Regional vs global physical therapy interventions to treat chronic pain in survivors of trauma: a randomized controlled trial

BACKGROUND

A history of traumatic life events is associated with chronic pain in later life. Physical therapists utilize a variety of methods to treat pain, however, they have struggled to find effective interventions to improve patient outcomes.

OBJECTIVE

To compare impairment-based, regional (REGION-PT) physical therapy (PT) to a global (GLOBAL-PT) model consisting of pain neuroscience education, graded motor imagery, and exercise for adults with chronic pain and history of trauma.

DESIGN

Randomized Controlled Trial.

METHODS

Adults ≥ 18 years of age with chronic pain and a history of ≥1 trauma identified through the Life Events Checklist received the allocated intervention once a week for six weeks. Treatment effects were assessed using linear mixed models.

RESULTS

Ninety-eight participants completed the trial. There were no difference in outcomes between groups. There were significant interactions between race and intervention. Both interventions were associated with improvements in pain interference for white participants, but non-white participants experienced improvement only with GLOBAL-PT. Regardless of allocation, participants improved in physical function, six of the PROMIS-29 domains, and in pain interference measures.

CONCLUSION

Both interventions are reasonable strategies for individuals with chronic pain and a history of trauma.

The effect of motion games on improving the psychomotor and intellectual performance of children with autism spectrum disorder and intellectual disabilities

Introduction. Depressive states and anxiety are common symptoms of children with autism spectrum disorder (ASD). The persons with intellectual disabilities show problems related to the development of basic motor skills, having learning problems compared to normal ones, imbalances between the processes of arousal and inhibition, limited motor ability, difficult understanding of language and motor tasks, difficult concentration, mechanical assimilation etc. Objectives. The study analyzes the effectiveness of structures and motion games, applied in specific activities for children with intellectual disabilities (ID) and autism spectrum disorders (ASD). Material and Methods. The research involved an experimental group of 5 children with one of these disabilities or their combination (age 10-11 years), included in a training process at the Ion Teodorescu Special Vocational School in Slobozia / Ialomița / Romania and comparing their results with a control group (6 normal children, with an average age of 10 years), between 20.09.2020-10.03.2021. The assessment of the level of psychomotor and intellectual development was made by the Cutout Test, the Cohs Cube Test (light task configurations) and an Attention Flexibility Test (movement to the corners of the room/field depending on the assigned color, counting successful attempts and mistakes). Results and discussion. The obtained results confirm the working hypothesis, so the use of the structures and games proposed in the program contributes to a significant improvement of the psychomotor and intellectual performances of students with intellectual disabilities and autism spectrum. Conclusion. espite all these improvements, they cannot approach or equal the reference values of children without problems, falling into the same age category. Keywords: psychomotor skills, adapted physical activities, recovery, children, learning disabilities,