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Gundmi VRN, Gangahanumaiah S, Maiya AG, Guddattu V. Effect of Structured Exercise-Based Intervention on Upper Quadrant Dysfunction among Fish Processing Workers with Work-Related Musculoskeletal Disorders. Indian J Community Med 2024; 49:489-495. [PMID: 38933785 PMCID: PMC11198529 DOI: 10.4103/ijcm.ijcm_59_23] [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: 02/02/2023] [Accepted: 12/27/2023] [Indexed: 06/28/2024] Open
Abstract
Background Musculoskeletal disorders (MSDs) are one of the major causes of morbidity, which affect particularly the upper quadrant in industrial settings and so upset the quality of life (QoL). The influence of the protocol of exercise-based programs at the workplace on the well-being of the worker is contradictory. The objective of the study was to find the effect of the structured exercise-based intervention on upper quadrant dysfunction among fish processing workers with work-related MSDs. Methods The intervention group (n = 91) participated in an individually tailored structured exercise-based intervention (SEBI) program for three months, which consisted of stretching, strengthening, and active exercises. The control group (n = 93) was instructed to continue routine daily activities. The outcome measures of the cluster-randomized controlled trial were Neck Disability Index (NDI), Disabilities of Arm, Shoulder, and Hand (DASH), Visual Analog Scale (VAS), and Short Form-36, used to evaluate at baseline, eighth, and twelfth week. The data were analyzed by repeated analysis of variance and Student's t-tests. Results The results for the overall perception of upper quadrant dysfunction showed statistically significant differences (P < 0.0001) for NDI, DASH, and VAS. Further, we obtained a significant difference in QoL between the intervention and control groups for physical and psychological health sub-domains. Conclusion SEBI effectively enhanced the general health of fish processing workers by showing improvements in the measures of NDI, DASH, VAS, and QoL. Hence, SEBI can be recommended in the fish processing industries to achieve potential impact on upper quadrant dysfunction and improve the QoL.
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Affiliation(s)
- V Rajesh N. Gundmi
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Somu Gangahanumaiah
- Department of Hospital Administration, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Arun G. Maiya
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Vasudeva Guddattu
- Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
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D Delgado A, Salazar SI, Rozaieski K, Putrino D, Tabacof L. Engagement in an mHealth-Guided Exercise Therapy Program Is Associated With Reductions in Chronic Musculoskeletal Pain. Am J Phys Med Rehabil 2023; 102:984-989. [PMID: 37026894 DOI: 10.1097/phm.0000000000002257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
CONTEXT Chronic musculoskeletal pain costs the US $980 billion annually. Conservative treatments are the criterion standard, but scalable methods of treatment remain to be evaluated. OBJECTIVE The aim of the study is to determine the effects of pain reduction and the perceived benefits of an mHealth exercise therapy program. DESIGN This is a retrospective observational study on data from 3109 people (18-98, 49% female) with musculoskeletal pain in an mHealth exercise program. Presession pain was measured via 11-point numeric rating scale and nonstandardized single-item questions for work and quality of life; all were analyzed using mixed-effects models. RESULTS By 11 sessions, there was an estimated a 2.09-point decrease in average numeric rating scale pain levels. There was an average percent increase of approximately 0.7 points for work life and quality of life ( tdf =6,632 = 12.06, P < 0.001). User engagement was high; 46% of participants were performing more than one session per day, and 88% were engaging within a week, indicating the feasibility of the deployment of an mHealth exercise app. CONCLUSIONS An mHealth exercise program was associated with significant decrease in pain and increased perceived benefits in a large population. These findings serve as preliminary findings of the feasibility for mHealth exercise interventions as scalable tools to improve chronic musculoskeletal pain outcomes.
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Affiliation(s)
- Andrew D Delgado
- From the Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York City, New York (ADD, SIS, DP, LT); and Cape May Veterans Affairs Community Based Outpatient Clinic, Wilmington VAMC, Wilmington, Delaware (KR)
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Souza PVS, Afonso G, de Rezende Pinto WBV, de Lima Serrano P, de Mattos Lombardi Badia B, Farias IB, Dos Santos Jorge AC, Machado RIL, Pinto IFN, Barros GB, de Oliveira HB, Calil SR, Franz C, Oliveira ASB. Brazilian registry of patients with porphyria: REBRAPPO study. Orphanet J Rare Dis 2023; 18:49. [PMID: 36890577 PMCID: PMC9996884 DOI: 10.1186/s13023-023-02653-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 02/27/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Porphyrias are a rare group of disease due to inherited defects of heme synthesis with important systemic manifestations and great burden of disease for patients and families due to the exceptional course of disease with disabling chronic symptoms interposed by life-threatening acute attacks. Unfortunately, the porphyrias are usually underrecognized reflecting a lack of medical and disease awareness as well as few studies about natural history in large cohorts of patients. The main aim of this article is present consistent data about natural history and burden of disease in a large Brazilian cohort. METHODS We conducted a national cross-sectional registry with retrospective clinical data of Brazilian patients with porphyria collected with Brazilian patients Association with Porphyria in collaboration with a tertiary care center for rare diseases. RESULTS A cohort of 172 patients was analyzed in which 148 (86%) patients had the diagnosis of acute hepatic porphyria [AHP] that needed a mean of 62.04 medical visits and 9.6 years to achieve a definitive diagnosis. About AHP cohort, the most common first clinical manifestation were abdominal pain in 77 (52%) patients and acute muscle weakness in 23 (15.5%) with 73 (49.3%) patients presenting only one attack during disease course and 37 (25%) exhibiting 4 or more attacks in the last year. Of note, 105 patients with AHP reported chronic manifestations and the scores for quality of life are lower when compared with general healthy population. CONCLUSIONS Brazilian patients with AHP had a higher prevalence of chronic disabling manifestations and a poor quality of life like other cohorts and a higher proportion of patients with recurrent attacks than previously reported.
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Affiliation(s)
- Paulo Victor Sgobbi Souza
- Neuromuscular Unit, Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), Embaú Street, 67, Vila Clementino, São Paulo, SP, 04039-060, Brazil.
| | | | - Wladimir Bocca Vieira de Rezende Pinto
- Neuromuscular Unit, Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), Embaú Street, 67, Vila Clementino, São Paulo, SP, 04039-060, Brazil
| | - Paulo de Lima Serrano
- Neuromuscular Unit, Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), Embaú Street, 67, Vila Clementino, São Paulo, SP, 04039-060, Brazil
| | - Bruno de Mattos Lombardi Badia
- Neuromuscular Unit, Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), Embaú Street, 67, Vila Clementino, São Paulo, SP, 04039-060, Brazil
| | - Igor Braga Farias
- Neuromuscular Unit, Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), Embaú Street, 67, Vila Clementino, São Paulo, SP, 04039-060, Brazil
| | - Ana Carolina Dos Santos Jorge
- Neuromuscular Unit, Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), Embaú Street, 67, Vila Clementino, São Paulo, SP, 04039-060, Brazil
| | - Roberta Ismael Lacerda Machado
- Neuromuscular Unit, Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), Embaú Street, 67, Vila Clementino, São Paulo, SP, 04039-060, Brazil
| | - Icaro França Navarro Pinto
- Neuromuscular Unit, Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), Embaú Street, 67, Vila Clementino, São Paulo, SP, 04039-060, Brazil
| | - Glenda Barbosa Barros
- Neuromuscular Unit, Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), Embaú Street, 67, Vila Clementino, São Paulo, SP, 04039-060, Brazil
| | - Helvia Bertoldo de Oliveira
- Neuromuscular Unit, Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), Embaú Street, 67, Vila Clementino, São Paulo, SP, 04039-060, Brazil
| | - Samia Rogatis Calil
- Neuromuscular Unit, Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), Embaú Street, 67, Vila Clementino, São Paulo, SP, 04039-060, Brazil
| | - Cibele Franz
- Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Acary Souza Bulle Oliveira
- Neuromuscular Unit, Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), Embaú Street, 67, Vila Clementino, São Paulo, SP, 04039-060, Brazil
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Kiani S, Rezaei I, Abasi S, Zakerabasali S, Yazdani A. Technical aspects of virtual augmented reality-based rehabilitation systems for musculoskeletal disorders of the lower limbs: a systematic review. BMC Musculoskelet Disord 2023; 24:4. [PMID: 36597077 PMCID: PMC9808732 DOI: 10.1186/s12891-022-06062-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 12/06/2022] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Musculoskeletal disorders are one of the most common causes of physical disability. The rehabilitation process after musculoskeletal disorders is long and tedious, and patients are not motivated to follow rehabilitation protocols. Therefore, new systems must be used to increase patient motivation. Virtual reality (VR) and augmented reality (AR) technologies can be used in this regard. In developing such systems, various technologies and methods of movement recognition are used; therefore, this study aims to summarize the technical aspects of using VR/AR in rehabilitation and evaluate and discuss efficient methods of investigating studies using the Statement of Standards for Reporting Implementation Studies (StaRI). METHODS Search in four scientific databases was done systematically based on PRISMA through online search engines from inception to June 2021. These databases include Medline (PubMed), Scopus, IEEE, and Web of Science. An updated search was also conducted on 17 December 2021. The research used keywords and MeSH terms associated with VR/AR, musculoskeletal disorder, and rehabilitation. Selected articles were evaluated qualitatively using the Standards for Reporting Implementation Studies (StaRI) statement. RESULTS A total of 2343 articles were found, and 20 studies were included. We found that 11 (55%) studies used Kinect technology as input tools, and 15 (75%) studies have described the techniques used to analyze human movements, such as dynamic time warping (DTW) and support vector machines (SVM). In 10 (50%) studies, the Unity game engine was used for visualization. In 8 studies (40%), usability was assessed, and high usability was reported. Similarly, the results of the review of studies according to the StaRI checklist showed poor reporting in the title and discussion of the studies. CONCLUSIONS We found that academic studies did not describe the technical aspects of rehabilitation systems. Therefore, a good description of the technical aspects of the system in such studies should be considered to provide repeatability and generalizability of these systems for investigations by other researchers.
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Affiliation(s)
- Shamim Kiani
- grid.412571.40000 0000 8819 4698Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Iman Rezaei
- grid.412571.40000 0000 8819 4698Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran ,grid.412571.40000 0000 8819 4698Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sanaz Abasi
- grid.412571.40000 0000 8819 4698Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Somayyeh Zakerabasali
- grid.412571.40000 0000 8819 4698Health Human Resources Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ,grid.412571.40000 0000 8819 4698Health Information Management Department, Shiraz University of Medical Sciences, Shiraz, Iran ,grid.412571.40000 0000 8819 4698 Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azita Yazdani
- grid.412571.40000 0000 8819 4698Health Human Resources Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ,grid.412571.40000 0000 8819 4698Health Information Management Department, Shiraz University of Medical Sciences, Shiraz, Iran ,grid.412571.40000 0000 8819 4698 Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Long-Term Clinical Outcomes of a Remote Digital Musculoskeletal Program: An Ad Hoc Analysis from a Longitudinal Study with a Non-Participant Comparison Group. Healthcare (Basel) 2022; 10:healthcare10122349. [PMID: 36553873 PMCID: PMC9778537 DOI: 10.3390/healthcare10122349] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/18/2022] [Accepted: 11/20/2022] [Indexed: 11/24/2022] Open
Abstract
Digital solutions have emerged as an alternative to conventional physiotherapy, particularly for chronic musculoskeletal pain (CMP) management; however, its long-term effects remain largely unexplored. This study focuses on patients reporting CMP, assessing 1-year clinical outcomes after a multimodal digital care program (DCP) versus non-participants, who enrolled in the program but never engaged in a single exercise session or partook of the educational content made available to them. In this longitudinal study ad-hoc analysis, pain and functionality outcomes at 1-year reassessment were studied, focusing on the odds of reaching minimal clinically important difference (MCID) and, overall average reduction in both outcomes. Healthcare utilization was additionally studied within the same period. From 867 individuals allocated to the study, 460 completed the 1-year reassessment (intervention group: 310; comparison group: 150). The intervention group presented sustained and greater pain reduction until 1-year reassessment than the comparison group, reflecting greater odds ratio of achieving the MCID both in pain and functionality (1.90 95% CI: 1.27-2.86, p = 0.002 and 2.02 95% CI: 1.31-3.12, p = 0.001, respectively). A lower healthcare utilization during the 1-year follow-up was observed in the intervention group than in the comparison group. This study suggests that a digital CMP program may have a lasting impact on improved pain and functionality in patients with CMP.
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Von Piekartz H, Geitner G, Möller D, Braun R, Hall T. Does combined individualized orofacial manual therapy, pain neuroscience education, and brain training change orofacial pain, chronic face dysfunction, (facial) body perception and pain? An observational mixed methods case series study. J Man Manip Ther 2022; 30:180-191. [PMID: 35045803 PMCID: PMC9255020 DOI: 10.1080/10669817.2021.2018102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Orofacial pain is a complex disabling condition. Multimodal physical therapy intervention may be helpful, yet studies of such approaches are not available and are the basis of this study. OBJECTIVE To identify whether combined orofacial manual therapy, pain neuroscience education, graded motor imagery, and face emotional expression training has an impact on orofacial pain and associated features. DESIGN Mixed-methods case series report. METHODS Eight subjects (five females) with predominant chronic unilateral face pain (mean duration 7.3 years) were given six individualized treatment sessions and a home program. The primary outcome was orofacial pain, while secondary outcomes were depression, quality of life, alexithymia, 2-point discrimination (TPD), laterality and emotional recognition, as well as qualitative analysis were evaluated post intervention. RESULTS Following the intervention orofacial pain intensity significantly reduced (p = 0.03) from 3.0 (0.53) to 2.2 (1.75) on the Graded Chronic Pain Status questionnaire. As well, secondary outcome measures depression, alexithymia, TPD, and quality of life also significantly improved. Changes were not significant in aspects of facial perception. Qualitative analysis of perception of therapy is discussed. CONCLUSION Multimodal therapy had a positive outcome in terms of improvement in unilateral persistent facial pain, depression score, facial body perception and quality of life, and pain in people with chronic unilateral facial pain. Based on the qualitative analysis of their perception of the therapy, multimodal therapy had beneficial effects through increased motivation and joy to exercise.
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Affiliation(s)
- Harry Von Piekartz
- Faculty of Business, Management and Social Science, Department Movement and Rehabilitation science Caprivistrasse 30a, OsnabrückGermany,CONTACT Harry Von Piekartz University of Applied Science Osnabrück,Faculty of Business,Management and Social Science , Department of Movement and Rehabilitation Science,Caprivistrasse 30a Osnabrück49076, Germany
| | - Gesche Geitner
- Faculty of Business, Management and Social Science, Department Movement and Rehabilitation science Caprivistrasse 30a, OsnabrückGermany
| | - Dirk Möller
- Faculty of Business, Management and Social Science, Department Movement and Rehabilitation science Caprivistrasse 30a, OsnabrückGermany
| | - Robert Braun
- Faculty of Business, Management and Social Science, Department Psychology, Caprivistrasse 30a, OsnabrueckGermany
| | - Toby Hall
- School for Physiotherapy, Department Psychology,School of Physiotherapy and Curtin Health Innovation Research, Curtin UniversityPerth, Australia
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The influence of cognitive factors in relation to the patients' treatment adherence for non-specific chronic low-back pain. A case series. J Bodyw Mov Ther 2022; 29:271-278. [DOI: 10.1016/j.jbmt.2021.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 08/11/2021] [Accepted: 10/17/2021] [Indexed: 11/20/2022]
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Courbalay A, Jobard R, Descarreaux M, Bouvard B. Direct and Indirect Relationships Between Physical Activity, Fitness Level, Kinesiophobia, and Health-Related Quality of Life in Patients with Rheumatic and Musculoskeletal Diseases: A Network Analysis. J Pain Res 2021; 14:3387-3399. [PMID: 34737633 PMCID: PMC8560166 DOI: 10.2147/jpr.s323424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/01/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction Using a network analysis, the present study investigated the extent to which physical activity (PA), objective fitness level, kinesiophobia, and health-related quality of life (HRQoL) interact in patients with rheumatic and musculoskeletal diseases. The objectives were twofold: 1) to clarify the direct and indirect relationships between these variables while controlling for the shared variance between them, and 2) to establish a potential ranking of influence among them. Methods This cross-sectional design study involved patients recruited from a rheumatology unit. One hundred and twenty patients completed self-reported measures of PA, the Tampa scale of kinesiophobia and the 36-item Short-Form Health Survey, and ninety-seven of those patients performed the six-minute walking test and the thirty-second sit-to-stand test. Network analyses were conducted using bootnet and qgraph packages. Results Weekly time spent on PA, as well as physical fitness measures, were directly linked to kinesiophobia and the HRQoL physical dimension, but indirectly linked to HRQoL mental dimension through the mediation of kinesiophobia. Specifically, weekly PA time had direct relationships to physical functioning, vitality, and role limitations due to physical and emotional problems. Fitness measures had direct relationships with physical functioning, bodily pain, and mental health. The analyses did not clearly highlight one variable as the most influential in the network. Discussion The study highlights the complexities of direct and indirect biopsychosocial relationships that are at the core of patients’ daily functioning. Measurement of PA, use of a longitudinal design, and interventions are discussed.
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Affiliation(s)
- Anne Courbalay
- Institut de Formation en Education Physique et en Sport d'Angers (IFEPSA-UCO), APCoSS, Les Ponts de Cé, France
| | - Romane Jobard
- Institut de Formation en Education Physique et en Sport d'Angers (IFEPSA-UCO), APCoSS, Les Ponts de Cé, France
| | - Martin Descarreaux
- Department of Human Kinetics, Université du Québec à Trois-Rivières Québec, Trois-Rivières, Canada
| | - Béatrice Bouvard
- Univ Angers, GEROM, SFR ICAT, Angers, France.,CHU Angers, Service de Rhumatologie, Angers, France
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Madrid-García A, León-Mateos L, Pato E, Jover JA, Fernández-Gutiérrez B, Abasolo L, Menasalvas E, Rodríguez-Rodríguez L. Predictors of health-related quality of life in musculoskeletal disease patients: a longitudinal analysis. Ther Adv Musculoskelet Dis 2021; 13:1759720X211034063. [PMID: 34367344 PMCID: PMC8317252 DOI: 10.1177/1759720x211034063] [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: 02/17/2021] [Accepted: 06/28/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction Rheumatic and musculoskeletal diseases (RMDs) have a significant impact on patients' health-related quality of life (HRQoL) exacerbating disability, reducing independence and work capacity, among others. Predictors' identification affecting HRQoL could help to place efforts that minimize the deleterious impact of these conditions on patients' wellbeing. This study evaluates the influence of demographic and clinical predictors on the HRQoL of a cohort of RMD patients, measured using the Rosser classification index (RCI). Methods We included patients attending the Hospital Clínico San Carlos (HCSC) rheumatology outpatient clinic from 1 April 2007 to 30 November 2017. The primary outcome was the HRQoL assessed in each of the patient's visits using the RCI. Demographic and clinical variables extracted from a departmental electronic health record (EHR) were used as predictors: RMD diagnoses, treatments, comorbidities, and averaged HRQoL values from previous periods (for this last variable, values were imputed if no information was available). Association between predictors and HRQoL was analyzed using penalized generalized estimating equations (PGEEs). To account for imputation bias, the PGEE model was repeated excluding averaged HRQoL predictors, and common predictors were considered. Discussion A total of 18,187 outpatients with 95,960 visits were included. From 410 initial predictors, 19 were independently associated with patients' HRQoL in both PGEE models. Chronic kidney disease (CKD), an episode of prescription of third level analgesics, monoarthritis, and fibromyalgia diagnoses were associated with worse HRQoL. Conversely, the prescription in the previous visit of acid-lowering medication, colchicine, and third level analgesics was associated with better HRQoL. Conclusion We have identified several diagnoses, treatments, and comorbidities independently associated with HRQoL in a cohort of outpatients attending a rheumatology clinic.
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Affiliation(s)
- Alfredo Madrid-García
- Grupo de Patología Musculoesquelética, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - Leticia León-Mateos
- Grupo de Patología Musculoesquelética, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - Esperanza Pato
- Rheumatology Service, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - Juan A Jover
- Rheumatology Service, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | | | - Lydia Abasolo
- Grupo de Patología Musculoesquelética, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - Ernestina Menasalvas
- Centro de Tecnología Biomédica, Universidad Politécnica de Madrid, Parque Científico y Tecnológico de la UPM, Madrid, Spain
| | - Luis Rodríguez-Rodríguez
- Grupo de Patología Musculoesquelética, Hospital Clínico San Carlos, c\ Prof. Martin Lagos s/n, Madrid 28040, Spain
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Castonguay J, Turcotte S, Fleet RP, Archambault PM, Dionne CE, Denis I, Foldes-Busque G. Physical activity and disability in patients with noncardiac chest pain: a longitudinal cohort study. Biopsychosoc Med 2020; 14:12. [PMID: 32612673 PMCID: PMC7324967 DOI: 10.1186/s13030-020-00185-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 06/23/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Noncardiac chest pain (NCCP) is one of the leading reasons for emergency department visits and significantly limits patients' daily functioning. The protective effect of physical activity has been established in a number of pain problems, but its role in the course of NCCP is unknown. This study aimed to document the level of physical activity in patients with NCCP and its association with NCCP-related disability in the 6 months following an emergency department visit. METHODS In this prospective, longitudinal, cohort study, participants with NCCP were recruited in two emergency departments. They were contacted by telephone for the purpose of conducting a medical and sociodemographic interview, after which a set of questionnaires was sent to them. Participants were contacted again 6 months later for an interview aimed to assess their NCCP-related disability. RESULTS The final sample consisted of 279 participants (57.0% females), whose mean age was 54.6 (standard deviation = 15.3) years. Overall, the proportion of participants who were physically active in their leisure time, based on the Actimètre questionnaire criteria, was 22.0%. Being physically active at the first measurement time point was associated with a 38% reduction in the risk of reporting NCCP-related disability in the following 6 months (ρ = .047). This association remained significant after controlling for confounding variables. CONCLUSIONS Being physically active seems to have a protective effect on the occurrence of NCCP-related disability in the 6 months following an emergency department visit with NCCP. These results point to the importance of further exploring the benefits of physical activity in this population.
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Affiliation(s)
- Joanne Castonguay
- School of Psychology, Université Laval, Pavillon Félix-Antoine-Savard, 2325 Allée des Bibliothèques, Québec, QC G1V 0A6 Canada
- Centre intégré de santé et de services sociaux de Chaudière-Appalaches, 143 Rue Wolfe,, Lévis, QC G6V 3Z1 Canada
| | - Stéphane Turcotte
- Centre intégré de santé et de services sociaux de Chaudière-Appalaches, 143 Rue Wolfe,, Lévis, QC G6V 3Z1 Canada
| | - Richard P Fleet
- Département de médecine familiale et de médecine d’urgence, Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Québec, QC G1V 0A6 Canada
| | - Patrick M Archambault
- Centre intégré de santé et de services sociaux de Chaudière-Appalaches, 143 Rue Wolfe,, Lévis, QC G6V 3Z1 Canada
| | - Clermont E Dionne
- Centre intégré de santé et de services sociaux de Chaudière-Appalaches, 143 Rue Wolfe,, Lévis, QC G6V 3Z1 Canada
| | - Isabelle Denis
- School of Psychology, Université Laval, Pavillon Félix-Antoine-Savard, 2325 Allée des Bibliothèques, Québec, QC G1V 0A6 Canada
- Centre intégré de santé et de services sociaux de Chaudière-Appalaches, 143 Rue Wolfe,, Lévis, QC G6V 3Z1 Canada
| | - Guillaume Foldes-Busque
- School of Psychology, Université Laval, Pavillon Félix-Antoine-Savard, 2325 Allée des Bibliothèques, Québec, QC G1V 0A6 Canada
- Centre intégré de santé et de services sociaux de Chaudière-Appalaches, 143 Rue Wolfe,, Lévis, QC G6V 3Z1 Canada
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Corvillo I, Armijo F, Álvarez-Badillo A, Armijo O, Varela E, Maraver F. Efficacy of aquatic therapy for neck pain: a systematic review. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:915-925. [PMID: 31209599 DOI: 10.1007/s00484-019-01738-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 05/29/2019] [Accepted: 05/30/2019] [Indexed: 05/19/2023]
Abstract
This study systematically reviews the current state of aquatic treatment of neck pain and assesses the scientific evidence of its benefits. The databases PubMed, Scopus, Web of Science and PEDro were searched for relevant reports published from January 1, 2008, to November 7, 2017, using the keywords "neck pain" in addition to "balneotherapy", "spa treatment", "spa", "thalassotherapy", "hydrotherapy", "aquatic therapy" or "aquatic". Inclusion criteria were full-text articles published in journals included in Journal Citation Reports in English and Spanish describing human studies. Case studies, letters to the editor and meeting presentations or other contributions were excluded. Of 367 articles identified, only 13 fulfilled the inclusion criteria: 5 randomized trials, 1 single blind controlled study, 2 pilot studies, 2 observational retrospective studies, 1 prospective study, 1 clinical study and 1 not specified. Participants were 658 subjects with chronic neck pain. Main symptoms and signs treated were neck pain, disability, cervical disc herniation and compromised quality of life. Evidence that aquatic treatment improves quality of life in affected individuals was good in four studies, fair in eight and weak in one. Treatment of neck pain using different waters and techniques reduced pain and disability, and improved functional capacity, quality of life, joint mobility, balance, relaxation and mood.
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Affiliation(s)
- Iluminada Corvillo
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Medicine, Universidad Complutense de Madrid, Plaza Ramon y Cajal, s/n, 28040, Madrid, Spain
- Professional School of Medical Hydrology, Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - Francisco Armijo
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Medicine, Universidad Complutense de Madrid, Plaza Ramon y Cajal, s/n, 28040, Madrid, Spain
- Professional School of Medical Hydrology, Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - Antonio Álvarez-Badillo
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Medicine, Universidad Complutense de Madrid, Plaza Ramon y Cajal, s/n, 28040, Madrid, Spain
- Professional School of Medical Hydrology, Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - Onica Armijo
- Professional School of Medical Hydrology, Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - Enrique Varela
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Medicine, Universidad Complutense de Madrid, Plaza Ramon y Cajal, s/n, 28040, Madrid, Spain
| | - Francisco Maraver
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Medicine, Universidad Complutense de Madrid, Plaza Ramon y Cajal, s/n, 28040, Madrid, Spain.
- Professional School of Medical Hydrology, Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain.
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12
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Hughes L, Patterson SD. The effect of blood flow restriction exercise on exercise-induced hypoalgesia and endogenous opioid and endocannabinoid mechanisms of pain modulation. J Appl Physiol (1985) 2020; 128:914-924. [DOI: 10.1152/japplphysiol.00768.2019] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
This study aimed to investigate and compare the magnitude of exercise-induced hypoalgesia (EIH) with low-intensity blood flow restriction (BFR) resistance exercise (RE) at varying pressures to other intensities of resistance exercise and examine endogenous mechanisms of pain reduction. Twelve individuals performed four experimental trials involving unilateral leg press exercise in a randomized crossover design: low-load RE at 30% of one repetition maximum (1RM), high-load RE (70% 1RM), and BFR-RE (30% 1RM) at a low and high pressure. BFR pressure was prescribed relative to limb occlusion pressure at 40% and 80% for the low- and high-pressure trials. Pressure pain thresholds (PPT) were assessed before and 5 min and 24 h following exercise in exercising and nonexercising muscles. Venous blood samples were collected at the same timepoints to determine plasma concentrations of beta-endorphin and 2-arachidonoylglycerol. High-pressure BFR-RE increased PPTs in the exercising limb to a greater extent than all other trials. Comparable systemic EIH effects were observed with HLRE and both BFR-RE trials. PPTs in the exercising limb remained elevated above baseline at 24 h postexercise following both BFR-RE trials. Postexercise plasma beta-endorphin concentration was elevated during the BFR-RE trials. No changes to 2-arachidonoylglycerol concentration were observed. High pressure BFR-RE causes a greater EIH response in the exercising limb that persists for up to 24 h following exercise. The reduction in pain sensitivity with BFR-RE is partly driven by endogenous opioid production of beta-endorphin. BFR-RE should be investigated as a possible pain-modulation tool in individuals with acute and chronic pain. NEW & NOTEWORTHY High-pressure blood flow restriction (BFR) causes a greater hypoalgesia response in the exercising limb (48%) compared with light and heavy load resistance exercise (10–34%). Performing light load resistance exercise with BFR causes systemic hypoalgesia comparable with heavy load resistance exercise (10–18%). BFR resistance exercise prolonged the exercise-induced hypoalgesia response for 24 h in the exercising limb (15% and 24%, respectively). Activation of endogenous opioid production and a conditioned pain modulation effect partly mediate the relationship between exercise and hypoalgesia.
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Affiliation(s)
- Luke Hughes
- Faculty of Sport, Health and Applied Science, St Mary’s University, London, United Kingdom
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13
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Czekierda K, Zarychta K, Knoll N, Keller J, Luszczynska A. Links between meaning in life and physical quality of life after rehabilitation: Mediating effects of positive experiences with physical exercises and mobility. PLoS One 2019; 14:e0224503. [PMID: 31671147 PMCID: PMC6822941 DOI: 10.1371/journal.pone.0224503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 10/15/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Indicators of emotional processes (positive experiences with physical exercises) and functional processes (mobility) were previously found to be associated with positive cognitive resources (meaning in life), and the key outcome in the rehabilitation, namely physical quality of life (QOL). Yet, the mediating roles of such processes were not tested. Therefore, this prospective study investigated whether the relationship between meaning in life and physical QOL was mediated by positive experiences with physical exercises and mobility. METHODS Prospective data were collected at two measurement points, 1 month apart. A total of N = 339 participants (aged 19-84 years old, 57.9% women) provided data at Time 1 (T1) at the beginning of inpatient rehabilitation from central nervous system diseases (CNSD, e.g., stroke; n = 89) or musculoskeletal system diseases (MSD, e.g., dorsopathies; n = 250), and n = 234 at Time 2 (T2, the end of rehabilitation; 4 weeks after T1). Mediation analysis with meaning in life as predictor (T1), positive experiences with physical exercises and mobility as sequential mediators (T2), and physical QOL (T2) as the outcome was conducted. RESULTS Higher meaning in life (T1) predicted more positive experiences with physical exercises (T2), which were associated with a higher level of mobility (T2), which in turn was associated with better physical quality of life (T2). CONCLUSIONS Meaning in life at the beginning of inpatient rehabilitation may trigger positive experiences with physical exercises and functional changes in mobility levels, leading to better physical quality of life. Screening for low meaning in life may allow to identify patients who are at risk for a lack of improvement of mobility and physical quality of life during rehabilitation.
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Affiliation(s)
- Katarzyna Czekierda
- Wroclaw Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
- * E-mail: (KC); (AL)
| | - Karolina Zarychta
- Wroclaw Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Nina Knoll
- Department of Psychology, Freie Universität Berlin, Berlin, Germany
| | - Jan Keller
- Department of Psychology, Freie Universität Berlin, Berlin, Germany
| | - Aleksandra Luszczynska
- Wroclaw Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
- Trauma, Health, & Hazards Center, University of Colorado at Colorado Springs, Colorado Springs, CO, United States of America
- * E-mail: (KC); (AL)
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14
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Hughes L, Patterson SD. Low intensity blood flow restriction exercise: Rationale for a hypoalgesia effect. Med Hypotheses 2019; 132:109370. [PMID: 31442920 DOI: 10.1016/j.mehy.2019.109370] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 08/07/2019] [Accepted: 08/16/2019] [Indexed: 12/13/2022]
Abstract
Exercise-induced hypoalgesia is characterised by a reduction in pain sensitivity following exercise. Recently, low intensity exercise performed with blood flow restriction has been shown to induce hypoalgesia. The purpose of this manuscript is to discuss the mechanisms of exercise-induced hypoalgesia and provide rationale as to why low intensity exercise performed with blood flow restriction may induce hypoalgesia. Research into exercise-induced hypoalgesia has identified several potential mechanisms, including opioid and endocannabinoid-mediated pain inhibition, conditioned pain modulation, recruitment of high threshold motor units, exercise-induced metabolite production and an interaction between cardiovascular and pain regulatory systems. We hypothesise that several mechanisms consistent with prolonged high intensity exercise may drive the hypoalgesia effect observed with blood flow restriction exercise. These are likely triggered by the high level of intramuscular stress in the exercising muscle generated by blood flow restriction including hypoxia, accumulation of metabolites, accelerated fatigue onset and ischemic pain. Therefore, blood flow restriction exercise may induce hypoalgesia through similar mechanisms to prolonged higher intensity exercise, but at lower intensities, by changing local tissue physiology, highlighting the importance of the blood flow restriction stimulus. The potential to use blood flow restriction exercise as a pain modulation tool has important implications following acute injury and surgery, and for several load compromised populations with chronic pain.
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Affiliation(s)
- Luke Hughes
- Faculty of Sport, Health and Applied Science, St Mary's University, London TW1 4SX, UK.
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A Therapeutic Exercise Program Improves Pain and Physical Dimension of Health-Related Quality of Life in Young Adults. Am J Phys Med Rehabil 2019; 98:392-398. [DOI: 10.1097/phm.0000000000001107] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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Polaski AM, Phelps AL, Kostek MC, Szucs KA, Kolber BJ. Exercise-induced hypoalgesia: A meta-analysis of exercise dosing for the treatment of chronic pain. PLoS One 2019; 14:e0210418. [PMID: 30625201 PMCID: PMC6326521 DOI: 10.1371/journal.pone.0210418] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 12/21/2018] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Increasing evidence purports exercise as a first-line therapeutic for the treatment of nearly all forms of chronic pain. However, knowledge of efficacious dosing respective to treatment modality and pain condition is virtually absent in the literature. The purpose of this analysis was to calculate the extent to which exercise treatment shows dose-dependent effects similar to what is seen with pharmacological treatments. METHODS A recently published comprehensive review of exercise and physical activity for chronic pain in adults was identified in May 2017. This report reviewed different physical activity and exercise interventions and their effectiveness in reducing pain severity and found overall modest effects of exercise in the treatment of pain. We analyzed this existing data set, focusing specifically on the dose of exercise intervention in these studies. We re-analyzed data from 75 studies looking at benefits of time of exercising per week, frequency of exercise per week, duration of intervention (in weeks), and estimated intensity of exercise. RESULTS Analysis revealed a significant positive correlation with exercise duration and analgesic effect on neck pain. Multiple linear regression modeling of these data predicted that increasing the frequency of exercise sessions per week is most likely to have a positive effect on chronic pain patients. DISCUSSION Modest effects were observed with one significant correlation between duration and pain effect for neck pain. Overall, these results provide insufficient evidence to conclude the presence of a strong dose effect of exercise in pain, but our modeling data provide tes predictions that can be used to design future studies to explicitly test the question of dose in specific patient populations.
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Affiliation(s)
- Anna M. Polaski
- Department of Biological Sciences, Duquesne University, Pittsburgh, Pennsylvania, United States of America
- Chronic Pain Research Consortium, Duquesne University, Pittsburgh, Pennsylvania, United States of America
| | - Amy L. Phelps
- Chronic Pain Research Consortium, Duquesne University, Pittsburgh, Pennsylvania, United States of America
- Palumbo Donahue School of Business, Duquesne University, Pittsburgh, Pennsylvania, United States of America
| | - Matthew C. Kostek
- Chronic Pain Research Consortium, Duquesne University, Pittsburgh, Pennsylvania, United States of America
- Department of Physical Therapy, Duquesne University, Pittsburgh, Pennsylvania, United States of America
| | - Kimberly A. Szucs
- Chronic Pain Research Consortium, Duquesne University, Pittsburgh, Pennsylvania, United States of America
- Department of Occupational Therapy, Duquesne University, Pittsburgh, Pennsylvania, United States of America
| | - Benedict J. Kolber
- Department of Biological Sciences, Duquesne University, Pittsburgh, Pennsylvania, United States of America
- Chronic Pain Research Consortium, Duquesne University, Pittsburgh, Pennsylvania, United States of America
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Marques ES, Meziat Filho NADM, Ferreira PDS, Andrade FGD, Ramsay EM, Amaral Corrêa L, Nogueira LAC. Group pain neuroscience education combined with supervised exercises reduces pain and improves function of Brazilian women with central sensitisation and a low level of education: a single-subject study. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2018. [DOI: 10.1080/21679169.2018.1531922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Elen Soares Marques
- Rehabilitation Science Postgraduate Program at Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
- Physiotherapy Department at Faculdade de Ciências Médias e da Saúde de Juiz de Fora (SUPREMA), Juiz de Fora, Brazil
| | | | | | | | | | - Leticia Amaral Corrêa
- Rehabilitation Science Postgraduate Program at Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
| | - Leandro Alberto Calazans Nogueira
- Rehabilitation Science Postgraduate Program at Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
- Physiotherapy Department at Federal Institute of Rio de Janeiro (IFRJ), Rio de Janeiro, Brazil
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18
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Changes in health-related quality of life (EQ-5D) dimensions associated with community-based musculoskeletal physiotherapy: a multi-centre analysis. Qual Life Res 2018; 27:2373-2382. [PMID: 29948600 PMCID: PMC6133001 DOI: 10.1007/s11136-018-1883-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2018] [Indexed: 11/17/2022]
Abstract
Purpose To determine the changes in each of the five dimensions of the EuroQol 5-dimension index associated with community-based physiotherapy. Methods Four thousand one hundred and thirty-six patients that received community-based musculoskeletal physiotherapy across five NHS centres completed the EQ-5D on entry into the service and upon discharge. Patients were categorised on symptom location and response to treatment based on their EQ-5D index improving by at least 0.1 (“EQ-5D responders”). For each symptom location, and for responders and non-responders to treatment, the mean (± SD) were calculated for each dimension pre- and post-treatment as well as the size of effect. Results The mobility dimension improved (p < 0.05) in all symptom locations for EQ-5D responders (d = 0.26–1.58) and in ankle, knee, hip and lumbar symptoms for EQ-5D non-responders (d = 0.17–0.45). The self-care dimension improved (p < 0.05) in all symptom locations for EQ-5D responders (d = 0.49–1.16). The usual activities dimension improved (p < 0.05) across all symptom locations for EQ-5D responders (d = 1.00–1.75) and EQ-5D non-responders (d = 0.14–0.60). Despite the pain/discomfort dimension improving (p < 0.05) across all symptom locations for both EQ-5D responders (d = 1.07–1.43) and EQ-5D non-responders (d = 0.29–0.66), the anxiety/depression dimension improved (p < 0.05) from higher starting levels in EQ-5D responders (d = 0.76–1.05) with no change seen for EQ-5D non-responders (d = − 0.16 to 0.06). Conclusions Clinicians should not assume that a patient presenting with pain but expressing high anxiety/depression is unlikely to respond to treatment, as they may show the best HRQoL outcomes. For patients presenting with pain/discomfort and low levels of anxiety/depression, the EQ-5D index is perhaps not a suitable tool for sole use in patient management and service evaluation.
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19
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Caplan N, Robson H, Robson A, Barry G, Wilkes G. Associations between community-based physiotherapy for musculoskeletal injury and health related quality of life (EQ-5D): a multi-centre retrospective analysis. Health Qual Life Outcomes 2017; 15:212. [PMID: 29065895 PMCID: PMC5655980 DOI: 10.1186/s12955-017-0789-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 10/16/2017] [Indexed: 11/10/2022] Open
Abstract
Background Community-based musculoskeletal physiotherapy is used to improve function and health related quality of life (HRQoL). The purpose of this retrospective, multi-centre observational study was to determine the association between community-based physiotherapy management for musculoskeletal disorders and changes in HRQoL. Methods Four thousand one hundred twelve patients’ data were included in the study. Patients were included if they received a single period of treatment for a musculoskeletal injury or disorder. Patients were only included if they were being treated for a single morbidity. Patients received standard physiotherapy appropriate to their specific disorder, which could include health education/advice, exercise therapy, manual therapy, taping, soft tissue techniques, electrotherapy and/or acupuncture. Health related quality of life was assessed using the EQ-5D index. Results EQ-5D improved by 0.203 across all patients (d = 1.10). When grouped by anatomical site of symptom, the largest increases in EQ-5D was in foot pain (0.233; d = 1.29) and lumbar pain (0.231; d = 1.13). Improvements in EQ-5D greater than the minimum clinically important difference (MCID) were seen in 68.4% of all patients. The highest proportion of patients with positive responses to treatment were in ankle pain (74.2%) and thoracic pain (73.4%). The hand (40.5%), elbow (34.7%), and hip (33.9%) showed the greatest proportion of patients that did not respond to treatment. Conclusions Community-based musculoskeletal physiotherapy is associated with improved health related quality of life. A randomised controlled trial is needed to determine any causal relationship between community-based physiotherapy and health related quality of life improvements.
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Affiliation(s)
- Nick Caplan
- Faculty of Health and Life Sciences, Northumbria University, Northumberland Building, Newcastle upon Tyne, NE1 8ST, UK.
| | - H Robson
- Connect Health, Newcastle upon Tyne, UK
| | - A Robson
- Connect Health, Newcastle upon Tyne, UK
| | - G Barry
- Faculty of Health and Life Sciences, Northumbria University, Northumberland Building, Newcastle upon Tyne, NE1 8ST, UK
| | - G Wilkes
- Connect Health, Newcastle upon Tyne, UK
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20
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Goldgrub R, Côté P, Sutton D, Wong JJ, Yu H, Randhawa K, Varatharajan S, Southerst D, Mior S, Shearer HM, Jacobs C, Stupar M, Chung CL, Abdulla S, Balogh R, Dogra S, Nordin M, Taylor-Vaisey A. The Effectiveness of Multimodal Care for the Management of Soft Tissue Injuries of the Shoulder: A Systematic Review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. J Manipulative Physiol Ther 2017; 39:121-139.e1. [PMID: 26976375 DOI: 10.1016/j.jmpt.2016.01.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 11/09/2015] [Accepted: 11/10/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The purpose of this systematic review was to evaluate the effectiveness of multimodal care for the management of soft tissue injuries of the shoulder. METHODS We conducted a systematic review and searched MEDLINE, EMBASE, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials from 1990 to 2015. Two independent reviewers critically appraised studies using the Scottish Intercollegiate Guidelines Network criteria. We used best evidence synthesis to synthesize evidence from studies with low risk of bias. RESULTS We screened 5885 articles, and 19 were eligible for critical appraisal. Ten randomized controlled trials had low risk of bias. For persistent subacromial impingement syndrome, multimodal care leads to similar outcomes as sham therapy, radial extracorporeal shock-wave therapy, or surgery. For subacromial impingement syndrome, multimodal care may be associated with small and nonclinically important improvement in pain and function compared with corticosteroid injections. For rotator cuff tendinitis, dietary-based multimodal care may be more effective than conventional multimodal care (exercise, soft tissue and manual therapy, and placebo tablets). For nonspecific shoulder pain, multimodal care may be more effective than wait list or usual care by a general practitioner, but it leads to similar outcomes as exercise or corticosteroid injections. CONCLUSIONS The current evidence suggests that combining multiple interventions into 1 program of care does not lead to superior outcomes for patients with subacromial impingement syndrome or nonspecific shoulder pain. One randomized controlled trial suggested that dietary-based multimodal care (dietary advice, acupuncture, and enzyme tablets) may provide better outcomes over conventional multimodal care. However, these results need to be replicated.
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Affiliation(s)
- Rachel Goldgrub
- Graduate Student, Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), Oshawa, ON, Canada
| | - Pierre Côté
- Canada Research Chair in Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), Oshawa, ON, Canada; Associate Professor, Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada; Director, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Toronto, ON, Canada.
| | - Deborah Sutton
- Research Associate, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Adjunct Professor, Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada
| | - Jessica J Wong
- Research Associate, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Associate Clinical Research Scientist, Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Instructor, Department of Graduate Studies, Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada
| | - Hainan Yu
- Research Associate, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Adjunct Professor, Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada
| | - Kristi Randhawa
- Research Associate, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Adjunct Professor, Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Instructor, Division of Undergraduate Education, Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Sharanya Varatharajan
- Research Associate, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Adjunct Professor, Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Instructor, Division of Undergraduate Education, Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Danielle Southerst
- Research Coordinator, Rebecca MacDonald Centre for Arthritis and Autoimmune Disease, Mount Sinai Hospital, Toronto, ON, Canada
| | - Silvano Mior
- Professor, Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Adjunct Professor, Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Heather M Shearer
- Adjunct Professor, Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Clinical Research Manager, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Senior Clinical Research Scientist, Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada
| | - Craig Jacobs
- Director, Clinical Education and Patient Care, Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada
| | - Maja Stupar
- Adjunct Professor, Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada; Postdoctoral Fellow, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada
| | - Chadwick L Chung
- Assistant to the Director, Department of Graduate Studies, Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada
| | - Sean Abdulla
- Graduate Student, Department of Graduate Studies, Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada
| | - Robert Balogh
- Assistant Professor, Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), Oshawa, ON, Canada
| | - Shilpa Dogra
- Assistant Professor, Faculty of Health Sciences, Kinesiology, University of Ontario Institute of Technology (UOIT), Oshawa, ON, Canada
| | - Margareta Nordin
- Professor, Departments of Orthopedic Surgery and Environmental Medicine, Occupational and Industrial Orthopedic Center, NYU School of Medicine, New York, NY
| | - Anne Taylor-Vaisey
- Research Associate, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, ON, Canada
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Blickenstaff C, Pearson N. Reconciling movement and exercise with pain neuroscience education: A case for consistent education. Physiother Theory Pract 2016; 32:396-407. [DOI: 10.1080/09593985.2016.1194653] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Schrier E, Schrier I, Geertzen JHB, Dijkstra PU. Quality of life in rehabilitation outpatients: normal values and a comparison with the general Dutch population and psychiatric patients. Qual Life Res 2015; 25:135-42. [PMID: 26159567 PMCID: PMC4706573 DOI: 10.1007/s11136-015-1060-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2015] [Indexed: 12/30/2022]
Abstract
Purpose
To provide Dutch normal values for rehabilitation outpatients with chronic pain or musculoskeletal diseases utilizing the World Health Organization Quality of Life questionnaire abbreviated version (WHOQOL-BREF) and analyse influence of diagnosis and patient characteristics on normal values and increase understanding in those values. Methods
Five hundred and forty-two outpatients were referred to a rehabilitation psychologist. Referral diagnoses were “musculoskeletal”, “chronic pain”, “neurological” and “miscellaneous”. Comparisons between groups were made for each of the four domains of the WHOQOL-BREF (scoring range 4–20).
Results Domain scores of rehabilitation outpatients were physical domain 11.0 (±2.7), psychological domain 13.6 (±2.4), social domain 14.8 (±3.4) and environmental domain 14.2 (±2.2). Outpatients with chronic pain reported the lowest scores on the WHOQOL-BREF when compared to the “musculoskeletal”, “neurological” and “miscellaneous” groups. Increased age, lower education, living alone and unemployment had a negative impact on WHOQOL-BREF scores. Compared to the general Dutch population, rehabilitation outpatients scored, unadjusted for age, significantly lower difference for the physical domain 4.5 [95 % confidence interval (CI) 4.2; 4.8], the environment domain 1.7 (95 % CI 1.5; 2.0), the psychological domain 1.1 (95 % CI 0.4; 1.2) and the social domain 0.4 (95 % CI 0.0; 0.8).
Conclusions WHOQOL-BREF scores of rehabilitation outpatients are lower and differed significantly from normal values of a Dutch population in all four domains. Therefore, the WHOQOL-BREF can be used to measure the subjective impact of their disease or injury. The subjective impact of chronic pain was found to be particularly high.
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Affiliation(s)
- Ernst Schrier
- Department of Rehabilitation Medicine HPC:CB40, Centre for Rehabilitation, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
| | | | - Jan H B Geertzen
- Department of Rehabilitation Medicine HPC:CB40, Centre for Rehabilitation, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Pieter U Dijkstra
- Department of Rehabilitation Medicine HPC:CB40, Centre for Rehabilitation, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.,Department of Oral and Maxillofacial Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
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Changes in disability, physical/mental health states and quality of life during an 8-week multimodal physiotherapy programme in patients with chronic non-specific neck pain: a prospective cohort study. PLoS One 2015; 10:e0118395. [PMID: 25710539 PMCID: PMC4339981 DOI: 10.1371/journal.pone.0118395] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 01/09/2015] [Indexed: 11/19/2022] Open
Abstract
AIM The aim of this study was to analyse the effect of an 8-week multimodal physiotherapy programme (MPP), integrating physical land-based therapeutic exercise (TE), adapted swimming and health education, as a treatment for patients with chronic non-specific neck pain (CNSNP), on disability, general health/mental states and quality of life. METHODS 175 CNSNP patients from a community-based centre were recruited to participate in this prospective study. INTERVENTION 60-minute session (30 minutes of land-based exercise dedicated to improving mobility, motor control, resistance and strengthening of the neck muscles, and 30 minutes of adapted swimming with aerobic exercise keeping a neutral neck position using a snorkel). Health education was provided using a decalogue on CNSNP and constant repetition of brief advice by the physiotherapist during the supervision of the exercises in each session. STUDY OUTCOMES primary: disability (Neck Disability Index); secondary: physical and mental health states and quality of life of patients (SF-12 and EuroQoL-5D respectively). Differences between baseline data and that at the 8-week follow-up were calculated for all outcome variables. RESULTS Disability showed a significant improvement of 24.6% from a mean (SD) of 28.2 (13.08) at baseline to 16.88 (11.62) at the end of the 8-week intervention. All secondary outcome variables were observed to show significant, clinically relevant improvements with increase ranges between 13.0% and 16.3% from a mean of 0.70 (0.2) at baseline to 0.83 (0.2), for EuroQoL-5D, and from a mean of 40.6 (12.7) at baseline to 56.9 (9.5), for mental health state, at the end of the 8-week intervention. CONCLUSION After 8 weeks of a MPP that integrated land-based physical TE, health education and adapted swimming, clinically-relevant and statistically-significant improvements were observed for disability, physical and mental health states and quality of life in patients who suffer CNSNP. The clinical efficacy requires verification using a randomised controlled study design. TRIAL REGISTRATION ClinicalTrials.gov NCT02046876.
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Exercise, Not to Exercise, or How to Exercise in Patients With Chronic Pain? Applying Science to Practice. Clin J Pain 2015; 31:108-14. [DOI: 10.1097/ajp.0000000000000099] [Citation(s) in RCA: 108] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Mariana C, Carmen-Oana T. Massage versus Kinesio Taping. Possibilities to Enhance the Kinetic Program in Mechanically Triggered Neck Pain. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.sbspro.2014.02.275] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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