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Negrini S, Ceravolo MG, Ferriero G. Trust/untrust is not the same as true/false. Lessons learned and ethical questions on the application of untrustworthiness scales to judge individuals. Eur J Phys Rehabil Med 2022; 58:888-891. [PMID: 36326819 PMCID: PMC10087099 DOI: 10.23736/s1973-9087.22.07767-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 11/03/2022] [Indexed: 11/06/2022]
Abstract
This special paper reflects on trustworthiness and its implications for scientific medical journals and all the communities they serve: health professionals, policymakers, the public, and a specific discipline, in our case, Physical and Rehabilitation Medicine. We start from a recent episode: a paper claimed the untrustworthiness of two randomised controlled trials (RCTs) published in the European Journal of Physical and Rehabilitation Medicine based on a newly developed trustworthiness scale, used until now only in systematic reviews. This likely represents the first case of applying such a scale focusing on a single leading author. Developing a proper answer to this case led us to present some insights from the perspective of a Journal editor. We discuss the impact of false research results, why trust is needed in science and medicine, the difference between untrust and false results, the problems in judging trustworthiness, the unfortunately weak capacity of the peer review system in preventing these issues, the problems of "post-hoc" judgements and the emerging ethical issues. We conclude with some suggestions for the future based on prevention at the system level.
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Affiliation(s)
- Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy -
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy -
| | - Maria G Ceravolo
- Department of Experimental and Clinical Medicine, "Politecnica delle Marche" University, Ancona, Italy
| | - Giorgio Ferriero
- Physical and Rehabilitation Medicine Unit, Scientific Institute of Tradate, IRCCS, Istituti Clinici Scientifici Maugeri, Tradate, Varese, Italy
- Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
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Huang J, Xu Y, Xuan R, Baker JS, Gu Y. A Mixed Comparison of Interventions for Kinesiophobia in Individuals With Musculoskeletal Pain: Systematic Review and Network Meta-Analysis. Front Psychol 2022; 13:886015. [PMID: 35846681 PMCID: PMC9277051 DOI: 10.3389/fpsyg.2022.886015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/30/2022] [Indexed: 11/28/2022] Open
Abstract
Objective This systematic review aims to make a mixed comparison of interventions for kinesiophobia and individuals with musculoskeletal pain. Methods A comprehensive search strategy was conducted in the database of PubMed, MEDLINE, and Web of Science with the inclusion criteria: (1) randomized controlled design; (2) patients with musculoskeletal pain as participants; (3) treatments protocols of kinesiophobia as interventions or comparisons; (4) the score of Tampa Scale Kinesiophobia (TSK) as outcome measures. A network meta-analysis was used to synthesize the data after checking the model consistency. The risk of bias was assessed by the Cochrane Collaboration Risk of Bias Assessment Tool. Results Thirty-one studies were included in this review after a comprehensive search strategy with a low risk of bias and good consistency. According to the results of the network meta-analysis, a multi-modal treatment protocol had the highest probability to become the best choice in dealing with kinesiophobia caused by musculoskeletal pain, whereas psychological treatment protocols also showed a potentially positive effect on musculoskeletal pain-induced kinesiophobia. Conclusion Multi-modal protocols could be recommended as the preferred option when dealing with kinesiophobia caused by musculoskeletal pain. However, it is still worth mentioning that there are also potentially positive therapeutic effects of psychological interventions. Since the concept of kinesiophobia is based on the fear-avoidance model, the psychological mechanism should be paid enough attention to during treatment. Registration Number CRD42021286450.
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Affiliation(s)
- Jialu Huang
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Yining Xu
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Rongrong Xuan
- The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
| | - Julien S. Baker
- Department of Sport and Physical Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China
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Higuchi D, Watanabe Y, Kondo Y, Miki T. New Factor Structure of the Tampa Scale for Kinesiophobia in Older Japanese Adults After Lumbar Surgery. J Pain Res 2021; 14:601-612. [PMID: 33692635 PMCID: PMC7939489 DOI: 10.2147/jpr.s277568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 02/05/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose The Tampa Scale for Kinesiophobia (TSK) has been used worldwide as a measure of kinesiophobia, but its factor structure in older Japanese adults after lumbar surgery is unknown. The purpose of this study was to fill this research gap by identifying the factors that comprise TSK in older Japanese adults after lumbar surgery. Patients and Methods Participants were older Japanese adults who had undergone surgery for lumbar spinal stenosis. Clinicodemographic data, TSK, intensity of low back pain and leg pain, dysesthesia (using an 11-point numerical rating scale), and HRQOL (using the EQ-5D-5L) were collected. After supplementing the missing values by the multiple assignment method, the hypothetical model of TSK was developed by categorical exploratory factor analysis (weighted least squares method, promax rotation). Confirmatory factor analysis (WLSMV method, promax rotation) was used to compare the hypothetical model and the traditional one-factor and two-factor models. Furthermore, we confirmed the relationship between factors extracted from the hypothetical model and HRQOL, pain, and dysesthesia. Results Questionnaires were mailed to 302 individuals, and responses were obtained from 211 (72.4±4.2 years [range: 65–88]; 115 men and 96 women; 804±343.1 [380–1531] days after surgery; 137 who had undergone decompression and fixation surgery, 74 who had undergone decompression surgery) (response rate: 69.9%). The hypothesized model consisted of “somatic focus,” “activity avoidance,” and “efficacy of physical activities,” all of which were highly consistent. The fit of the hypothetical model was slightly inferior to that of the traditional two-factor model, but the hypothetical model met the criteria for fit. Somatic focus in the hypothetical model was significantly associated with HRQOL, pain, and dysesthesia. Conclusion In older Japanese adults after lumbar surgery, the goodness of fit of the TSK model was maintained by adding efficacy of physical activities as a third factor to the traditional two factors.
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Affiliation(s)
- Daisuke Higuchi
- Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, Takasaki, Japan
| | - Yuta Watanabe
- Department of Rehabilitation, Sapporo Maruyama Orthopedic Hospital, Sapporo, Japan
| | - Yu Kondo
- Department of Rehabilitation, Sapporo Maruyama Orthopedic Hospital, Sapporo, Japan
| | - Takahiro Miki
- Department of Rehabilitation, Sapporo Maruyama Orthopedic Hospital, Sapporo, Japan
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García-Dasí M, Pérez-Alenda S, Carrasco JJ, Marques-Sule E, Aguilar-Rodríguez M, Moreno-Segura N, Gómez-Tomás C, Querol F, Bonanad S. Effects of a non-pharmacological approach for chronic pain management in patients with haemophilia: efficacy of cognitive-behavioural therapy associated with physiotherapy. Haemophilia 2021; 27:e357-e367. [PMID: 33650767 DOI: 10.1111/hae.14284] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 02/10/2021] [Accepted: 02/12/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION More than half of adult patients with severe haemophilia (PWH) suffer pain daily, with chronic pain (CP) in more than 15% of cases, thereby reducing their quality of life (QoL). However, there are no evidence-based therapeutic guidelines for pain management. AIM To evaluate the effectiveness of a combined protocol based on psychology and physiotherapy in the improvement of CP self-efficacy in PWH with CP. Secondary outcomes are changes in QoL, emotional status, pain and kinesiophobia. METHODS In this prospective controlled trial study, recruited patients were allocated either to an experimental group (EG, n = 10) or to a control group (CG, n = 9). EG received interventions over four months: one cognitive-behavioural therapy (CBT) session per month and three home exercise sessions per week. Self-efficacy (Chronic Pain Self-Efficacy Scale), QoL (A36 Hemophilia-QoL), emotional status (Hospital Anxiety and Depression Scale and Rosenberg's Self-esteem Scale), pain (Visual Analogue Scale) and kinesiophobia (Tampa Scale for Kinesiophobia) were assessed at three time points (Week 0, Month 4 and Month 7). The intervention effects were determined with mixed 2-factor ANOVAs. RESULTS The EG showed a significant improvement (p < .05) in the control of symptoms and pain management scores on the Self-Efficacy Scale, QoL, self-esteem emotional status, pain and kinesiophobia. The intervention effects remained significant (p < .05) over time for pain management, QoL, pain and kinesiophobia. CONCLUSION The non-pharmacological treatment applied based on CBT and physiotherapy showed to be effective in improving CP self-efficacy, QoL and emotional status, while reducing pain and kinesiophobia in PWH with CP.
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Affiliation(s)
- María García-Dasí
- Instituto de Investigaciones Sanitarias La Fe, University and Polytechnic Hospital La Fe, Valencia, Spain.,Haemostasis and Thrombosis Unit, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Sofía Pérez-Alenda
- Haemostasis and Thrombosis Unit, University and Polytechnic Hospital La Fe, Valencia, Spain.,Physiotherapy in Motion, Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Juan J Carrasco
- Physiotherapy in Motion, Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain.,Intelligent Data Analysis Laboratory, University of Valencia, Valencia, Spain
| | - Elena Marques-Sule
- Physiotherapy in Motion, Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Marta Aguilar-Rodríguez
- Haemostasis and Thrombosis Unit, University and Polytechnic Hospital La Fe, Valencia, Spain.,Research unit in Clinical biomechanics (UBIC), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | | | - Cinta Gómez-Tomás
- Grupo de Investigación en Fisioterapia y Readaptación al Deporte, Universidad Católica San Antonio de Murcia, Murcia, España
| | - Felipe Querol
- Haemostasis and Thrombosis Unit, University and Polytechnic Hospital La Fe, Valencia, Spain.,Physiotherapy in Motion, Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Santiago Bonanad
- Haemostasis and Thrombosis Unit, University and Polytechnic Hospital La Fe, Valencia, Spain
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Hawk C, Whalen W, Farabaugh RJ, Daniels CJ, Minkalis AL, Taylor DN, Anderson D, Anderson K, Crivelli LS, Cark M, Barlow E, Paris D, Sarnat R, Weeks J. Best Practices for Chiropractic Management of Patients with Chronic Musculoskeletal Pain: A Clinical Practice Guideline. J Altern Complement Med 2020; 26:884-901. [PMID: 32749874 PMCID: PMC7578188 DOI: 10.1089/acm.2020.0181] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Objective: To develop an evidence-based clinical practice guideline (CPG) through a broad-based consensus process on best practices for chiropractic management of patients with chronic musculoskeletal (MSK) pain. Design: CPG based on evidence-based recommendations of a panel of experts in chronic MSK pain management. Methods: Using systematic reviews identified in an initial literature search, a steering committee of experts in research and management of patients with chronic MSK pain drafted a set of recommendations. Additional supportive literature was identified to supplement gaps in the evidence base. A multidisciplinary panel of experienced practitioners and educators rated the recommendations through a formal Delphi consensus process using the RAND Corporation/University of California, Los Angeles, methodology. Results: The Delphi process was conducted January-February 2020. The 62-member Delphi panel reached consensus on chiropractic management of five common chronic MSK pain conditions: low-back pain (LBP), neck pain, tension headache, osteoarthritis (knee and hip), and fibromyalgia. Recommendations were made for nonpharmacological treatments, including acupuncture, spinal manipulation/mobilization, and other manual therapy; modalities such as low-level laser and interferential current; exercise, including yoga; mind-body interventions, including mindfulness meditation and cognitive behavior therapy; and lifestyle modifications such as diet and tobacco cessation. Recommendations covered many aspects of the clinical encounter, from informed consent through diagnosis, assessment, treatment planning and implementation, and concurrent management and referral. Appropriate referral and comanagement were emphasized. Conclusions: These evidence-based recommendations for a variety of conservative treatment approaches to the management of common chronic MSK pain conditions may advance consistency of care, foster collaboration between provider groups, and thereby improve patient outcomes.
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Affiliation(s)
- Cheryl Hawk
- Texas Chiropractic College, Pasadena, TX, USA
| | | | | | | | | | | | | | | | | | | | | | - David Paris
- VA Northern CA Health Care System, Redding, CA, USA
| | - Richard Sarnat
- Advanced Medicine Integration Group, L.P., Columbus, OH, USA
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