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Lee YG, Kim SR. Predictors of Quality of Life in Patients With Degenerative Cervical Myelopathy Receiving Nonsurgical Management Due to Chronic Pain. Pain Manag Nurs 2023:S1524-9042(23)00035-8. [PMID: 36959040 DOI: 10.1016/j.pmn.2023.02.007] [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: 06/29/2022] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND Most patients with degenerative cervical myelopathy (DCM) experience pain, and their quality of life (QoL) is poor. AIMS This study aimed to identify predictors of QoL, including demographic, clinical, physical, and psychosocial characteristics, in chronic pain patients with DCM receiving non-surgical management. DESIGN A descriptive study design was used. SETTING Participants were recruited at the pain clinic at a university hospital in Seoul, South Korea. PARTICIPANTS/SUBJECTS The subjects included 157 inpatients and outpatients with DCM receiving non-surgical management. METHODS We administered a written, structured, self-reported questionnaire, which included standard validated measures for the main variables of interest. RESULTS The median number of pain sites was two, and the average and most pain severities were 4.63 ± 2.35 and 5.71 ± 2.32 out of 10 within one month, respectively. Stepwise multiple regression analysis revealed that depression, education level, and headache were factors influencing physical QoL. Depression, education level, and marital status were factors influencing psychological QoL, whereas depression and education level were factors influencing social relationships QoL. Finally, the factors influencing environmental QoL were depression, educational level, and marital status. CONCLUSIONS Demographic characteristics, including educational level and marital status, clinical characteristics, including pain site, and psychological characteristics, including depression, were identified as factors influencing QoL in chronic pain patients with DCM receiving non-surgical management. CLINICAL IMPLICATIONS Healthcare professionals should consider demographic, clinical, and psychological characteristics when evaluating patients... QoL. In addition, it is necessary to pay attention to the QoL of participants who are single and have lower levels of education, headache pain, and high levels of depression. These patients are likely to have low QoL and strategies to improve their QoL should be developed.
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Affiliation(s)
- Yeong Gi Lee
- Department of Nursing, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Sung Reul Kim
- College of Nursing, Korea University, Seoul, Republic of Korea.
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Vongsirinavarat M, Wangbunkhong S, Sakulsriprasert P, Petviset H. Prevalence of scapular dyskinesis in office workers with neck and scapular pain. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2023; 29:50-55. [PMID: 34927576 DOI: 10.1080/10803548.2021.2018855] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Objectives. This study aimed to investigate the presence of scapular dyskinesis (SD) in office workers with neck and scapular complaints. The postural malalignment and related muscle adaptations were also explored. Methods. SD and its subtypes were determined. Postural deviations and the length of commonly reported muscle tightness were evaluated. Results. Among 99 participants, 90% of them had SD. Considering both sides or 198 scapula, 90.4% were identified as having painful scapula and 19% as having painless scapula. There was a difference in the proportion of SD on painful (93%) and painless (69%) sides. Postural deviations including rounded shoulder (100%), forward head (43.3%) and thoracic hyperkyphosis (54.5%) were prevalent. Persons with type III SD had a higher percentage of forward head than other types. There was also tightness of the pectoralis minor (100%), levator scapulae (93.0%) and upper trapezius (98.3%) muscles without different proportions among types of SD. The greatest proportion of persons with SD had tightness of the levator scapulae. Conclusions. There was a high prevalence of SD among office workers with neck and scapular complaints. SD was also associated with abnormal posture and muscle tightness. The proper management of SD and working posture is warranted.
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Affiliation(s)
| | - Sukhon Wangbunkhong
- Physical Medicine and Rehabilitation Department, Rajavithi Hospital, Thailand
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García-Perea E, Pedraz-Marcos A, Martínez-Rodríguez SH, Otones-Reyes P, Palmar-Santos AM. Effectiveness of a Fibromyalgia Online Nursing Consultation in the Quality of Life: A Randomized Controlled Trial. Pain Manag Nurs 2022; 23:478-485. [PMID: 34654636 DOI: 10.1016/j.pmn.2021.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 09/02/2021] [Accepted: 09/05/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Aim: To evaluate the effectiveness of an online nursing consultation through the Internet platform Red Sinapsis (RS) in improving the perceived quality of life of patients with fibromyalgia (FM). METHOD Eighty patients with FM were randomized to an intervention group (n = 40) or control group (n= 40). The intervention group (IG) was monitored by a nursing specialist through the online platform RS while the control group (CG) received standard follow-up at the clinic. The Fibromyalgia Impact Questionnaire (FIQ) and 36-item Short-Form Health Survey (SF-36) were used at baseline, 6-month, and 12-month follow-up. RESULTS The IG showed a 65% improvement in the perception of their general state of health at 12 months into the study, compared with an improvement of 5.6% in the CG (p < .001). The IG also achieved better results for emotional status, with a maintained improvement throughout the study of more than 2 points in the anxiety variable (from 7.64 to 5.36), that remained constant in the CG. The depression variable also showed constant improvement over the 12 months of the study in the IG, rising from an average of 7.72 (standard deviation [SD] = 2.05) to 5.33 (SD = 1.65), while in the CG a slight deterioration was observed. In both cases, the difference in mood evolution was significant (p < .001). CONCLUSIONS Online nursing follow-up for people with fibromyalgia improves patients' perceived quality of life related to their welfare and emotional state. Fibromyalgia (FM) is among the diseases causing the highest rate of occupational disability in Spain. Fibromyalgia (FM) is a complex condition that causes pain, fatigue, non-refreshed sleep, mood disturbance and cognitive impairment.
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Affiliation(s)
- Eva García-Perea
- Department of Nursing, School of Medicine, University Autonoma of Madrid, Spain
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Özel M, Kaya Ciddi P. The effectiveness of telerehabilitation-based structured exercise therapy for chronic nonspecific neck pain: A randomized controlled trial. J Telemed Telecare 2022:1357633X221095782. [PMID: 35570728 DOI: 10.1177/1357633x221095782] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The aim of this research was to investigate the effects of telerehabilitation-based remote supervised or unsupervised structured exercise therapy on pain, disability, and quality of life related to chronic nonspecific neck pain. METHOD The study was designed as a single-blinded randomized controlled trial. Sixty-six eligible chronic nonspecific neck pain patients were randomized across three groups: remote supervised group (RSG, n = 22), unsupervised group (UG, n = 22), and waitlist control group (CG, n = 22). Progressive structured exercise therapy program was delivered weekly to patients in remote supervised group and unsupervised group to perform four days a week for four weeks. Remote supervised group was supervised by videoconference and text message. Pain, disability, and quality of life of participants were assessed at baseline, week 2, and post-therapy. RESULTS Post-therapy pain and disability total change scores were -3.64 (95% CI -4.85 to -2.42) and -7.27 (95% CI -11.05 to -3.50) for remote supervised group compared with a change of -2.44 (95% CI -3.46 to -1.43) and -5.77 (95% CI -8.54 to -3.01) for unsupervised group, respectively. Post-therapy, quality of life improvements were greater for remote supervised group than unsupervised group overall (general health; remote supervised group: 19.01 (95% CI 6.86 to 31.16), unsupervised group: 12.50 (95% CI 4.79 to 20.21), and physical health; remote supervised group: 18.35 (95% CI 10.35 to 26.35), unsupervised group: 7.31 (95% CI 0.01 to 14.60)). Significant improvements in psychological health and environment-telerehabilitation for remote supervised group were not seen for unsupervised group and outcomes differences did not reach significance for control group (p > 0.05) post-therapy, except environment-telerehabilitation. DISCUSSION Structured exercise therapy can improve chronic nonspecific neck pain outcomes when remotely supervised or unsupervised. Structured exercise therapy content and frequent communication are important for remote chronic nonspecific neck pain management.
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Affiliation(s)
- Merve Özel
- Physiotherapy and Rehabilitation Department, Medipol University, Health Sciences Institute, Istanbul, Turkey
| | - Pınar Kaya Ciddi
- Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, 218502Istanbul Medipol University, Istanbul, Turkey
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Tuntiyasawasdikul S, Sripanidkulchai B. Development and clinical trials on anti-inflammatory effect of transdermal patch containing a combination of Kaempferia parviflora and Curcuma longa extracts. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Effect of Combined Manual Therapy and Therapeutic Exercise Protocols on the Postural Stability of Patients with Non-Specific Chronic Neck Pain. A Secondary Analysis of Randomized Controlled Trial. J Clin Med 2021; 11:jcm11010084. [PMID: 35011823 PMCID: PMC8745098 DOI: 10.3390/jcm11010084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 12/19/2021] [Accepted: 12/22/2021] [Indexed: 11/16/2022] Open
Abstract
Postural stability is a little-studied factor in non-specific chronic neck pain; the causes that can alter it are unknown. The relationship with chronic pain could be a determining factor for its deficit. The aim of this study was to investigate the relationship between sustained pain and a postural stability deficit. A randomized and blinded clinical trial (double-blind; placebo control; 12 weeks follow-up) was conducted with a total of 69 subjects divided into three groups, two experimental (manual therapy and specific exercise) and a control treatment, and carried out over a treatment period of three weeks with a follow-up after 12 weeks. Their postural stability was assessed through the overall balance index (OBI). The postural stability of subjects with non-specific chronic neck pain improved in the experimental treatments. There were no statistically significant differences between the experimental groups. This trial found that manual therapy and therapeutic exercise significantly improved OBI compared to the control group. Trial registration: Brazilian Clinical Trial Registry, RBR-2vj7sw.
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Bruce SL, Wilkerson GB. Whole-Body Reactive Agility Metrics to Identify Football Players With a Core and Lower Extremity Injury Risk. Front Sports Act Living 2021; 3:733567. [PMID: 34746776 PMCID: PMC8564038 DOI: 10.3389/fspor.2021.733567] [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: 06/30/2021] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
Clinical prediction models are useful in addressing several orthopedic conditions with various cohorts. American football provides a good population for attempting to predict injuries due to their relatively high injury rate. Physical performance can be assessed a variety of ways using an assortment of different tests to assess a diverse set of metrics, which may include reaction time, speed, acceleration, and deceleration. Asymmetry, the difference between right and left performance has been identified as a possible risk factor for injury. The purpose of this study was to determine the whole-body reactive agility metrics that would identify Division I football players who were at elevated risk for core, and lower extremity injuries (CLEI). This cohort study utilized 177 Division I football players with a total of 57 CLEI suffered who were baseline tested prior to the season. Single-task and dual-task whole-body reactive agility movements in lateral and diagonal direction reacting to virtual reality targets were analyzed separately. Receiver operator characteristic (ROC) analyses narrowed the 34 original predictor variables to five variables. Logistic regression analysis determined the three strongest predictors of CLEI for this cohort to be: lateral agility acceleration asymmetry, lateral flanker deceleration asymmetry, and diagonal agility reaction time average. Univariable analysis found odds ratios to range from 1.98 to 2.75 for these predictors of CLEI. ROC analysis had an area under the curve of 0.702 for any combination of two or more risk factors produced an odds ratio of 5.5 for risk of CLEI. These results suggest an asymmetry of 8-15% on two of the identified metrics or a slowed reaction time of ≥0.787 s places someone at increased risk of injury. Sixty-three percent (36/57) of the players who sustained an injury had ≥2 positive predictors In spite of the recognized limitation, these finding support the belief that whole-body reactive agility performance can identify Division I football players who are at elevated risk for CLEI.
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Affiliation(s)
- Scott L Bruce
- Masters of Athletic Training Program, Arkansas State University, Jonesboro, AR, United States
| | - Gary B Wilkerson
- Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, TN, United States
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Ünlüer NÖ, Ateş Y. An investigation of neck pain in older adults, and its relation with shoulder position sense and upper extremity function. Somatosens Mot Res 2021; 38:333-338. [PMID: 34538197 DOI: 10.1080/08990220.2021.1977266] [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: 10/20/2022]
Abstract
PURPOSE Neck pain is a musculoskeletal problem increasing with age. The disorders that occurs in the neck region may also affect the upper extremity due to its close anatomical relationships. The aim of this study was to determine whether neck pain affects shoulder position sense and upper extremity function in the older adults. METHODS This cross-sectional study was carried out in nursing homes. The older adults over 65 years of age with chronic neck pain for the last 6 months were included. Pain intensity was evaluated with a Visual Analog Scale. Acumar dual digital inclinometer was used for the evaluation of shoulder position sense. 9-Hole Peg Test was used for the measure of upper extremity function. RESULTS It was found dominant side shoulder position sense and the function of both upper extremities were different between the three groups (p < 0.05). Pain was correlated with dominant and non-dominant 60ᵒ flexion shoulder position sense and 60ᵒ abduction shoulder position sense (p < 0.05). Additionally, a relationship was found only between pain and non-dominant side upper extremity function (p < 0.05). CONCLUSION In conclusion, we found that in older adults with neck pain, position sense and function decreased in upper extremities. The findings from this study support that detailed evaluation of anatomically related regions as well as the cervical region where pain is felt is important in creating a more effective rehabilitation program.
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Affiliation(s)
- Nezehat Özgül Ünlüer
- Faculty of Health Sciences, Physiotherapy and Rehabilitation, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Yasemin Ateş
- Faculty of Health Sciences, Physiotherapy and Rehabilitation, Ankara Yildirim Beyazit University, Ankara, Turkey
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Pina D, Puente-López E, Ruiz-Hernández JA, Ruiz-Cabello AL, Aguerrevere L, Magalhães T. Whiplash-Associated Disorders. Biopsychosocial Profiles of Pain Perception in Forensic Cases of Victims of Motor Vehicle Accidents. Front Psychol 2021; 12:716513. [PMID: 34484077 PMCID: PMC8415298 DOI: 10.3389/fpsyg.2021.716513] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/26/2021] [Indexed: 01/22/2023] Open
Abstract
In order to make a complete diagnosis of all the factors influencing whiplash associated disorders (WAD), the evidence suggests that the condition evaluation should follow an integrated biopsychosocial model. This perspective would offer a fuller view of it, recognizing the interplay between the medical, biomechanical, social, and psychological factors. Despite the progress made in the subject, evidence of which psychosocial factors influence the experience of pain in litigant WAD patients is limited. A cross-sectional design and a cluster analysis was used to study the experience of pain and the psychosocial factors included therein in 249 patients with WAD assessed after suffering a motor vehicle accident. Three clusters were obtained: C1, with low scores of pain and a slight-moderate alteration of the Health-Related Quality of Life (HRQoL); C2, with medium scores of pain, alteration of HRQoL and a perception of moderate disability; and C3, with medium-high scores of pain, alteration of the HQoL, perception of moderate disability, presence of anxious-depressive symptomatology, poorer comprehension of the condition suffered, and the belief that it will extend over a long period of time. The results show a heterogeneous experience of pain in WAD, compatible with the biopsychosocial model of disease and the multidimensional approach to pain. The role of the psychologist in the evaluation of the condition could be useful to obtain a complete view of the condition, thus ensuring that the treatment is adapted to the needs of the patient.
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Affiliation(s)
- David Pina
- Servicio Externo de Ciencias y Técnicas Forenses, Universidad de Murcia, Murcia, Spain
- Facultad de Medicina, Universidad de Murcia, Murcia, Spain
| | - Esteban Puente-López
- Servicio Externo de Ciencias y Técnicas Forenses, Universidad de Murcia, Murcia, Spain
| | | | | | - Luis Aguerrevere
- Department of Human Services, Stephen F. Austin State University, Nacogdoches, TX, United States
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Albornoz-Cabello M, Barrios-Quinta CJ, Espejo-Antúnez L, Escobio-Prieto I, Casuso-Holgado MJ, Heredia-Rizo AM. Immediate clinical benefits of combining therapeutic exercise and interferential therapy in adults with chronic neck pain: a randomized controlled trial. Eur J Phys Rehabil Med 2021; 57:767-774. [PMID: 33759439 DOI: 10.23736/s1973-9087.21.06688-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Therapeutic exercise is highly recommended for the management of non-specific neck pain and has shown promising results combined with interferential current therapy. Yet, the clinical relevance of the pooled effect of these approaches remains uncertain. AIM To investigate the immediate clinical effect size of combining therapeutic exercise and interferential therapy, compared with the isolated use of therapeutic exercise, in adults with chronic non-specific neck pain. DESIGN Randomized, single-blinded, controlled, superiority trial. SETTING Outpatients, primary care center. POPULATION Forty-nine adults with chronic non-specific neck pain. METHODS Participants with neck pain (grades I or II) lasting for more than 12 weeks were allocated to a therapeutic exercise plus interferential currents group (n = 25) or to a therapeutic exercise only group (n = 24). All individuals underwent treatment 5 times a week for 2 weeks. The primary outcome was current neck pain intensity (11-point numeric pain rating scale). Secondary outcomes included neck disability (Neck Disability Index) and active cervical range-of-movement (CROM device). Measurements were taken at baseline and immediately after treatment. An intention-to-treat analysis was carried out. To quantify the effect size of the interventions, the relative risk, the absolute and relative risk reduction, and the number needed to treat were calculated. RESULTS A significant time*group effect was found for pain intensity, disability, and neck flexion and right rotation (all, p < 0.05). In the analysis for treatment benefit, the number needed to treat was 2 (95% CI: 2 to 4, p < 0.001) for neck pain and disability, and 3 (95% CI: 2 to 11, p = 0.029) for neck flexion. CONCLUSIONS Adding interferential therapy to therapeutic exercise is clinically more effective than therapeutic exercise alone to immediately improve neck pain and disability, but not active cervical range-of-movement, in adults with persistent neck pain. CLINICAL REHABILITATION IMPACT Our results suggest that this multimodal intervention can be a useful strategy for rehabilitation of patients with non-specific neck pain. This is the first study on this topic reporting findings in terms of clinical relevance, which is key to transfer research evidence into practice.
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Affiliation(s)
- Manuel Albornoz-Cabello
- Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Sevilla, Spain
| | | | - Luis Espejo-Antúnez
- Department of Medical-Surgical Therapeutics, Faculty of Medicine, Extremadura University, Badajoz, Spain
| | - Isabel Escobio-Prieto
- Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Sevilla, Spain
| | - María J Casuso-Holgado
- Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Sevilla, Spain -
| | - Alberto M Heredia-Rizo
- Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Sevilla, Spain
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Kapitza C, Lüdtke K, Tampin B, Ballenberger N. Application and utility of a clinical framework for spinally referred neck-arm pain: A cross-sectional and longitudinal study protocol. PLoS One 2020; 15:e0244137. [PMID: 33370389 PMCID: PMC7769468 DOI: 10.1371/journal.pone.0244137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 12/02/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The clinical presentation of neck-arm pain is heterogeneous with varying underlying pain types (nociceptive/neuropathic/mixed) and pain mechanisms (peripheral/central sensitization). A mechanism-based clinical framework for spinally referred pain has been proposed, which classifies into (1) somatic pain, (2) neural mechanosensitivity, (3) radicular pain, (4) radiculopathy and mixed pain presentations. This study aims to (i) investigate the application of the clinical framework in patients with neck-arm pain, (ii) determine their somatosensory, clinical and psychosocial profile and (iii) observe their clinical course over time. METHOD We describe a study protocol. Patients with unilateral neck-arm pain (n = 180) will undergo a clinical examination, after which they will be classified into subgroups according to the proposed clinical framework. Standardized quantitative sensory testing (QST) measurements will be taken in their main pain area and contralateral side. Participants will have to complete questionnaires to assess function (Neck Disability Index), psychosocial factors (Tampa Scale of Kinesiophobia, Pain Catastrophizing Scale, Depression, anxiety and stress scale), neuropathic pain (Douleur Neuropathique 4 Questions, PainDETECT Questionnaire) and central sensitization features (Central Sensitization Inventory). Follow-ups at three, six and 12 months include the baseline questionnaires. The differences of QST data and questionnaire outcomes between and within groups will be analyzed using (M)AN(C)OVA and/or regression models. Repeated measurement analysis of variance or a linear mixed model will be used to calculate the differences between three, six, and 12 months outcomes. Multiple regression models will be used to analyze potential predictors for the clinical course. CONCLUSION The rationale for this study is to assess the usability and utility of the proposed clinical framework as well as to identify possible differing somatosensory and psychosocial phenotypes between the subgroups. This could increase our knowledge of the underlying pain mechanisms. The longitudinal analysis may help to assess possible predictors for pain persistency.
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Affiliation(s)
- Camilla Kapitza
- Faculty of Business, Management and Social Sciences, Department Movement and Rehabilitation Science, Hochschule Osnabrueck, University of Applied Sciences, Osnabrueck, Germany
| | - Kerstin Lüdtke
- Department of Health Sciences, Academic Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L), Luebeck, Germany
| | - Brigitte Tampin
- Faculty of Business, Management and Social Sciences, Department Movement and Rehabilitation Science, Hochschule Osnabrueck, University of Applied Sciences, Osnabrueck, Germany
- Department of Physiotherapy, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
- School of Physiotherapy and Exercises Sciences, Curtin University, Perth, Western Australia, Australia
| | - Nikolaus Ballenberger
- Faculty of Business, Management and Social Sciences, Department Movement and Rehabilitation Science, Hochschule Osnabrueck, University of Applied Sciences, Osnabrueck, Germany
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Harris J, Purssell E, Ream E, Jones A, Armes J, Cornelius V. How to Develop Statistical Predictive Risk Models in Oncology Nursing to Enhance Psychosocial and Supportive Care. Semin Oncol Nurs 2020; 36:151089. [PMID: 33223408 DOI: 10.1016/j.soncn.2020.151089] [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: 11/30/2022]
Abstract
OBJECTIVES Predictive risk models are advocated in psychosocial oncology practice to provide timely and appropriate support to those likely to experience the emotional and psychological consequences of cancer and its treatments. New digital technologies mean that large scale and routine data collection are becoming part of everyday clinical practice. Using these data to try to identify those at greatest risk for late psychosocial effects of cancer is an attractive proposition in a climate of unmet need and limited resource. In this paper, we present a framework to support the development of high-quality predictive risk models in psychosocial and supportive oncology. The aim is to provide awareness and increase accessibility of best practice literature to support researchers in psychosocial and supportive care to undertake a structured evidence-based approach. DATA SOURCES Statistical prediction risk model publications. CONCLUSION In statistical modeling and data science different approaches are needed if the goal is to predict rather than explain. The deployment of a poorly developed and tested predictive risk model has the potential to do great harm. Recommendations for best practice to develop predictive risk models have been developed but there appears to be little application within psychosocial and supportive oncology care. IMPLICATIONS FOR NURSING PRACTICE Use of best practice evidence will ensure the development and validation of predictive models that are robust as these are currently lacking. These models have the potential to enhance supportive oncology care through harnessing routine digital collection of patient-reported outcomes and the targeting of interventions according to risk characteristics.
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Affiliation(s)
- Jenny Harris
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, United Kingdom.
| | - Edward Purssell
- School of Health Sciences, City, University of London, London, United Kingdom
| | - Emma Ream
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, United Kingdom
| | - Anne Jones
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom
| | - Jo Armes
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, United Kingdom
| | - Victoria Cornelius
- Imperial Clinical Trials Unit, School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom
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Short-Term Effects of PENS versus Dry Needling in Subjects with Unilateral Mechanical Neck Pain and Active Myofascial Trigger Points in Levator Scapulae Muscle: A Randomized Controlled Trial. J Clin Med 2020; 9:jcm9061665. [PMID: 32492884 PMCID: PMC7355914 DOI: 10.3390/jcm9061665] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 12/23/2022] Open
Abstract
Procedures such as dry needling (DN) or percutaneous electrical nerve stimulation (PENS) are commonly proposed for the treatment of myofascial trigger points (MTrP). The aim of the present study is to investigate if PENS is more effective than DN in the short term in subjects with mechanical neck pain. This was an evaluator-blinded randomized controlled trial. Subjects were recruited through announcements and randomly allocated into DN or PENS groups. Pain intensity, disability, pressure pain threshold (PPT), range of motion (ROM), and side-bending strength were measured. The analyses included mixed-model analyses of variance and pairwise comparisons with Bonferroni correction. The final sample was composed of 44 subjects (22 per group). Both groups showed improvements in pain intensity (ηp2 = 0.62; p < 0.01), disability (ηp2 = 0.74; p < 0.01), PPT (ηp2 = 0.79; p < 0.01), and strength (ηp2 = 0.37; p < 0.01). The PENS group showed greater improvements in disability (mean difference, 3.27; 95% CI, 0.27–6.27) and PPT (mean difference, 0.88–1.35; p < 0.01). Mixed results were obtained for ROM. PENS seems to produce greater improvements in PPT and disability in the short term.
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