The mediating effect of psychological factors on the relationship between pain intensity and wrist joint function: a longitudinal study with mediation analysis

Associations between the perception of dental pain and pain anxiety, mental pain, and dental anxiety in Iranian sample

OBJECTIVE

This study examined the perception of dental pain and its relationship to pain anxiety, dental anxiety, and mental pain.

METHODS

This cross-sectional study was conducted on 328 patients referred to dental clinics in Kermanshah (Iran) from 2020 to 2021. The instruments used in this study included scales assessing pain anxiety, dental anxiety, mental pain, and pain perception.

RESULTS

There was a significant relationship (p = .001) between pain perception with dental anxiety (r = .38), pain anxiety (r = .45), and mental pain (r = .25).

CONCLUSION

Psychological factors are associated with the perception of dental pain. Given the importance of dental care to overall health, psychological interventions may help to reduce the perception of dental pain and fear of seeing dentists in Iran.

Effect of Occupation-Based Intervention Using the ADOC-H Combined With Physical Function-Based Intervention on Patients With Distal Radius Fractures: A Retrospective Case-Control Study

Objectives

Occupation-based intervention (OBI) involves daily and meaningful activities for evaluation and intervention. Recently, the "aid for decision-making in occupation choice for hand" (ADOC-H) was developed to facilitate OBI in patients with hand injuries. We aimed to examine the efficacy of OBI using the ADOC-H combined with physical function-based interventions (PBI) for patients with distal radius fractures (DRF).

Material and methods

Patients with DRF were retrospectively allocated to two groups, ADOC-H group (n = 14) and PBI group (n = 14), and compared.

Results

Improvements in the Pain Catastrophizing Scale magnification and Hospital Anxiety and Depression Scale and Disabilities of the Arm, Shoulder, and Hand questionnaire scores were significantly higher in the ADOC-H group than in the PBI group (p < .05). The groups showed no differences in measure of physical function, such as range of motion and grip strength.

Conclusion

OBI using the ADOC-H combined with PBI is clinically useful for patients with DRF as it promotes use of the injured hand for daily activities in a step-by-step approach, improving psychological difficulties in using the hand.

Psychological Factors Mediate the Relationship between Physical Activity and Goal Attainment for Occupational Therapy Practice: An Observational Study in Japan

Occupational therapy can improve physical activity, anxiety, and goal achievement after high tibial osteotomy. However, the role of psychological factors in physical activity and goal attainment after high tibial osteotomy is unclear. We examined how psychological factors mediate the relationship between physical activity and goal achievement. Participants included 55 individuals post-high tibial osteotomy. Physical activity and performance and satisfaction in everyday tasks had a significant indirect effect on the anxiety and depression. Anxiety and depression mediated the physical activity-goal attainment relationship. Thus, occupational therapy practices focusing on anxiety and depression may be important in post- high tibial osteotomy rehabilitation.

Occupational Therapy Practice With Cognitive Behavioral Therapy for Early Postoperative Pain: A Case Report

Structuring psychological interventions using cognitive behavioral therapy in the early postoperative period is crucial to mitigate the risk of chronic pain. In this study, specific practices were presented through the case of a woman in her 60s who experienced psychological factors, such as catastrophic thinking and anxiety, due to pain after high tibial osteotomy. The aim was to evaluate the structure of cognitive behavioral therapy and its application in the early postoperative period. Cognitive behavioral therapy was initiated postoperatively, incorporating three phases: cognitive restructuring, coping skills and active pacing, and occupational therapy. As a result of occupational therapy using cognitive behavioral therapy, the patient's pain and anxiety are reduced while achieving the goals. This case study suggests that cognitive behavioral therapy may promote goal attainment in cases where postoperative pain exacerbates psychological factors, such as catastrophic thinking and anxiety, ultimately leading to functional impairments. Implementation of cognitive behavioral therapy in Japan is lacking, necessitating urgent development. This case report serves as a foundational step in structuring cognitive behavioral therapy during the early postoperative period in Japan.

Prognostic factors for persistent pain after a distal radius fracture: a systematic review

Introduction

The aim of this systematic review was to synthesize the evidence regarding prognostic factors for persistent pain, including Complex Regional Pain Syndrome (CRPS), after a distal radius fracture (DRF), a common condition after which persistent pain can develop.

Methods

Medline, Pubmed, Embase, Psychinfo, CINAHL, BNI, AMED and the Cochrane Register of Clinical Trials were searched from inception to May 2021 for prospective longitudinal prognostic factor studies investigating persistent pain in adults who had sustained a DRF. The Quality in Prognostic Studies (QUIPS) tool and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework were used to assess the strength of evidence.

Results

A search yielded 440 studies of which 7 studies met full eligibility criteria. From five studies we found low evidence for high baseline pain or an ulnar styloid fracture as prognostic factors for persistent pain, and very low evidence for diabetes or older age. From two studies, investigating an outcome of CRPS, there was low evidence for high baseline pain, slow reaction time, dysynchiria, swelling and catastrophising as prognostic factors, and very low evidence for depression. Sex was found not to be a prognostic factor for CRPS or persistent pain.

Conclusions

The associations between prognostic factors and persistent pain following a DRF are unclear. The small number of factors investigated in more than one study, along with poor reporting and methodological limitations contributed to an assessment of low to very low strength of evidence. Further prospective studies, investigating psychosocial factors as candidate predictors of multidimensional pain outcomes are recommended.

Mediating Effect of Upper Limb Use on the Relationship Between Upper Limb Performance and Activities of Daily Living: A Longitudinal Mediation Analysis

INTRODUCTION

Upper limb performance, frequency of upper limb use, and psychological factors are associated with activities of daily living (ADLs) after stroke. We performed a mediation analysis to investigate how the frequency of upper limb use and some psychological factors mediate the relationship between upper limb performance and ADLs.

METHODS

Twenty-two patients with stroke were included in this longitudinal study. We utilized the frequency of upper limb use outcome measures (amount of use and quality of motion of the motor activity log), psychological factors outcome measures (General Self-Efficacy Scale), upper limb performance outcome measures (Fugl-Meyer Assessment (FMA)), and ADLs outcome measure (Functional Independence Measure (FIM) motor subscale (M)). Mediation analysis with a bootstrap sampling procedure was used to assess the indirect effects.

RESULTS

Mediation analysis showed that the FMA, as measured by the FIM (M), had significant indirect effects on the amount of use (95% bootstrapped confidence interval (CI): 0.36-2.42) and quality of motion (95% bootstrapped CI: 0.06-1.88). The relationship between upper limb performance and ADLs was mediated by the frequency of upper limb use.

CONCLUSION

Our findings suggest that improving the frequency of upper limb use may accelerate post-stroke recovery.

Occupational Therapy Using Coping Lists After Total Knee Arthroplasty: A Case Series

Total knee arthroplasty (TKA) can improve the postoperative quality of life in patients with severe knee osteoarthritis. Although occupational therapy (OT) using a coping list may be useful for post-TKA patients, its use has not been documented. This study aimed to explore the effectiveness of OT using coping skills. Five post-TKA patients underwent OT using coping skills. The Canadian Occupational Performance Measure (COPM), numerical rating scale (NRS), Hospital Anxiety and Depression Scale (HADS), EQ-5D (EuroQol-5-dimension)-5-level (5L), EQ-5D Visual Analogue Scale (VAS), modified fall efficacy scale (MFES), Pain Disability Assessment Scale (PDAS), and coping skills were measured at the start and end of the study. Significant improvements were observed in COPM, NRS, HADS, EQ-5D-5L, and PDAS scores (p <0.05). No significant improvements were found in the EQ-5D VAS and MFES scores. All evaluations showed a large effect size (r ≤ 0.5). The total number of coping skills also increased. This report suggests that OT with coping strategies is effective for pain, psychological factors, quality of life, and activities of daily living. Incorporating coping skills in OT may be useful in postoperative TKA pain management. However, larger studies are needed to validate this.

Effect of Acupotomy Combined with Electroacupuncture Therapy on Finger Mobility and Pain Relief in Patients with Carpal Tunnel Syndrome

Objective. To explore the effect of acupotomy in combination with electroacupuncture therapy on the finger mobility and pain relief in patients who had carpal tunnel syndrome (CTS). Methods. The clinical data of 60 CTS patients in our hospital from November 2020 to November 2021 received retrospective analysis. With 30 cases in each group, they were randomly divided into the treatment group and the control group. The control group underwent hot compress, oral medication, and local injection during hospitalization, while the treatment group received acupotomy and electroacupuncture therapy on top of the above treatments, and the clinical effects, finger mobility, and pain relief were compared between both groups. Results. The clinical indexes in the treatment group after treatment were remarkably better than those in the control group ( $P<0.05$ ), with the remarkably higher number of cured cases in the treatment group ( $P<0.05$ ). After treatment, the treatment group had remarkably higher mean total active motion (TAM) and score of the 36-item short form (SF-36) health survey and a remarkably lower mean score of visual analog scale (VAS) than those in the control group ( $P<0.001$ ). Conclusion. The quality of life and finger mobility of CTS sufferers can be improved with acupotomy in conjunction with electroacupuncture therapy. In-depth research will help build better procedures for these patients because this approach lessens the discomfort and shortens the symptom duration in CTS sufferers.