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Salazar-Méndez J, Cuyul-Vásquez I, Ponce-Fuentes F, Guzmán-Muñoz E, Núñez-Cortés R, Huysmans E, Lluch-Girbés E, Viscay-Sanhueza N, Fuentes J. Pain neuroscience education for patients with chronic pain: A scoping review from teaching-learning strategies, educational level, and cultural perspective. PATIENT EDUCATION AND COUNSELING 2024; 123:108201. [PMID: 38387389 DOI: 10.1016/j.pec.2024.108201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024]
Abstract
OBJECTIVE (1) To identify the characteristics of PNE programs in terms of teaching-learning strategies, session modality, content delivery format, number of sessions, total minutes and instructional support material used in patients with chronic musculoskeletal pain, (2) to describe PNE adaptations for patients with different educational levels or cultural backgrounds, and (3) to describe the influence of the patient's educational level or cultural background on the effects of PNE. METHODS The PRISMA guideline for scoping reviews was followed. Nine databases were systematically searched up to July 8, 2023. Articles that examined clinical or psychosocial variables in adults with chronic musculoskeletal pain who received PNE were included. RESULTS Seventy-one articles were included. Studies found benefits of PNE through passive/active teaching-learning strategies with group/individual sessions. However, PNE programs presented great heterogeneity and adaptations to PNE were poorly reported. Most studies did not consider educational level and culture in the effects of PNE. CONCLUSIONS Despite the large number of studies on PNE and increased interest in this intervention, the educational level and culture are poorly reported in the studies. PRACTICAL IMPLICATIONS It is recommended to use passive and/or active teaching-learning strategies provided in individual and/or group formats considering the patient's educational level and culture.
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Affiliation(s)
| | - Iván Cuyul-Vásquez
- Departamento de Procesos Terapéuticos, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Chile; Facultad de las Ciencias de la Salud, Universidad Autónoma de Chile, Temuco, Chile
| | - Felipe Ponce-Fuentes
- Escuela de Kinesiología, Facultad de Medicina y Ciencias de la Salud, Universidad Mayor, Temuco, Chile
| | - Eduardo Guzmán-Muñoz
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Chile; Escuela de Kinesiología, Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Rodrigo Núñez-Cortés
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain; Departament of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Eva Huysmans
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy,Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels 1090, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels 1090, Belgium; Research Foundation - Flanders (FWO), Brussels, Belgium
| | - Enrique Lluch-Girbés
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain; Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy,Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels 1090, Belgium
| | | | - Jorge Fuentes
- Clinical Research Lab, Department of Physical Therapy, Catholic University of Maule, Chile; Faculty of Rehab Medicine, University of Alberta, Edmonton, Canada.
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Ruiz Romero MV, Lobato Parra E, Porrúa Del Saz A, Martínez Monrobé MB, Pereira Delgado CM, Gómez Hernández MB. [Management of chronic non-oncologic pain by multicomponent programs using non-pharmacologic therapies: A systematic review of the literature]. J Healthc Qual Res 2024; 39:168-187. [PMID: 38556371 DOI: 10.1016/j.jhqr.2024.02.004] [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: 12/20/2023] [Revised: 02/13/2024] [Accepted: 02/21/2024] [Indexed: 04/02/2024]
Abstract
Chronic pain is a public health problem suffered by 20% of the world's population. Pharmacological approaches are insufficient, so a multi-therapeutic approach that also includes non-pharmacological therapies (psychological therapies, meditation, physical exercise, healthy habits, etc.) is proposed. The aim of this review was to review the existing scientific evidence on the effect of multicomponent programs with non-pharmacological therapies in people with chronic non-oncologic pain. To this end, a search for scientific articles was carried out in three databases (PubMed, Web of Science and PsycINFO) and 17 articles were selected, following the PRISMA recommendations. The patients who participated in these programs were mostly women, aged 18 to 80years, working or on sick leave due to pain, with secondary education or less and married. The most frequent pain was musculoskeletal, mainly low back pain. All the articles studied the effectiveness of two or more therapies, highlighting psychological therapies, physical exercise and education. Positive results were obtained in the reduction of different variables such as pain, pain catastrophizing, anxiety and depression, in addition to improving functionality and quality of life. It has also been shown that patients' prior expectations regarding the intervention influence its effectiveness. Although throughout the review there was great heterogeneity in the interventions, in the evaluation methods and in the results themselves, it can be concluded that multicomponent programs show positive results in the management of chronic pain, and should therefore be incorporated as a routine therapeutic treatment.
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Affiliation(s)
- M V Ruiz Romero
- Unidad de Calidad e Investigación, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España; Universidad Internacional de Valencia, Valencia, España
| | - E Lobato Parra
- Unidad de Calidad e Investigación, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España.
| | - A Porrúa Del Saz
- Servicio de Rehabilitación, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España
| | - M B Martínez Monrobé
- Unidad de Psicología, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España
| | - C M Pereira Delgado
- Servicio de Medicina Interna, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España
| | - M B Gómez Hernández
- Servicio de Rehabilitación, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España
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Ruiz Romer MV, Porrúa Del Saz A, Gómez Hernández MB, Lobato Parra E, Soler Jiménez A, Pereira Delgado C. [Impact of a multicomponent program with nonpharmacological therapies for patients with chronic pain]. J Healthc Qual Res 2024; 39:109-119. [PMID: 38402091 DOI: 10.1016/j.jhqr.2024.01.005] [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: 12/20/2023] [Revised: 01/10/2024] [Accepted: 01/29/2024] [Indexed: 02/26/2024]
Abstract
INTRODUCTION 25.9% of Spanish people suffer from chronic pain. An integrated, interdisciplinary approach is recommended, with pharmacological and non-pharmacological therapies, involving patients in their self-care. OBJECTIVE To evaluate the effectiveness and impact on resources of a program with non-pharmacological therapies in the control of non-oncological chronic pain in the short and medium term. MATERIAL AND METHODS Quasi-experimental before-after study, follow-up 3-6 months, measuring: pain, well-being, quality of life, self-esteem, resilience, anxiety/depression (validated scales); patient-reported outcomes of workshop impact on pain management, habits and mood; ED and office visits; drug consumption and employment status. RESULTS One hundred and forty-two patients completed the program; 131 (92.3%) were women, age: 56.0. Decreased: pain (scale 0-10) (start: 6.0; end of workshop: 4.0; 3 months: 5.0); anxiety (12.9; 10.4; 8.8) and depression (12.3; 7.23; 6.47) (scales 0-21). They increased: well-being (scale 0-10) (4.0; 6.0; 4.0); quality of life (scale 0-1) (0.418; 0.580; 0.536); health status (scale 0-100) (47.5; 60.0; 60.0); self-esteem (scale 9-36) (24.1; 27.5; 26.7); resilience (scale 6-30) (14.8; 17.4; 18.6). Patient-reported outcomes were performed by 136 patients at the end of the workshop and 79 at 3 months: pain decreased (end of program: 104, 76.5%; 3 months: 66, 83.5%); medication decreased (96, 76.2%; 60, 78.9%); habits improved (112, 88.2%; 69, 90.8%). Forty patients (37.4%) reduced visits to the emergency room, 40 (37.4%) reduced scheduled visits. Overall satisfaction: 9.8 out of 10. CONCLUSIONS Patients learn to mitigate their pain, participate in their self-care and improve their quality of life, self-esteem and emotional state. The effects remained for 3-6 months.
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Affiliation(s)
- M V Ruiz Romer
- Unidad de Calidad e Investigación, Hospital San Juan de Dios del Aljarafe (HSJDA), Bormujos (Sevilla), España
| | - A Porrúa Del Saz
- Servicio de Rehabilitación, Hospital San Juan de Dios del Aljarafe (HSJDA), Bormujos (Sevilla), España
| | - M B Gómez Hernández
- Fisioterapia. Servicio de Rehabilitación, Hospital San Juan de Dios del Aljarafe (HSJDA), Bormujos (Sevilla), España.
| | - E Lobato Parra
- Unidad de Calidad e Investigación, Hospital San Juan de Dios del Aljarafe (HSJDA), Bormujos (Sevilla), España
| | - A Soler Jiménez
- Especialista interno residente de Cirugía Traumatológica y Ortopédica, Hospital San Juan de Dios del Aljarafe (HSJDA), Bormujos (Sevilla), España
| | - C Pereira Delgado
- Unidad de Medicina Interna, Servicio de Medicina, Hospital San Juan de Dios del Aljarafe (HSJDA), Bormujos (Sevilla), España
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Pain, Sleep, and Health-Related Quality of Life after Multidisciplinary Intervention for Chronic Pain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910233. [PMID: 34639534 PMCID: PMC8508437 DOI: 10.3390/ijerph181910233] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/24/2021] [Accepted: 09/24/2021] [Indexed: 12/15/2022]
Abstract
Multidisciplinary pain-management programs have the potential to decrease pain intensity, improve health-related quality of life (HRQOL), and increase sleep quality. In this longitudinal prospective cohort study, the aim was to investigate the long-term effects of multidisciplinary pain rehabilitation interventions in Iceland. More precisely, we (a) explored and described how individuals with chronic pain evaluated their pain severity, sleep, and HRQOL at pre-treatment and at one-year follow-up and (b) examined what predicted the participants' one-year follow-up HRQOL. Seventy-nine patients aged 20-68 years, most of whom were women (85%), responded. The participants scored their pain lower at one-year follow-up (p < 0.001). According to their response, most of them had disrupted sleep, mainly because of pain. One year after the treatment, more participants slept through the night (p = 0.004), and their HRQOL increased. Higher pre-treatment mental component summary (MCS) scores and having pursued higher education predicted higher MCS scores at one-year follow-up, and higher pre-treatment physical component summary (PCS) scores predicted higher PCS scores at one-year follow-up. Sleep problems, being a woman, and having children younger than 18 years of age predicted lower MCS scores at one-year follow-up. These findings are suggestive that patients should be examined with respect to their mental status, and it could be beneficial if they received some professional support after completing the intervention.
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Minen M, Kaplan K, Akter S, Espinosa-Polanco M, Guiracocha J, Khanns D, Corner S, Roberts T. Neuroscience Education as Therapy for Migraine and Overlapping Pain Conditions: A Scoping Review. PAIN MEDICINE 2021; 22:2366-2383. [PMID: 34270769 DOI: 10.1093/pm/pnab131] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Neuroscience Education Therapy (NET) has been successfully used for numerous overlapping pain conditions, but few studies have investigated NET for migraine. OBJECTIVE We sought to (1) review the literature on NET used for the treatment of various pain conditions to assess how NET has been studied thus far and (2) recommend considerations for future research of NET for the treatment of migraine. DESIGN/METHODS Following the PRISMA guideline for scoping reviews (PRISMA-ScR) Co-author (TR), a Medical Librarian, searched the MEDLINE, PsychInfo, Embase & Cochrane Central Clinical Trials Registry databases for peer-reviewed articles describing NET to treat migraine and other chronic pain conditions. Each citation was reviewed by two trained independent reviewers. Conflicts were resolved through consensus. RESULTS Overall, a NET curriculum consists of the following topics: pain does not equate to injury, pain is generated in the brain, perception, genetics, reward systems, fear, brain plasticity, and placebo/nocebo effects. Delivered through individual, group, or a combination of individual and group sessions, NET treatments often incorporate exercise programs and/or components of other evidence-based behavioral treatments. NET has significantly reduced catastrophizing, kinesiophobia, pain intensity, and disability in overlapping pain conditions. In migraine-specific studies, when implemented together with traditional pharmacological treatments, NET has emerged as a promising therapy by reducing migraine days, pain intensity and duration, and acute medication intake. CONCLUSION NET is an established treatment for pain conditions, and future research should focus on refining NET for migraine, examining delivery modality, dosage, components of other behavioral therapies to integrate, and migraine-specific NET curricula.
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Affiliation(s)
- Mia Minen
- Department of Neurology, NYU Langone Health, 222 E 41st Street, Floor 9, New York, NY, 10017.,Department of Population Health, NYU Langone Health
| | - Kayla Kaplan
- Department of Biological Sciences, Barnard College, New York, NY
| | - Sangida Akter
- Department of Psychology, The City College of New York, New York, NY
| | | | - Jenny Guiracocha
- Department of Psychology, The City College of New York, New York, NY
| | - Dennique Khanns
- Department of Chemistry and Biochemistry, The City College of New York, New York, NY, USA
| | - Sarah Corner
- Department of Neurology, NYU Langone Health, 222 E 41st Street, Floor 9, New York, NY, 10017
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Ballou S, Katon J, Rangan V, Cheng V, Nee J, Iturrino J, Lembo A. Brief Behavioral Therapy for Insomnia in Patients with Irritable Bowel Syndrome: A Pilot Study. Dig Dis Sci 2020; 65:3260-3270. [PMID: 32152868 DOI: 10.1007/s10620-020-06182-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 02/27/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Up to 60% of patients with irritable bowel syndrome (IBS) report fatigue and 50% meet criteria for clinical insomnia. Recent studies have demonstrated a relationship between poor sleep and next-day IBS symptoms. However, no study to-date has evaluated behavioral therapy to treat poor sleep in IBS. AIMS The aim of the current pilot study is to test feasibility of behavioral therapy for insomnia among patients with IBS and poor sleep. METHODS This randomized controlled pilot study tested the feasibility of administering brief behavioral therapy for insomnia (BBT-I) to patients with IBS who report poor sleep. Participants were randomized to BBT-I or self-monitoring control. Exploratory analyses evaluated group differences after 4 weeks of treatment. RESULTS A total of 25 participants were randomized to the study, 13 to BBT-I and 12 to the control group. Three participants dropped out of the treatment group. Satisfaction with treatment was high. At follow-up, there were significant differences between groups in measures of sleep quality and insomnia severity. There were trends toward significance in IBS severity score, with 40% of the BBT-I sample reporting clinically meaningful drop in symptoms compared to 17% of the control group. Similar trends were observed with belly pain and global improvement scores. CONCLUSIONS This pilot study demonstrates feasibility/acceptability of a brief behavioral therapy for patients with IBS and poor sleep. Additionally, this study provides preliminary evidence to suggest that treatment of sleep difficulties in patients with IBS may improve IBS symptom outcomes. Future, larger randomized controlled studies are needed.
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Affiliation(s)
- Sarah Ballou
- Division of Gastroenterology, Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA.
| | - Jesse Katon
- Division of Gastroenterology, Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Vikram Rangan
- Division of Gastroenterology, Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Vivian Cheng
- Division of Gastroenterology, Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Judy Nee
- Division of Gastroenterology, Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Johanna Iturrino
- Division of Gastroenterology, Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Anthony Lembo
- Division of Gastroenterology, Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
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Craner JR, Lake ES, Bancroft KA, George LL. Treatment Outcomes and Mechanisms for an
ACT
‐Based 10‐Week Interdisciplinary Chronic Pain Rehabilitation Program. Pain Pract 2019; 20:44-54. [DOI: 10.1111/papr.12824] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 07/11/2019] [Accepted: 07/12/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Julia R. Craner
- Mary Free Bed Rehabilitation Hospital Grand Rapids Michigan U.S.A
- Michigan State University College of Human Medicine Grand Rapids Michigan U.S.A
| | - Eric S. Lake
- Mary Free Bed Rehabilitation Hospital Grand Rapids Michigan U.S.A
| | | | - Logan L. George
- Michigan State University College of Human Medicine Grand Rapids Michigan U.S.A
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Lennox Thompson B, Gage J, Kirk R. Living well with chronic pain: a classical grounded theory. Disabil Rehabil 2019; 42:1141-1152. [DOI: 10.1080/09638288.2018.1517195] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Bronwyn Lennox Thompson
- Department of Orthopaedic Surgery & Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
| | - Jeffrey Gage
- College of Nursing, California Baptist University, Riverside, CA, USA
| | - Ray Kirk
- UC Health, University of Canterbury, Christchurch, New Zealand
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Teckchandani S, Barad M. Treatment Strategies for the Opioid-Dependent Patient. Curr Pain Headache Rep 2017; 21:45. [DOI: 10.1007/s11916-017-0644-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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