebæk
- Section of Public Health Science, ILP, Norwegian University of Life Sciences, Ås, Norway
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13
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Marchand GH, Lau B, Myhre K, Røe C, Bautz-Holter E, Leivseth G. Pain and disability do not influence psychological and social factors at work among sick-listed patients with neck and back pain. Work 2016; 53:499-509. [DOI: 10.3233/wor-152226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Gunn Hege Marchand
- Faculty of Medicine, Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Bjørn Lau
- Lovisenberg Diakonale Hospital, Oslo, Norway
- National Institute of Occupational Health, Oslo, Norway
| | - Kjersti Myhre
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ulleval, Oslo, Norway
| | - Cecilie Røe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ulleval, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Erik Bautz-Holter
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ulleval, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Gunnar Leivseth
- Faculty of Medicine, Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Clinical Medicine, Neuromuscular Diseases Research Group, The Arctic University of Norway UIT, Tromsø, Norway
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14
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Suni JH, Rinne M, Kankaanpää M, Taulaniemi A, Lusa S, Lindholm H, Parkkari J. Neuromuscular exercise and back counselling for female nursing personnel with recurrent non-specific low back pain: study protocol of a randomised controlled trial (NURSE-RCT). BMJ Open Sport Exerc Med 2016; 2:e000098. [PMID: 27900169 PMCID: PMC5117067 DOI: 10.1136/bmjsem-2015-000098] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2016] [Indexed: 12/19/2022] Open
Abstract
Introduction Nursing personnel have high risk for incidence of low back pain (LBP) followed by development of chronic pain and disability. Multiple risk factors such as patient handling, night shift work and lack of supporting work culture have been identified. In subacute LBP, high-fear avoidance is prognostic for more pain, disability and not returning to work. Lack of leisure-time physical activity predicts long-term sickness absence. The purpose of this study is to compare effectiveness of 6-month neuromuscular exercise and counselling in treating back pain in female nursing personnel with recurrent non-specific LBP pain compared with either (exercise or counselling) alone and a non-treatment control group. Methods and analysis The design is of a double-blinded four-arm randomised controlled trial with cost-effectiveness evaluation at 12 and 24 months. The study is conducted in 3 consecutive substudies. The main eligibility criteria are experience of LBP during the past 4 weeks with intensity of at least 2 (Numeric Rating Scale 0–10) and engagement in patient handling. Sample size was estimated for the primary outcome of pain intensity (visual analogue scale). Study measurements are outlined according to the model of International Classification of Functioning, Disability and Health, which incorporates the biopsychosocial processes assessed. Ethics and dissemination This study is carried out conforming to the guidelines of good scientific practice and provisions of the declaration of Helsinki. Increasing physical and mental capacity with interventions taking place immediately after working hours near the worksite may reduce development of chronic LBP and work disability in female nursing personnel with recurrent non-specific LBP. Trial registration number NCT04165698.
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Affiliation(s)
- Jaana H Suni
- UKK Institute for Health Promotion Research , Tampere , Finland
| | - Marjo Rinne
- UKK Institute for Health Promotion Research , Tampere , Finland
| | - Markku Kankaanpää
- Pirkanmaa Hospital District, Physical and Rehabilitation Medicine Outpatient Clinic , Tampere , Finland
| | | | - Sirpa Lusa
- Finnish Institute of Occupational Medicine , Helsinki , Finland
| | - Harri Lindholm
- Finnish Institute of Occupational Medicine , Helsinki , Finland
| | - Jari Parkkari
- UKK Institute for Health Promotion Research , Tampere , Finland
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15
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Comparative Effectiveness of Conservative Interventions for Nonspecific Chronic Spinal Pain: Physical, Behavioral/Psychologically Informed, or Combined? A Systematic Review and Meta-Analysis. THE JOURNAL OF PAIN 2016; 17:755-74. [PMID: 26844416 DOI: 10.1016/j.jpain.2016.01.473] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 12/05/2015] [Accepted: 01/14/2016] [Indexed: 12/11/2022]
Abstract
UNLABELLED Nonspecific chronic spinal pain (NSCSP) is highly disabling. Current conservative rehabilitation commonly includes physical and behavioral interventions, or a combination of these approaches. Physical interventions aim to enhance physical capacity by using methods such as exercise, manual therapy, and ergonomics. Behavioral/psychologically informed interventions aim to enhance behaviors, cognitions, or mood by using methods such as relaxation and cognitive behavioral therapy. Combined interventions aim to target physical and also behavioral/psychological factors contributing to patients' pain by using methods such as multidisciplinary pain management programs. Because it remains unclear whether any of these approaches are superior, this review aimed to assess the comparative effectiveness of physical, behavioral/psychologically informed, and combined interventions on pain and disability in patients with NSCSP. Ten electronic databases were searched for randomized controlled trials (RCTs) including participants reporting NSCSP. Studies were required to have an "active" conservative treatment control group for comparison. Studies were not eligible if the interventions were from the same domain (eg, if the study compared 2 physical interventions). Study quality was assessed used the Cochrane Back Review Group risk of bias criteria. The treatment effects of physical, behavioral/psychologically informed, and combined interventions were assessed using meta-analyses. Twenty-four studies were included. No clinically significant differences were found for pain and disability between physical, behavioral/psychologically informed, and combined interventions. The simple categorization of interventions into physical, behavioral/psychologically informed, and combined could be considered a limitation of this review, because these interventions may not be easily differentiated to allow accurate comparisons to be made. Further work should consider investigating whether tailoring rehabilitation to individual patients and their perceived risk of chronicity, as seen in recent RCTs for low back pain, can enhance outcomes in NSCSP. PERSPECTIVE In this systematic review of RCTs in NSCSP, only small differences in pain or disability were observed between physical, behavioral/psychologically informed, and combined interventions.
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Kaka B, Ogwumike OO, Idowu OA, Odole AC, Saidu AM, Fawole HO, Ibrahim M. Translation of the fear avoidance beliefs questionnaire into Hausa language. Glob J Health Sci 2014; 7:116-23. [PMID: 25948442 PMCID: PMC4802154 DOI: 10.5539/gjhs.v7n3p116] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 10/08/2014] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Self-report measures of fear-avoidance beliefs are widely used in clinical practice and research. To date there is no Hausa version of the Fear Avoidance Beliefs Questionnaire (FABQ). This is important as the Hausa language is a widely spoken language in West Africa. OBJECTIVES The purpose of this study was to translate and validate the Hausa version of the FABQ in patients with non-specific neck pain. METHODS Two independent bilingual Hausa translators translated the English version of the FABQ into Hausa which was thereafter back translated by one independent bilingual translator. A professional expert panel revised the translations to produce a consensus version. The psychometric testing of the final translated instrument was investigated by surveying 54 Hausa speaking patients with chronic non-specific neck pain. Cross-sectional construct validity was evaluated by comparing Hausa Fear Avoidance Beliefs Questionnaire (FABQ-H) with the English version of the FABQ. Internal consistency of the FABQ-H was examined by Cronbach alpha by comparing the scores between the FABQ-H and its subscales. Test-retest reliability was evaluated by administering the Hausa version twice. RESULTS The translated Hausa version of FABQ proved to be acceptable. The FABQ-H showed strong correlations (r=0.94, p=0.000) with the original English version. There was also high internal consistency between the FABQ-H and its subscales (physical activity component-alpha=0.88, p=0.000 and work component- alpha=0.94, p= 0.000). The FABQ-H also showed a high test-retest reliability (intra-class correlation coefficient =0.98). CONCLUSION The FABQ-H demonstrated excellent psychometric properties similar to other existing versions. The FABQ-H is recommended for clinical practice.
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Affiliation(s)
| | | | - Opeyemi A Idowu
- Department of Physiotherapy, School of Basic Medical Sciences, College of Medicine, University of Benin, Benin-City.
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Brox JI. Current evidence on catastrophizing and fear avoidance beliefs in low back pain patients. Spine J 2014; 14:2679-81. [PMID: 25441973 DOI: 10.1016/j.spinee.2014.08.454] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 08/23/2014] [Indexed: 02/03/2023]
Affiliation(s)
- Jens Ivar Brox
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, University of Oslo, Pb 4950 Nydalen, N-0424 Oslo, Norway.
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