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da Silva MDV, Martelossi-Cebinelli G, Yaekashi KM, Carvalho TT, Borghi SM, Casagrande R, Verri WA. A Narrative Review of the Dorsal Root Ganglia and Spinal Cord Mechanisms of Action of Neuromodulation Therapies in Neuropathic Pain. Brain Sci 2024; 14:589. [PMID: 38928589 PMCID: PMC11202229 DOI: 10.3390/brainsci14060589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 06/05/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024] Open
Abstract
Neuropathic pain arises from injuries to the nervous system in diseases such as diabetes, infections, toxicity, and traumas. The underlying mechanism of neuropathic pain involves peripheral and central pathological modifications. Peripheral mechanisms entail nerve damage, leading to neuronal hypersensitivity and ectopic action potentials. Central sensitization involves a neuropathological process with increased responsiveness of the nociceptive neurons in the central nervous system (CNS) to their normal or subthreshold input due to persistent stimuli, leading to sustained electrical discharge, synaptic plasticity, and aberrant processing in the CNS. Current treatments, both pharmacological and non-pharmacological, aim to alleviate symptoms but often face challenges due to the complexity of neuropathic pain. Neuromodulation is emerging as an important therapeutic approach for the treatment of neuropathic pain in patients unresponsive to common therapies, by promoting the normalization of neuronal and/or glial activity and by targeting cerebral cortical regions, spinal cord, dorsal root ganglia, and nerve endings. Having a better understanding of the efficacy, adverse events and applicability of neuromodulation through pre-clinical studies is of great importance. Unveiling the mechanisms and characteristics of neuromodulation to manage neuropathic pain is essential to understand how to use it. In the present article, we review the current understanding supporting dorsal root ganglia and spinal cord neuromodulation as a therapeutic approach for neuropathic pain.
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Affiliation(s)
- Matheus Deroco Veloso da Silva
- Laboratory of Pain, Inflammation, Neuropathy and Cancer, Department of Immunology, Parasitology and General Pathology, Londrina State University, Londrina 86057-970, PR, Brazil; (M.D.V.d.S.); (G.M.-C.); (K.M.Y.); (S.M.B.)
| | - Geovana Martelossi-Cebinelli
- Laboratory of Pain, Inflammation, Neuropathy and Cancer, Department of Immunology, Parasitology and General Pathology, Londrina State University, Londrina 86057-970, PR, Brazil; (M.D.V.d.S.); (G.M.-C.); (K.M.Y.); (S.M.B.)
| | - Kelly Megumi Yaekashi
- Laboratory of Pain, Inflammation, Neuropathy and Cancer, Department of Immunology, Parasitology and General Pathology, Londrina State University, Londrina 86057-970, PR, Brazil; (M.D.V.d.S.); (G.M.-C.); (K.M.Y.); (S.M.B.)
| | - Thacyana T. Carvalho
- Department of Pediatrics, Division of Infectious Diseases and Immunology, Guerin Children’s at Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA;
| | - Sergio M. Borghi
- Laboratory of Pain, Inflammation, Neuropathy and Cancer, Department of Immunology, Parasitology and General Pathology, Londrina State University, Londrina 86057-970, PR, Brazil; (M.D.V.d.S.); (G.M.-C.); (K.M.Y.); (S.M.B.)
- Center for Research in Health Sciences, University of Northern Paraná, Londrina 86041-140, PR, Brazil
| | - Rubia Casagrande
- Department of Pharmaceutical Sciences, Center of Health Science, Londrina State University, Londrina 86038-440, PR, Brazil;
| | - Waldiceu A. Verri
- Laboratory of Pain, Inflammation, Neuropathy and Cancer, Department of Immunology, Parasitology and General Pathology, Londrina State University, Londrina 86057-970, PR, Brazil; (M.D.V.d.S.); (G.M.-C.); (K.M.Y.); (S.M.B.)
- Biological Sciences Center, State University of Londrina, Rod. Celso Garcia Cid Pr 445, KM 380, P.O. Box 10.011, Londrina 86057-970, PR, Brazil
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Sayed D, Deer TR, Hagedorn JM, Sayed A, D’Souza RS, Lam CM, Khatri N, Hussaini Z, Pritzlaff SG, Abdullah NM, Tieppo Francio V, Falowski SM, Ibrahim YM, Malinowski MN, Budwany RR, Strand NH, Sochacki KM, Shah A, Dunn TM, Nasseri M, Lee DW, Kapural L, Bedder MD, Petersen EA, Amirdelfan K, Schatman ME, Grider JS. A Systematic Guideline by the ASPN Workgroup on the Evidence, Education, and Treatment Algorithm for Painful Diabetic Neuropathy: SWEET. J Pain Res 2024; 17:1461-1501. [PMID: 38633823 PMCID: PMC11022879 DOI: 10.2147/jpr.s451006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 03/19/2024] [Indexed: 04/19/2024] Open
Abstract
Introduction Painful diabetic neuropathy (PDN) is a leading cause of pain and disability globally with a lack of consensus on the appropriate treatment of those suffering from this condition. Recent advancements in both pharmacotherapy and interventional approaches have broadened the treatment options for PDN. There exists a need for a comprehensive guideline for the safe and effective treatment of patients suffering from PDN. Objective The SWEET Guideline was developed to provide clinicians with the most comprehensive guideline for the safe and appropriate treatment of patients suffering from PDN. Methods The American Society of Pain and Neuroscience (ASPN) identified an educational need for a comprehensive clinical guideline to provide evidence-based recommendations for PDN. A multidisciplinary group of international experts developed the SWEET guideline. The world literature in English was searched using Medline, EMBASE, Cochrane CENTRAL, BioMed Central, Web of Science, Google Scholar, PubMed, Current Contents Connect, Meeting Abstracts, and Scopus to identify and compile the evidence for diabetic neuropathy pain treatments (per section as listed in the manuscript) for the treatment of pain. Manuscripts from 2000-present were included in the search process. Results After a comprehensive review and analysis of the available evidence, the ASPN SWEET guideline was able to rate the literature and provide therapy grades for most available treatments for PDN utilizing the United States Preventive Services Task Force criteria. Conclusion The ASPN SWEET Guideline represents the most comprehensive review of the available treatments for PDN and their appropriate and safe utilization.
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Affiliation(s)
- Dawood Sayed
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Timothy Ray Deer
- Pain Services, Spine and Nerve Center of the Virginias, Charleston, WV, USA
| | - Jonathan M Hagedorn
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Asim Sayed
- Podiatry/Surgery, Susan B. Allen Memorial Hospital, El Dorado, KS, USA
| | - Ryan S D’Souza
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Christopher M Lam
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Nasir Khatri
- Interventional Pain Medicine, Novant Spine Specialists, Charlotte, NC, USA
| | - Zohra Hussaini
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Scott G Pritzlaff
- Department of Anesthesiology and Pain Medicine, University of California, Davis, Sacramento, CA, USA
| | | | - Vinicius Tieppo Francio
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, KS, USA
| | | | - Yussr M Ibrahim
- Pain Medicine, Northern Light Eastern Maine Medical Center, Bangor, ME, USA
| | | | - Ryan R Budwany
- Pain Services, Spine and Nerve Center of the Virginias, Charleston, WV, USA
| | | | - Kamil M Sochacki
- Department of Anesthesiology and Perioperative Medicine, Rutgers Robert Wood Johnson, New Brunswick, NJ, USA
| | - Anuj Shah
- Department of Physical Medicine and Rehabilitation, Detroit Medical Center, Detroit, MI, USA
| | - Tyler M Dunn
- Anesthesiology and Pain Medicine, Mayo Clinic, Phoenix, AZ, USA
| | - Morad Nasseri
- Interventional Pain Medicine / Neurology, Boomerang Healthcare, Walnut Creek, CA, USA
| | - David W Lee
- Pain Management Specialist, Fullerton Orthopedic, Fullerton, CA, USA
| | | | - Marshall David Bedder
- Chief of Pain Medicine Service, Augusta VAMC, Augusta, GA, USA
- Associate Professor and Director, Addiction Medicine Fellowship Program, Department Psychiatry and Health Behavior, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Erika A Petersen
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Kasra Amirdelfan
- Director of Clinical Research, Boomerang Healthcare, Walnut Creek, CA, USA
| | - Michael E Schatman
- Department of Anesthesiology, Perioperative Care & Pain Medicine, NYU Grossman School of Medicine, New York, NY, USA
- Department of Population Health – Division of Medical Ethics, NYU Grossman School of Medicine, New York, NY, USA
| | - Jay Samuel Grider
- Anesthesiology, Division of Pain Medicine, University of Kentucky College of Medicine, Lexington, KY, USA
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Navas-Otero A, Calvache-Mateo A, Martín-Núñez J, Valenza-Peña G, Hernández-Hernández S, Ortiz-Rubio A, Valenza MC. The Effectiveness of Combined Exercise and Self-Determination Theory Programmes on Chronic Low Back Pain: A Systematic Review and Metanalysis. Healthcare (Basel) 2024; 12:382. [PMID: 38338267 PMCID: PMC10855905 DOI: 10.3390/healthcare12030382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/25/2024] [Accepted: 01/28/2024] [Indexed: 02/12/2024] Open
Abstract
Low back pain is a pervasive issue worldwide, having considerable prevalence and a significant impact on disability. As low back pain is a complicated condition with many potential contributors, the use of therapeutic exercise, combined with other techniques such as self-determination theory programmes, has the potential to improve several outcomes. The aim of this systematic review was to explore the effectiveness of combined exercise and self-determination theory programmes on chronic low back pain. This study was designed according to Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. A systematic search in three databases (PubMed/MEDLINE, Web of Science, and Scopus) was conducted from September to November 2023. After screening, a total of five random control trials with patients with chronic low back pain were included in this systematic review and meta-analysis. The results showed significant differences in disability (SMD = -0.98; 95% CI = -1.86, -0.09; p = 0.03) and in quality of life (SMD = 0.23; 95% CI = 0.02, 0.44; p = 0.03) in favour of the intervention group versus the control group.
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Affiliation(s)
| | | | | | | | | | - Araceli Ortiz-Rubio
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Av. de la Ilustración 60, 18016 Granada, Spain; (A.N.-O.); (A.C.-M.); (J.M.-N.); (G.V.-P.); (S.H.-H.); (M.C.V.)
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Dillon BR, Ang L, Pop-Busui R. Spectrum of Diabetic Neuropathy: New Insights in Diagnosis and Treatment. Annu Rev Med 2024; 75:293-306. [PMID: 38285516 DOI: 10.1146/annurev-med-043021-033114] [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] [Indexed: 01/31/2024]
Abstract
Diabetic neuropathy is a highly prevalent complication of diabetes. It consists of a broad range of neuropathic conditions, such as distal symmetric polyneuropathy and various forms of autonomic neuropathies involving the cardiovascular, gastrointestinal, and urogenital systems. Prevention or diagnosis in early stages of disease is crucial to prevent symptomatic onset and progression, particularly in the absence of current disease-modifying therapies. In this review, we describe the four main types of diabetic neuropathy. We review current understanding with respect to diagnosis and treatment while highlighting knowledge gaps and future directions.
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Affiliation(s)
- Brendan R Dillon
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA;
| | - Lynn Ang
- Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan Medical School, Ann Arbor, Michigan, USA; ,
| | - Rodica Pop-Busui
- Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan Medical School, Ann Arbor, Michigan, USA; ,
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Yeung AM, Huang J, Nguyen KT, Xu NY, Hughes LT, Agrawal BK, Ejskjaer N, Klonoff DC. Painful Diabetic Neuropathy: The Need for New Approaches. J Diabetes Sci Technol 2024; 18:159-167. [PMID: 36305521 PMCID: PMC10899841 DOI: 10.1177/19322968221132252] [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] [Indexed: 11/16/2022]
Abstract
Painful diabetic neuropathy is a common vexing problem for people with diabetes and a costly problem for society. The pathophysiology is not well understood, and no safe and effective mechanistically-based treatment has been identified. Poor glycemic control is a risk factor for painful diabetic neuropathy. Excessive intraneuronal glucose in people with diabetes can be shunted away from physiological glycolysis into multiple pathological pathways associated with neuropathy and pain. The first three treatments that are traditionally offered consist of risk factor reduction, lifestyle modifications, and pharmacological therapy, which includes only three drugs that are approved for this indication by the United States Food and Drug Administration. All of these traditional treatments are often inadequate for relieving neuropathic pain, and thus, new approaches are needed. Modern devices based on neuromodulation technology, which act directly on the nervous system, have been recently cleared by the United States Food and Drug Administration for painful diabetic neuropathy and offer promise as next-in-line therapy when traditional therapies fail.
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Affiliation(s)
| | | | | | - Nicole Y. Xu
- Diabetes Technology Society, Burlingame, CA, USA
| | - Lorenzo T. Hughes
- Balance Health, San Francisco, CA, USA
- Mills-Peninsula Medical Center, Burlingame, CA, USA
| | | | - Niels Ejskjaer
- Steno Diabetes Center North Denmark and Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - David C. Klonoff
- Diabetes Technology Society, Burlingame, CA, USA
- Diabetes Research Institute, Mills-Peninsula Medical Center, San Mateo, CA, USA
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Elafros MA, Callaghan BC. Diabetic Neuropathies. Continuum (Minneap Minn) 2023; 29:1401-1417. [PMID: 37851036 PMCID: PMC11088946 DOI: 10.1212/con.0000000000001291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
OBJECTIVE This article provides an up-to-date review of the diagnosis and management of the most common neuropathies that occur in patients with diabetes. LATEST DEVELOPMENTS The prevalence of diabetes continues to grow worldwide and, as a result, the burden of diabetic neuropathies is also increasing. Most diabetic neuropathies are caused by hyperglycemic effects on small and large fiber nerves, and glycemic control in individuals with type 1 diabetes reduces neuropathy prevalence. However, among people with type 2 diabetes, additional factors, particularly metabolic syndrome components, play a role and should be addressed. Although length-dependent distal symmetric polyneuropathy is the most common form of neuropathy, autonomic syndromes, particularly cardiovascular autonomic neuropathy, are associated with increased mortality, whereas lumbosacral radiculoplexus neuropathy and treatment-induced neuropathy cause substantial morbidity. Recent evidence-based guidelines have updated the recommended treatment options to manage pain associated with distal symmetric polyneuropathy of diabetes. ESSENTIAL POINTS Identifying and appropriately diagnosing the neuropathies of diabetes is key to preventing progression. Until better disease-modifying therapies are identified, management remains focused on diabetes and metabolic risk factor control and pain management.
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Decker V, King C, Cassisi J, Tofthagen C. Usability and Acceptability of a Videoconference Program for the Treatment of Depression in Adults With Peripheral Neuropathy. Comput Inform Nurs 2023; 41:746-751. [PMID: 36719756 DOI: 10.1097/cin.0000000000001008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Peripheral neuropathy is a debilitating neurological disorder affecting 13% to 14% of the US population. Estimates for co-occurring mood disorders in individuals with neuropathy range from 30% to 47%, but sparse evidence exists regarding depression treatment for adults with neuropathy. A cognitive-behavioral treatment, Acceptance and commitment therapy, is known to reduce depression in people with chronic pain, but little is known about its effectiveness in adults with neuropathy, particularly when the treatment is provided via videoconference. Acceptability and usability of this therapeutic treatment provided via videoconference was assessed in participants with peripheral neuropathy and symptoms of depression. Participants completed pre- and post-self-report outcome measures: the nine-item depression scale of the Patient Health Questionnaire and the 36-item Short-Form Health Survey. They also completed the Acceptability e-Scale and Post-Study System Usability Questionnaire after treatment. Depression decreased significantly, with scores declining from an average of 9.2 to 5.1 on the Patient Health Questionnaire ( P < .05). The Short-Form Health Survey indicated significant improvement post-treatment on the "Energy/Fatigue" and "Emotional Well Being" subscales. The intervention was rated by participants as acceptable and demonstrated high usability. This initial therapeutic treatment via videoconference offers promise to treat depression in older adults with neuropathy.
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Affiliation(s)
- Veronica Decker
- Author Affiliations: College of Nursing (Dr Decker), School of Global Health Management and Informatics (Dr King), and Department of Psychology (Dr Cassisi), University of Central Florida, Orlando, FL; and Department of Nursing, Mayo Clinic College of Medicine and Science, Jacksonville, FL (Dr Tofthagen)
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Gracia-Sánchez A, López-Pineda A, Lázaro-Martínez JL, Pérez A, Pomares-Gómez FJ, Fernández-Seguín LM, Gil-Guillén VF, Chicharro-Luna E. Consensus-based recommendations on physical activity and exercise in patients with diabetes at risk of foot ulcerations: a Delphi study. Braz J Phys Ther 2023; 27:100500. [PMID: 37079949 DOI: 10.1016/j.bjpt.2023.100500] [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: 08/12/2022] [Revised: 03/08/2023] [Accepted: 03/24/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Patients with diabetes mellitus are exposed to important complications. Currently little evidence exist on the guidelines that these patients, at some risk of foot ulceration, should follow for physical exercise. OBJECTIVES To reach a consensus among multidisciplinary and international experts on physical activity/exercise recommendations for patients with diabetes, according to foot ulcer risk. METHODS Using a three-round Delphi method, a panel composed of 28 multidisciplinary experts in the management of diabetic foot assessed 109 recommendations on physical activity/exercise for patients with diabetes mellitus, according to their risk of foot ulcer. Consensus was assumed when 80% of responses matched the same category (agreement/disagreement). RESULTS Twenty-nine experts participated in the first and second rounds of consultation, and twenty-eight did so in the third, reaching final agreement on 86 of the 109 recommendations considered (78.9%). The study, thus, generated a consensus set of recommendations concerning different aspects of diabetic footcare before, during, and after exercise (e.g. when to examine the foot, how to assess it, what type of sock and insole to use, what types of exercise to perform, and when it is advisable to return to activity after an ulceration). CONCLUSION This Delphi study generated recommendations based on the consensus of international experts on physical activity and exercise by patient with diabetes at risk of ulceration. Recommendations considered the state of the foot and the patient's history and status before physical activity and included information on intensity, duration, frequency, and progressions of physical activity/exercise, and the use of custom-made plantar orthoses, shoe prescription, and the convenience of returning to physical activity after an ulceration.
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Affiliation(s)
- Alba Gracia-Sánchez
- Nursing Service, Department of Health and Behavioral Sciences, Faculty of Medicine, University Miguel Hernández de Elche, San Juan de Alicante, Spain
| | - Adriana López-Pineda
- Clinical Medicine Department, University Miguel Hernández de Elche, San Juan de Alicante, Spain; Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, San Juan de Alicante, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Alicante, Spain.
| | - José Luis Lázaro-Martínez
- Diabetic Foot Unit,Universidad Complutense de Madrid. Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - Antonio Pérez
- Endocrinology and Nutrition Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Medicine Department, Universitat Autònoma de Barcelona, CIBER de Diabetes y Enfermedades metabólicas (CIBERDEM), Barcelona, Spain
| | | | | | - Vicente F Gil-Guillén
- Clinical Medicine Department, University Miguel Hernández de Elche, San Juan de Alicante, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Alicante, Spain; Research Unit, University General Hospital of Elda, Elda, Spain
| | - Esther Chicharro-Luna
- Nursing Service, Department of Health and Behavioral Sciences, Faculty of Medicine, University Miguel Hernández de Elche, San Juan de Alicante, Spain
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Small Fiber Neuropathy: A Clinical and Practical Approach. J Nurse Pract 2023. [DOI: 10.1016/j.nurpra.2023.104547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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Effect of Cognitive-Behavioral Therapy or Mindfulness Therapy on Pain and Quality of Life in Patients with Diabetic Neuropathy: A Systematic Review and Meta-Analysis. Pain Manag Nurs 2022; 23:861-870. [PMID: 35934662 DOI: 10.1016/j.pmn.2022.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 05/23/2022] [Accepted: 05/26/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVES This study aimed to evaluate the effectiveness of cognitive behavioral therapy (CBT) and mindfulness therapy (MT) for pain relief and quality of life (QOL) in patients with diabetic neuropathy. REVIEW/ANALYSIS METHODS Four databases were systematically searched from their respective inception dates to 29 June 2021. Relevant randomized controlled trials (RCTs) were screened and assessed for risk of bias. Eight RCTs evaluating CBT or MT were included. Statistical analysis was performed using Review Manager 5.4. RESULTS Eight RCTs involving 384 patients with painful diabetic neuropathy (PDN) tested psychological interventions, including three CBT and five MT studies. The results showed that patients' pain severity (standardized mean difference [SMD] = -0.60, 95% confidence interval [CI; -0.93 to -0.27], P = .0003) and QOL (SMD = -0.43, 95% CI [-0.83 to -0.04], p = .03) were improved immediately after treatment. Besides, the pain intensity (SMD = -0.67, 95% CI [-1.37 to 0.03], p = .06), pain interference (SMD = -0.75, 95% CI [-1.20 to -0.30], p = .001) and depressive symptoms (SMD = -0.62, 95% CI [-0.96 to -0.28], p = .0003) were superior to the control group after follow up. The subgroup analysis results of different intervention type showed that the CBT group could immediately improve pain (SMD = -0.44, 95% CI [-0.78 to -0.10], p = .01) after treatment. However, there was no statistically significant difference in the CBT group after follow-up (SMD = -0.15, 95% CI [-0.52 to 0.22], p = .42). CONCLUSIONS Cognitive behavioral therapy or MT is effective for treating pain in patients with diabetic peripheral neuropathy, improving the QOL, and reducing depressive symptoms. However, large-scale, multi-centre, rigorously designed RCTs are needed to further verify the long-term effects.
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Elafros MA, Andersen H, Bennett DL, Savelieff MG, Viswanathan V, Callaghan BC, Feldman EL. Towards prevention of diabetic peripheral neuropathy: clinical presentation, pathogenesis, and new treatments. Lancet Neurol 2022; 21:922-936. [PMID: 36115364 PMCID: PMC10112836 DOI: 10.1016/s1474-4422(22)00188-0] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/15/2022] [Accepted: 04/29/2022] [Indexed: 12/24/2022]
Abstract
Diabetic peripheral neuropathy (DPN) occurs in up to half of individuals with type 1 or type 2 diabetes. DPN results from the distal-to-proximal loss of peripheral nerve function, leading to physical disability and sometimes pain, with the consequent lowering of quality of life. Early diagnosis improves clinical outcomes, but many patients still develop neuropathy. Hyperglycaemia is a risk factor and glycaemic control prevents DPN development in type 1 diabetes. However, glycaemic control has modest or no benefit in individuals with type 2 diabetes, probably because they usually have comorbidities. Among them, the metabolic syndrome is a major risk factor for DPN. The pathophysiology of DPN is complex, but mechanisms converge on a unifying theme of bioenergetic failure in the peripheral nerves due to their unique anatomy. Current clinical management focuses on controlling diabetes, the metabolic syndrome, and pain, but remains suboptimal for most patients. Thus, research is ongoing to improve early diagnosis and prognosis, to identify molecular mechanisms that could lead to therapeutic targets, and to investigate lifestyle interventions to improve clinical outcomes.
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Affiliation(s)
| | - Henning Andersen
- Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
| | - David L Bennett
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK
| | | | - Vijay Viswanathan
- MV Hospital for Diabetes and Prof M Viswanathan Diabetes Research Centre, Royapuram, Chennai, India
| | | | - Eva L Feldman
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
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Wang J, Li Z. EFFECT OF PHYSICAL EXERCISE ON MEDICAL REHABILITATION TREATMENT OF DEPRESSION. REV BRAS MED ESPORTE 2022. [DOI: 10.1590/1517-8692202228032021_0483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction: Depression is a common disease worldwide. The main treatment methods currently include medication, psychotherapy, and physical therapy. However, due to limitations in treatment methods, treatment compliance is poor. Participating in various sports is very effective in treating depression. Objective: To verify the influence of sports on the condition of depression and on the effect of its clinical treatment. Methods: The article selected a total of 60 hospitalized patients with depression who were randomly divided into two groups: an experimental group and a control group. The control group took antidepressant drugs for eight weeks, and the experimental group took the drugs with the supplementary practice of sports. The two groups of patients were tested for serum β-endorphin (β-EP) levels before and after treatment, and HAMD scores were performed. Results: The scores and serum β-endorphin (β-EP) levels of the two groups of patients were different, showing that effect of the treatment was better in the experimental group. Conclusion: Physical exercise therapy can mobilize the enthusiasm of patients with depression. This treatment plan increases treatment efficiency and is suitable for long-term clinical promotion and application. Level of evidence II; Therapeutic studies - investigation of treatment results.
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Affiliation(s)
- Jing Wang
- Northeast Agricultural University, China
| | - Zhaohe Li
- Northeast Agricultural University, China
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Cai Y, Liu X, Zhao A, Mao J, Guo X, Li G, Yang J, Wu Y, Fei Y. Effects of Tai Chi on health outcomes in patients with type 2 diabetes mellitus: A systematic review and meta-analysis. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2022. [DOI: 10.1016/j.jtcms.2022.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Li Q, Wang Y, Shen X. Effect of Psychological Support Therapy on Psychological State, Pain, and Quality of Life of Elderly Patients With Femoral Neck Fracture. Front Surg 2022; 9:865238. [PMID: 35402487 PMCID: PMC8987194 DOI: 10.3389/fsurg.2022.865238] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose To explore the intervention effect of psychological support therapy (PST) on elderly patients with femoral neck fracture. Methods A total of 82 elderly patients with femoral neck fractures admitted to our hospital from July 2020 to June 2021 were selected. Patients were randomly divided into conventional group (n = 41) and intervention group (n = 41). The conventional group received routine nursing care. The intervention group was given PST on the basis of the conventional group. The joint function, psychological state, pain, quality of life, and nursing satisfaction of both groups were observed. Results Compared with before intervention, the Harris hip joint score and the General Quality-of-Life Inventory-74 scores of both groups increased after the intervention, and the increase was more obvious in the intervention group (p < 0.05). Compared with before intervention, the self-rating anxiety scale, the self-rating depression scale scores, and the visual analog scales score in both groups decreased after the intervention, and the decrease was more obvious in the intervention group (p < 0.05). The total satisfaction of the intervention group (92.68%) was higher than that of the conventional group (75.61%) (p < 0.05). Conclusion Psychological support therapy has a certain intervention effect on elderly patients with femoral neck fracture, which can improve psychological state, reduce pain, improve quality of life, and improve nursing satisfaction.
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Davies B, Cramp F, Gauntlett-Gilbert J, McCabe CS. Peoples' experiences of painful diabetic neuropathy: are pain management programmes appropriate? Br J Pain 2021; 15:450-459. [PMID: 34840793 PMCID: PMC8611298 DOI: 10.1177/2049463721989753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Painful diabetic neuropathy (PDN) is a painful complication of diabetes. This study aimed to explore: (1) strategies used by participants to manage impacts of PDN and (2) their perspectives on whether strategies from pain management programmes (PMPs) had applicability for PDN. DESIGN Participants were recruited through local National Health Service (NHS) diabetes and PDN clinics, and nationally from a diabetes support charity. One-to-one interviews were conducted. The transcribed data were analysed using inductive thematic analysis. RESULTS Twenty-three people were interviewed who had PDN symptoms for mean 10 years. Four themes emerged from the data: seeking help and advice, pragmatic approach to management, perspectives on physical activity and perspectives on psychological coping strategies. CONCLUSION Some participants were open to the strategies advised by PMP strategies. There were also strong opinions that no exercise or psychological approach could help with diabetes-related pain. It is possible PMPs as currently delivered need to be adapted to maximise engagement from people with PDN. Research is required to understand the healthcare priorities of people with PDN and whether these priorities can be mapped to existing management strategies.
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Affiliation(s)
- Ben Davies
- Virgin Care, St Martins Hospital, Bath,
UK
| | - Fiona Cramp
- Faculty of Health and Applied Sciences,
University of the West of England, Bristol, UK
| | - Jeremy Gauntlett-Gilbert
- Faculty of Health and Applied Sciences,
University of the West of England, Bristol, UK
- Bath Centre for Pain Services, Royal
United Hospitals Bath, Bath, UK
| | - Candida S McCabe
- Faculty of Health and Applied Sciences,
University of the West of England, Bristol, UK
- Florence Nightingale Foundation, London,
UK
- Dorothy House Hospice Care, Winsley,
UK
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Afonso J, Claudino JG, Fonseca H, Moreira-Gonçalves D, Ferreira V, Almeida JM, Clemente FM, Ramirez-Campillo R. Stretching for Recovery from Groin Pain or Injury in Athletes: A Critical and Systematic Review. J Funct Morphol Kinesiol 2021; 6:jfmk6030073. [PMID: 34564192 PMCID: PMC8482255 DOI: 10.3390/jfmk6030073] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 08/24/2021] [Accepted: 08/27/2021] [Indexed: 01/01/2023] Open
Abstract
Stretching is usually used as part of rehabilitation protocols for groin pain or injury, but its specific contribution to and within multimodal recovery protocols is unclear. Our goal was to systematically review the effects of stretching for the recovery from groin pain or injury. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, with eligibility criteria defined according to PICOS: (Participants) athletes with groin pain or injuries; (Interventions) interventions with stretching as the differentiating factor; (Comparators) comparators not applying stretching; (Outcomes) symptom remission or improvement and/or time to return to sport and/or return to play; (Study design) randomized controlled trials. Searches were performed on 26 March 2021, in CINAHL, Cochrane Library, EBSCO, EMBASE, PEDro, PubMed, Scielo, Scopus, SPORTDiscus, and Web of Science, with no limitations regarding language or date, and no filters. Of 117 retrieved results, 65 were duplicates and 49 were excluded at the screening stage. The three articles eligible for full-text analysis failed to comply with one or more inclusion criteria (participants, intervention and/or comparators). We then went beyond the protocol and searched for non-randomized trials and case series, but no intervention was found where stretching was the differentiating factor. We found no trials specifically assessing the effects of stretching on recovery or improvement of groin pain or injury in athletes. Currently, the efficacy of these interventions is unknown, and more research is warranted.
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Affiliation(s)
- José Afonso
- Centre for Research, Education, Innovation, and Intervention in Sport (CIFI2D), Faculty of Sport of the University of Porto (FADEUP), 4200-450 Porto, Portugal; (J.A.); (V.F.); (J.M.A.)
| | - João Gustavo Claudino
- Laboratory of Biomechanics, School of Physical Education and Sport, Universidade de São Paulo, São Paulo 05403-010, Brazil;
- Research and Development Department, LOAD CONTROL, Contagem 32280-440, Brazil
| | - Hélder Fonseca
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport of the University of Porto (FADEUP), 4200-450 Porto, Portugal; (H.F.); (D.M.-G.)
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-091 Porto, Portugal
| | - Daniel Moreira-Gonçalves
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport of the University of Porto (FADEUP), 4200-450 Porto, Portugal; (H.F.); (D.M.-G.)
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-091 Porto, Portugal
| | - Victor Ferreira
- Centre for Research, Education, Innovation, and Intervention in Sport (CIFI2D), Faculty of Sport of the University of Porto (FADEUP), 4200-450 Porto, Portugal; (J.A.); (V.F.); (J.M.A.)
| | - José Marques Almeida
- Centre for Research, Education, Innovation, and Intervention in Sport (CIFI2D), Faculty of Sport of the University of Porto (FADEUP), 4200-450 Porto, Portugal; (J.A.); (V.F.); (J.M.A.)
| | - Filipe Manuel Clemente
- Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun’Álvares, 4900-347 Viana do Castelo, Portugal
- Instituto de Telecomunicações, Delegação da Covilhã, 1049-001 Lisboa, Portugal
- Correspondence:
| | - Rodrigo Ramirez-Campillo
- Department of Physical Activity Sciences, Universidad de Los Lagos, Santiago 8320000, Chile;
- Centro de Investigación en Fisiología del Ejercicio, Facultad de Ciencias, Universidad Mayor, Santiago 7500000, Chile
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17
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Effect of Psychological Intervention Combined with Family Cooperation on the Perioperative Quality of Life and Psychological States of Elderly Patients with Prostate Cancer Treated with Compound Kushen Injection. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:2971644. [PMID: 34335804 PMCID: PMC8315856 DOI: 10.1155/2021/2971644] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/13/2021] [Indexed: 11/17/2022]
Abstract
Objective The purpose of the study was to investigate the nursing effect of psychological intervention combined with family cooperation on elderly patients with prostate cancer treated with compound kushen injection and put forward effective suggestions. Methods 122 elderly patients with prostate cancer admitted to our hospital from June 2018 to June 2019 were selected and randomly divided into a control group (n = 61) and experimental group (n = 61). The patients in the control group received routine nursing intervention during the perioperative period, while the patients in the experimental group were treated with psychological intervention combined with family cooperation on the basis of routine nursing. The quality of life and psychological states of patients in the two groups were statistically analyzed. Results The evaluation of psychological states at 24 hours before surgery and 24 hours before discharge in the experimental group was significantly better than that in the control group (P < 0.05), with statistical significance. On comparing the basic conditions between the two groups in the perioperative period, the length of hospitalization, length of catheter retention after surgery, and incidence of complications in the experimental group were all significantly better than those in the control group (P < 0.05), with statistical significance. The satisfaction of patients with the nursing process in both groups was recorded and statistically analyzed through questionnaires. The satisfaction with nursing process in the experimental group was significantly higher than that in the control group (P < 0.05), with statistical significance. The quality of life of the patients was followed up at three months after discharge. The quality of life of the experimental group was significantly better than that of the control group (P < 0.05), with statistical significance. Conclusion Psychological intervention combined with family cooperation for the elderly patients with prostate cancer treated with compound kushen injection is beneficial to improve their psychological states, encourage them to face the disease in a more positive manner, effectively improve the quality of life after intervention, ensure the therapeutic effect during perioperative period, increase happiness index, and enhance their satisfaction with the nursing process, which is worthy of clinical application and popularization.
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18
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Sanjari M, Esmaeili S, Yarmohammadi H, Atlasi R, Aalaa M, Larijani B, Nasli-Esfahani E. Evidence Gap and Knowledge Map of Physical Activity Research in Diabetes in Iran: A Scoping Review. Int J Endocrinol Metab 2021; 19:e110636. [PMID: 34149848 PMCID: PMC8198613 DOI: 10.5812/ijem.110636] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 04/04/2021] [Accepted: 04/12/2021] [Indexed: 12/02/2022] Open
Abstract
CONTEXT The important role of physical activity in the prevention and management of diabetes necessitates a review of current research to shed light on gaps in national diabetes guidelines. EVIDENCE ACQUISITION This scoping review was part of the Iran Diabetes Research Roadmap (IDRR) study. A systematic search was used based on the Arksey and O'Malley method consisting of six steps. The descriptive analysis was done with SPSS software. Additionally, VOS veiwer software was used to draw the knowledge map of the included studies. RESULTS There were 169 articles included from the beginning of 2015 to the end of 2019 in Iran. Aerobic and resistance exercises were types of physical activity with more number of articles. Most of the included clinical studies were randomized clinical trials and had a level of evidence two. Also, there was more interest in outcomes such as glycemic control and insulin sensitivity, metabolic syndrome, metabolism, and cardiovascular health. The network of co-authorship was drawn, and "controlled study", "male", and "rat" were the most frequent keywords. CONCLUSIONS The number of Iranian diabetes researchers on physical activity is increasing, and the majority of clinical studies had a high level of evidence. With maintaining previous interests and investigations, there should be more emphasis on research in elderly and children age groups as evidence gap in Iran. Also, longitudinal cohort studies should be highlighted and Iranian researchers should be encouraged to participate in new topics of research worldwide.
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Affiliation(s)
- Mahnaz Sanjari
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahnaz Esmaeili
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Yarmohammadi
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Medical Students Research Committee, Shahed University, Tehran, Iran
| | - Rasha Atlasi
- Evidence Based Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Aalaa
- Evidence Based Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Centre for Educational Research in Medical Sciences (CERMS), Department of Medical Education, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ensieh Nasli-Esfahani
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding Author: Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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19
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Nagpal AS, Leet J, Egan K, Garza R. Diabetic Neuropathy: a Critical, Narrative Review of Published Data from 2019. Curr Pain Headache Rep 2021; 25:15. [PMID: 33630186 DOI: 10.1007/s11916-020-00928-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 01/01/2023]
Abstract
PURPOSE OF REVIEW This manuscript is a systematic, narrative review that compiles and describes all data available from 2019 related to epidemiologic, diagnostic, and therapeutic advances in diabetic neuropathy (DN). RECENT FINDINGS Epidemiology of DN is discussed. Diagnostic modalities include predictive models, electrodiagnostics, imaging, and biomarkers. A majority of studies on the treatment of diabetic peripheral neuropathy (DPN) involve pharmacotherapy, but complementary and alternative medicine, exercise, modalities, psychological, interventional, and surgical options are also explored. DN is a highly prevalent and debilitating consequence of diabetes that can present challenges to the clinician as the assessment is largely subjective with different phenotypic presentations among patients. Treatment of DN is largely symptomatic as the pathogenesis of DN is not fully understood and is likely multifactorial. It is evident from the broad range of treatments that too often provide unsatisfactory relief that there is no consensus about a single most effective treatment for DN, and monotherapy rarely proves to be successful.
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Affiliation(s)
- Ameet S Nagpal
- Department of Anesthesiology, Joe R. & Thereza Lozano Long School of Medicine, UT Health San Antonio, San Antonio, TX, USA.
| | - Jennifer Leet
- Department of Rehabilitation Medicine, Joe R. & Theresa Lozano Long School of Medicine, UT Health San Antonio, San Antonio, TX, USA
| | - Kaitlyn Egan
- Department of Rehabilitation Medicine, Joe R. & Theresa Lozano Long School of Medicine, UT Health San Antonio, San Antonio, TX, USA
| | - Rudy Garza
- Department of Anesthesiology, Joe R. & Thereza Lozano Long School of Medicine, UT Health San Antonio, San Antonio, TX, USA
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20
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Faizah R, Efendi F, Suprajitno S. The effects of foot exercise with audiovisual and group support foot exercises to diabetes mellitus patients. J Diabetes Metab Disord 2021; 20:377-382. [PMID: 34178845 DOI: 10.1007/s40200-021-00756-9] [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: 09/24/2020] [Accepted: 01/26/2021] [Indexed: 11/21/2022]
Abstract
Objectives This study aimed to analyze the effect of audiovisual and group support foot exercises on the Ankle Brachial Pressure Index and foot sensation. Methods This study used a quasi-experimental design. The sample number of this study was 156 using a purposive sampling technique. The research group was divided into three groups. The variables measured in this study were ABPI, foot sensation, and foot exercise experience. The statistical analysis was conducted by a paired-sample t-test, an independent-sample t-test, and a two-way Manova. Results The results showed that each group had a difference in how ABPI and foot sensation were influenced (p = 0.000). Additionally, audiovisual and group support foot exercises have been shown to influence ABPI (p = 0.000) and foot sensation (p) = 0.000). Conclusions Audiovisual and group support foot exercises significantly influenced the Ankle Brachial Pressure Index value and foot sensation in diabetic mellitus patients. This intervention is encouraged for diabetic mellitus patients who would like to see the benefits of exercise and group support.
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Affiliation(s)
- Rohmatul Faizah
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Ferry Efendi
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
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21
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Abstract
AbstractPain is a challenge to rheumatologists. Not only patients with active arthritis
but also patients with a good therapeutic response and even in remission
complain of persistent joint pain. It has been proposed that a chronic pain
stimulus may have a greater impact in a chronic inflammatory state, and the
process towards a pain condition may be influenced by individual predisposition
for development of chronic pain. In addition, features of peripheral pain
processing may be exacerbated by inflammation, and disturbed pain processing may
be a feature contributing to widespread pain. Furthermore, a neuropathic
component may be part of the total pain experience of our patients. There are
many different strategies of pain therapy in patients with rheumatic diseases,
such as pharmacological and non- pharmacological modalities.
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Affiliation(s)
- Olga Seifert
- Abteilung für Rheumatologie, Medizinische Klinik III,
Universitätskliniken Leipzig, Leipzig
| | - Christoph Baerwald
- Abteilung für Rheumatologie, Medizinische Klinik III,
Universitätskliniken Leipzig, Leipzig
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22
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Taheri AA, Foroughi AA, Mohammadian Y, Ahmadi SM, Heshmati K, Hezarkhani LA, Parvizifard AA. The Effectiveness of Acceptance and Commitment Therapy on Pain Acceptance and Pain Perception in Patients with Painful Diabetic Neuropathy: A Randomized Controlled Trial. Diabetes Ther 2020; 11:1695-1708. [PMID: 32533548 PMCID: PMC7376796 DOI: 10.1007/s13300-020-00851-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Neuropathic pain is a complex phenomenon in patients with diabetes. These patients have many problems, such as psychological problems, high-level pain perception, and pain acceptance. This study aimed to evaluate the effectiveness of acceptance and commitment therapy on pain acceptance and pain perception in patients with painful diabetic neuropathy. METHODS This study was performed according to the clinical trial method. The sample size was 50 participants. In this study, participants were divided into interventional and control groups. According to the diagnosis of neurologists, all participants received conventional medications to manage neuropathic pain. The intervention group received acceptance and commitment therapy for eight sessions. The results in the three phases of pre-test, post-test, and follow-up were evaluated. After completing the study, to comply with ethical standards, the control group received psycho-education. The tools used were the McGill Pain Questionnaire (MPQ) and the Chronic Pain Acceptance Questionnaire (CPAQ). Statistical analysis includes mean, standard deviation, and repeated-measures (ANOVA) conducted by SPSS software version 22. RESULTS The results demonstrated that in the post-test and follow-up phases, acceptance and commitment therapy could improve pain acceptance and reduce pain perception in the intervention group compared to the control group (P < 0.01). CONCLUSION The results indicated that acceptance and commitment therapy could be used as a psychological intervention besides pharmacotherapy to improve pain acceptance and reduce pain perception in patients with painful diabetic neuropathy. CLINICAL TRAIL REGISTRATION This study was registered at the Iranian Registry of Clinical Trials (IRCT20180205038630N4).
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Affiliation(s)
- Amir Abbas Taheri
- Department of Clinical Psychology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Akbar Foroughi
- Department of Clinical Psychology, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Youkhabeh Mohammadian
- Department of Clinical Psychology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed Mojtaba Ahmadi
- Department of Clinical Psychology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Khatereh Heshmati
- Department of Clinical Psychology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Ali Akbar Parvizifard
- Department of Clinical Psychology, Kermanshah University of Medical Sciences, Kermanshah, Iran
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23
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Therapeutic Approaches for Peripheral and Central Neuropathic Pain. Behav Neurol 2019; 2019:8685954. [PMID: 31871494 PMCID: PMC6906810 DOI: 10.1155/2019/8685954] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 09/20/2019] [Accepted: 10/30/2019] [Indexed: 12/11/2022] Open
Abstract
Neuropathic pain is a chronic secondary pain condition, which is a consequence of peripheral or central nervous (somatosensory) system lesions or diseases. It is a devastating condition, which affects around 7% of the general population. Numerous etiological factors contribute to the development of chronic neuropathic pain. It can originate from the peripheral part of the nervous system such as in the case of trigeminal or postherpetic neuralgia, peripheral nerve injury, painful polyneuropathies, or radiculopathies. Central chronic neuropathic pain can develop as a result of spinal cord or brain injury, stroke, or multiple sclerosis. As first-line pharmacological treatment options, tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, and gabapentinoids are recommended. In trigeminal neuralgia, carbamazepine and oxcarbazepine are the first-choice drugs. In drug-refractory cases, interventional, physical, and psychological therapies are available. This review was structured based on a PubMed search of papers published in the field from 2010 until May 2019.
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Souto EB, Souto SB, Campos JR, Severino P, Pashirova TN, Zakharova LY, Silva AM, Durazzo A, Lucarini M, Izzo AA, Santini A. Nanoparticle Delivery Systems in the Treatment of Diabetes Complications. Molecules 2019; 24:E4209. [PMID: 31756981 PMCID: PMC6930606 DOI: 10.3390/molecules24234209] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/15/2019] [Accepted: 11/18/2019] [Indexed: 12/25/2022] Open
Abstract
Diabetes mellitus, an incurable metabolic disease, is characterized by changes in the homeostasis of blood sugar levels, being the subcutaneous injection of insulin the first line treatment. This administration route is however associated with limited patient's compliance, due to the risk of pain, discomfort and local infection. Nanoparticles have been proposed as insulin carriers to make possible the administration of the peptide via friendlier pathways without the need of injection, i.e., via oral or nasal routes. Nanoparticles stand for particles in the nanometer range that can be obtained from different materials (e.g., polysaccharides, synthetic polymers, lipid) and are commonly used with the aim to improve the physicochemical stability of the loaded drug and thereby its bioavailability. This review discusses the use of different types of nanoparticles (e.g., polymeric and lipid nanoparticles, liposomes, dendrimers, niosomes, micelles, nanoemulsions and also drug nanosuspensions) for improved delivery of different oral hypoglycemic agents in comparison to conventional therapies.
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Affiliation(s)
- Eliana B. Souto
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra (FFUC), Pólo das Ciências da Saúde, 3000-548 Coimbra, Portugal;
- CEB—Centre of Biological Engineering, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Selma B. Souto
- Department of Endocrinology, Hospital de São João, Alameda Prof. Hernâni Monteiro, 4200–319 Porto, Portugal;
| | - Joana R. Campos
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra (FFUC), Pólo das Ciências da Saúde, 3000-548 Coimbra, Portugal;
| | - Patricia Severino
- Tiradentes Institute, University of Tiradentes (Unit) and Institute of Technology and Research (ITP), Av. Murilo Dantas, 300, Aracaju-SE 49010-390, Brazil;
- Laboratory of Nanotechnology and Nanomedicine (LNMED), Institute of Technology and Research (ITP), Av. Murilo Dantas, 300, Aracaju 49010-390, Brazil
| | - Tatiana N. Pashirova
- Arbuzov Institute of Organic and Physical Chemistry, FRC Kazan Scientific Center, Russian Academy of Sciences, 8, ul. Arbuzov, Kazan 420088, Russia; (T.N.P.); (L.Y.Z.)
| | - Lucia Y. Zakharova
- Arbuzov Institute of Organic and Physical Chemistry, FRC Kazan Scientific Center, Russian Academy of Sciences, 8, ul. Arbuzov, Kazan 420088, Russia; (T.N.P.); (L.Y.Z.)
- Department of Organic Chemistry, Kazan State Technological University, ul. Karla Marksa 68, Kazan 420015, Russia
| | - Amélia M. Silva
- Centre for Research and Technology of Agro-Environmental and Biological Sciences (CITAB-UTAD), Quinta de Prados, 5001-801 Vila Real, Portugal;
- Department of Biology and Environment, University of Trás-os Montes e Alto Douro (UTAD), Quinta de Prados, 5001-801 Vila Real, Portugal
| | - Alessandra Durazzo
- CREA-Research Centre for Food and Nutrition, Via Ardeatina, 546, 00178 Rome, Italy; (A.D.); (M.L.)
| | - Massimo Lucarini
- CREA-Research Centre for Food and Nutrition, Via Ardeatina, 546, 00178 Rome, Italy; (A.D.); (M.L.)
| | - Angelo A. Izzo
- Department of Pharmacy, University of Napoli Federico II, Via D. Montesano, 49, 80131 Napoli, Italy
| | - Antonello Santini
- Department of Pharmacy, University of Napoli Federico II, Via D. Montesano, 49, 80131 Napoli, Italy
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25
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Kiekens C. Should Pregabalin Be Used in the Management of Chronic Neuropathic Pain in Adults? A Cochrane Review Summary With Commentary. PM R 2019; 11:1360-1363. [PMID: 31729182 DOI: 10.1002/pmrj.12283] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 11/04/2019] [Indexed: 01/30/2023]
Affiliation(s)
- Carlotte Kiekens
- Department of Physical and Rehabilitation Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven - University of Leuven, Leuven, Belgium
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