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Chowdhury AR, Graham PL, Schofield D, Costa DS, Nicholas M. Productivity outcomes from chronic pain management interventions in the working age population; a systematic review. Pain 2024; 165:1233-1246. [PMID: 38323645 PMCID: PMC11090028 DOI: 10.1097/j.pain.0000000000003149] [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: 06/17/2023] [Revised: 11/02/2023] [Accepted: 11/06/2023] [Indexed: 02/08/2024]
Abstract
ABSTRACT Productivity loss because of chronic pain in the working age population is a widespread concern internationally. Interventions for chronic pain in working age adults might be expected to achieve enhanced productivity in terms of reduced costs of workers' compensation insurance, reduced disability support, and improved rates of return to work for injured workers. This would require the use of measures of productivity in the evaluation of chronic pain management interventions. The aim of this review was to identify and interpret the productivity outcomes of randomised controlled trials reported by studies that conducted economic evaluations (eg, cost-effectiveness and cost-utility) of chronic pain management interventions in the working age population published from database inception to March 2023. Econlit, Embase, and Pubmed electronic databases were searched, yielding 12 studies that met the selection criteria. All 12 studies used absenteeism to measure productivity, translating return to work measures into indirect costs. Only one study included return to work as a primary outcome. Ten studies found no statistically significant improvements in productivity-related costs. Despite evidence for reduced pain-related disability after pain management interventions, this review suggests that the use of measures for assessing productivity gains is lacking. Including such measures would greatly assist administrators and payers when considering the broader societal benefits of such interventions.
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Affiliation(s)
- Anonnya Rizwana Chowdhury
- Faculty of Medicine and Health, Pain Management Research Institute, University of Sydney, Sydney, Australia
| | - Petra L. Graham
- School of Mathematical and Physical Sciences, Faculty of Science and Engineering, Macquarie University, Sydney, Australia
| | - Deborah Schofield
- Centre for Economic Impacts of Genomic Medicine (GenIMPACT), Macquarie Business School, Macquarie University, Sydney, Australia
| | - Daniel S.J. Costa
- Faculty of Medicine and Health, Pain Management Research Institute, University of Sydney, Sydney, Australia
| | - Michael Nicholas
- Faculty of Medicine and Health, Pain Management Research Institute, University of Sydney, Sydney, Australia
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Runge N, Ahmed I, Saueressig T, Perea J, Labie C, Mairesse O, Nijs J, Malfliet A, Verschueren S, Van Assche D, de Vlam K, Van Waeyenberg T, Van Haute J, De Baets L. The bidirectional relationship between sleep problems and chronic musculoskeletal pain: a systematic review with meta-analysis. Pain 2024:00006396-990000000-00613. [PMID: 38809241 DOI: 10.1097/j.pain.0000000000003279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/18/2024] [Indexed: 05/30/2024]
Abstract
ABSTRACT Chronic musculoskeletal pain and sleep problems/disorders exhibit a recognized bidirectional relationship; yet, systematic investigations of this claim, particularly in a prospective context, are lacking. This systematic review with meta-analysis aimed to synthesize the literature on the prospective associations between sleep problems/disorders and chronic musculoskeletal pain. A comprehensive search across 6 databases identified prospective longitudinal cohort studies in adults examining the relationship between sleep problems/disorders and chronic musculoskeletal pain. Random-effects meta-analyses, using the Hartung-Knapp adjustment for 95% confidence intervals (CIs), were conducted, and all results were presented as odds ratios (ORs). Certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations approach. Including 16 articles from 11 study populations (116,746 participants), meta-analyses indicated that sleep problems at baseline may heighten the risk of chronic musculoskeletal pain in both short term (OR 1.64, 95% CI 1.01-2.65) and long term (OR 1.39, 95% CI 1.21-1.59). The evidence for different sleep problem categories was very uncertain. Chronic musculoskeletal pain at baseline may increase the risk of short-term sleep problems (OR 1.56, 95% CI 1.02-2.38), but long-term evidence was very uncertain. The impact of only local or only widespread pain on short-term sleep problems was very uncertain, whereas widespread pain may elevate the risk of long-term sleep problems (OR 2.0, 95% CI 1.81-2.21). In conclusion, this systematic review with meta-analysis suggests that sleep problems are associated with an increased risk of chronic musculoskeletal pain, but the bidirectional nature of this relationship requires further investigation.
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Affiliation(s)
- Nils Runge
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Belgium
- Brain, Body and Cognition (BBCO), Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Ishtiaq Ahmed
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium
| | | | - Julya Perea
- Department of Physical Therapy, Federal University of São Carlos, São Paulo, Brazil
| | - Celine Labie
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Belgium
| | - Olivier Mairesse
- Brain, Body and Cognition (BBCO), Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Laboratoire de Psychologie Médicale et d'Addictologie (ULB312), Department of Psychiatry, Brugmann University Hospital, Université Libre de Bruxelles (ULB) and Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium
- Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussel, Belgium
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anneleen Malfliet
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium
- Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussel, Belgium
- Research Foundation Flanders (FWO), Brussels, Belgium
| | - Sabine Verschueren
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Belgium
| | - Dieter Van Assche
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Belgium
- Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium
| | - Kurt de Vlam
- Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium
- Skeletal Biology & Engineering Research Center, Department of Development & Regeneration, KU Leuven, Belgium
| | - Tybo Van Waeyenberg
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium
| | - Jelle Van Haute
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium
| | - Liesbet De Baets
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium
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Kaczorowski S, Donath L, Owen PJ, Saueressig T, Mundell NL, Topp M, Samanna CL, Döding R, Belavy DL. Telemedicine for Patients with Musculoskeletal Pain Lacks High-Quality Evidence on Delivery Modes and Effectiveness: An Umbrella Review. Telemed J E Health 2024; 30:1221-1238. [PMID: 38117672 DOI: 10.1089/tmj.2023.0255] [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: 12/22/2023] Open
Abstract
Background: Musculoskeletal (MSK) pain is the leading cause of disability worldwide. Telemedicine is of growing importance, yet impacts on treatment efficacy remain unclear. Objective: This umbrella review (CRD42022298047) examined the effectiveness of telemedicine interventions on pain intensity, disability, psychological function, quality of life, self-efficacy, and adverse events in MSK pain. Methods: PubMed, SPORTDiscus, Cochrane Library, EMBASE, and CINAHL were searched from inception to August 9, 2022, for systematic reviews with meta-analysis, including telemedicine-delivered exercise, education, and psychological interventions, in randomized controlled trials (RCTs). AMSTAR-2 was implemented. Standardized mean differences (SMDs; negative favors telemedicine) were extracted as effect estimates. Results: Of 1,135 records, 20 reviews (RCTs: n = 97, participants: n = 15,872) were included. Pain intensity SMDs were -0.66 to 0.10 for mixed pain (estimates: n = 16), -0.64 to -0.01 for low-back pain (n = 9), -0.31 to -0.15 for osteoarthritis (n = 7), -0.29 for knee pain (n = 1), -0.66 to -0.58 for fibromyalgia (n = 2), -0.16 for back pain (n = 1), and -0.09 for rheumatic disorders (n = 1). Disability SMDs were -0.50 to 0.10 for mixed pain (n = 14), -0.39 to 0.00 for low-back pain (n = 8), -0.41 to -0.04 for osteoarthritis (n = 7), -0.22 for knee pain (n = 1), and -0.56 for fibromyalgia (n = 1). Methodological quality was "critically low" for 17 reviews. Effectiveness tended to favor telemedicine for all secondary outcomes. Conclusions: Primary RCTs are required that compare telemedicine interventions with in-person delivery of the intervention (noninferiority trials), consider safety, assess videoconferencing, and combine different treatment approaches.
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Affiliation(s)
- Svenja Kaczorowski
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit [University of Applied Sciences], Bochum, Germany
- Department of Intervention Research in Exercise Training, German Sport University, Cologne, Germany
| | - Lars Donath
- Department of Intervention Research in Exercise Training, German Sport University, Cologne, Germany
| | - Patrick J Owen
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Burwood Victoria, Australia
| | | | - Niamh L Mundell
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Burwood Victoria, Australia
| | - Moritz Topp
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit [University of Applied Sciences], Bochum, Germany
| | - Claire L Samanna
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Burwood Victoria, Australia
| | - Rebekka Döding
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit [University of Applied Sciences], Bochum, Germany
| | - Daniel L Belavy
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit [University of Applied Sciences], Bochum, Germany
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Alsobhi M, Aldhabi R. Understanding the pattern of musculoskeletal pain and its contributing factors among Hajj pilgrims. Work 2024:WOR230483. [PMID: 38427527 DOI: 10.3233/wor-230483] [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: 03/03/2024] Open
Abstract
BACKGROUND Hajj is a series of rituals that are done in specific areas and periods in Mecca. Performing Hajj requires a great amount of physical demand which may result in musculoskeletal pain (MSP) in different age groups. OBJECTIVE To estimate the prevalence of MSP and understand its pattern via exploring the factors that could be associated with muscular pain among pilgrims in the 2022 Hajj. METHODS A web-based survey was distributed during the annual Hajj mass gathering. Pilgrims were recruited from Hajj ritual sites. The collected data included demographics, musculoskeletal pain at ten anatomical body sites, and physical activity (PA) level. Descriptive and inferential statistics were used to analyze the data at a 0.05 significance level. RESULTS A total of 248 pilgrims participated in the study. The mean age of the sample was 43.49±12.70 years. Of all pilgrims, 78.6% had reported MSP in at least one anatomical body site during performing Hajj. Results revealed that Pilgrims were more likely to have MSP in the lower limb while performing Hajj rituals where the most prevalent reported pain was in the legs (46% ), followed by the lower back (45% ), knees (37% ), and ankles/feet (30% ). Age, sex, and PA were not significantly associated with MSP except the BMI was found to be a significant factor related to MSP among pilgrims (p <0.05). CONCLUSION Many pilgrims exhibited pain in at least one body part. Although physical fitness recommendations are published in the Saudi Ministry of Health, MSP preventative measures need to be disseminated by organizations and interested parties worldwide.
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Affiliation(s)
- Mashael Alsobhi
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rawan Aldhabi
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
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Modi A, Pandey P, Uniyal A, Chouhan D, Agrawal S, Allani M, Singh AK, Kumar S, Tiwari V. Disentangling the enigmatic role of ephrin signaling in chronic pain: Moving towards future anti-pain therapeutics. Life Sci 2023:121796. [PMID: 37230378 DOI: 10.1016/j.lfs.2023.121796] [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: 01/08/2023] [Revised: 05/08/2023] [Accepted: 05/18/2023] [Indexed: 05/27/2023]
Abstract
Chronic pain is a common and debilitating condition with a huge social and economic burden worldwide. Currently, available drugs in clinics are not adequately effective and possess a variety of severe side effects leading to treatment withdrawal and poor quality of life. The ongoing search for new therapeutics with minimal side effects for chronic pain management remains a high research priority. Erythropoietin-producing human hepatocellular carcinoma cell receptor (Eph) is a tyrosine kinase receptor that is involved in neurodegenerative disorders, including pain. The Eph receptor interacts with several molecular switches, such as N methyl d-aspartate receptor (NMDAR), mitogen-activated protein kinase (MAPK), calpain 1, caspase 3, protein kinase a (PKA), and protein kinase Cy (PKCy), which in turn regulates pathophysiology of chronic pain. Here we highlight the emerging evidence of the Ephs/ephrin system as a possible near-future therapeutic target for the treatment of chronic pain and discuss the various mechanism of its involvement. We critically analyse the present status of Eph receptor system and conclude that extrapolating the pharmacological and genetic approaches using a strong therapeutic development framework could serve as next-generation analgesics for the management of chronic pain.
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Affiliation(s)
- Ajay Modi
- Neuroscience and Pain Research Laboratory, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi, Uttar Pradesh, India
| | - Priyanka Pandey
- Neuroscience and Pain Research Laboratory, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi, Uttar Pradesh, India
| | - Ankit Uniyal
- Neuroscience and Pain Research Laboratory, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi, Uttar Pradesh, India
| | - Deepak Chouhan
- Neuroscience and Pain Research Laboratory, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi, Uttar Pradesh, India
| | - Somesh Agrawal
- Neuroscience and Pain Research Laboratory, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi, Uttar Pradesh, India
| | - Meghana Allani
- Neuroscience and Pain Research Laboratory, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi, Uttar Pradesh, India
| | - Anurag Kumar Singh
- Neuroscience and Pain Research Laboratory, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi, Uttar Pradesh, India
| | - Sonu Kumar
- Neuroscience and Pain Research Laboratory, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi, Uttar Pradesh, India
| | - Vinod Tiwari
- Neuroscience and Pain Research Laboratory, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi, Uttar Pradesh, India.
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Wagemans J, Taeymans J, Kuppens K, Baur H, Bleakley C, Vissers D. Determining key clinical predictors for chronic ankle instability and return to sports with cost of illness analysis: protocol of a prospective cohort study. BMJ Open 2023; 13:e069867. [PMID: 37164478 PMCID: PMC10174038 DOI: 10.1136/bmjopen-2022-069867] [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] [Indexed: 05/12/2023] Open
Abstract
INTRODUCTION Ankle sprains are common in sports and the general population. Although considered innocuous, a large proportion has residual complaints such as recurrent ankle sprains and develop chronic ankle instability. Although some predicting factors are identified, there is no unequivocality regarding the development of chronic ankle instability, nor about the optimal rehabilitation for an acute ankle sprain. Alongside the biomechanical impairments, ankle sprains are a burden on society due to substantial economic costs. Therefore, we aim to identify key clinical predictors of chronic ankle instability or recovery after acute lateral ankle sprain. Additionally, we aim to determine cost-of-illness of patients who developed chronic ankle instability. METHODS AND ANALYSIS This prospective cohort study (Clinicaltrials.gov: NCT05637008 - pre-results) aims to recruit adult (18-55 years) patients with an acute lateral ankle sprain who are active in sports. Clinical assessments and patient-reported outcome measures will be used to collect data at 7-14 days, 6 weeks, 12 weeks and 12 months after enrolment in the study. The primary outcome will be chronic ankle instability at 12-month follow-up. Salient outcomes will be analysed by logistic regression to determine association with the development of chronic ankle instability. Participants will fill in a cost diary containing direct and indirect costs related to their injury. ETHICS AND DISSEMINATIONS The ethical committee of the Antwerp University Hospital (B3002022000138) has given approval of the protocol and consent forms on 10 October 2022. We perform this study according to the Helsinki Declaration. We will present results at conferences or webinars and publish in peer-reviewed articles.NCT05637008.
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Affiliation(s)
- Jente Wagemans
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerpen, Belgium
- Department of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland
| | - Jan Taeymans
- Department of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland
| | - Kevin Kuppens
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerpen, Belgium
| | - Heiner Baur
- Department of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland
| | - Chris Bleakley
- School of Health Sciences, Faculty of Life and Health Science, Ulster University, Newtownabbey, UK
| | - Dirk Vissers
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerpen, Belgium
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Lasalvia P, Gil-Rojas Y, Rosselli D. Burden of disease of chronic pain in Ecuador. Expert Rev Pharmacoecon Outcomes Res 2023; 23:547-554. [PMID: 36946473 DOI: 10.1080/14737167.2023.2193689] [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: 03/23/2023]
Abstract
OBJECTIVES to estimate the burden of disease related to chronic pain in Ecuador. METHODS We used Global Burden of Disease (GBD) methods to estimated disability-adjusted life years (DALYs) related to chronic pain in Ecuador. We focused on chronic pain related to lumbar pain, osteoarthritis, post-herpetic neuralgia, diabetic neuropathy, cancer-related pain, and other musculoskeletal pain. We estimated the prevalent cases by sex and age group using literature data. We only estimated years lived with disability using disability weights obtained from the GBD, with the assumption that no premature death would be related to pain. We used a prevalence-based approach to estimate cases by sex and age group using literature, without discounting or age adjustment. We calculated total DALYs and DALYs/100,000 inhabitants. RESULTS Our estimated yielded a total of 3,644,108 patients with chronic pain. They would produce 256,090 DALYs or 1,483 DALYs/100,000 inhabitants attributable to chronic pain. Low back pain, osteoarthritis and cancer-related pain were the drivers of DALY production. CONCLUSIONS Chronic pain is an important source of burden of disease. It is comparable to other important causes such as headaches, stroke, diabetes and chronic obstructive pulmonary disease, among others. Low back pain, osteoarthritis and other musculoskeletal pain were the biggest contributors given their high prevalence.
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Affiliation(s)
- Pieralessandro Lasalvia
- Department of Economic Studies, NeuroEconomix, Bogotá, Colombia
- Faculty of Medicine, Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | - Diego Rosselli
- Department of Economic Studies, NeuroEconomix, Bogotá, Colombia
- Faculty of Medicine, Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia
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Chronic pain in Chile: first prevalence report of noncancer chronic pain, fibromyalgia, and neuropathic pain and its associated factors. Pain 2023:00006396-990000000-00262. [PMID: 36893316 DOI: 10.1097/j.pain.0000000000002886] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 01/11/2023] [Indexed: 03/11/2023]
Abstract
ABSTRACT Although we know chronic pain (CP) affects approximately 30% of people in developed countries, data from Latin America are scarce. Moreover, prevalence of specific CP conditions, such as chronic noncancer pain (CNCP), fibromyalgia (FM), and neuropathic pain (NP), is unknown. To estimate them in Chile, we prospectively enrolled 1945 participants (61.4% women and 38.6% men), aged 38 to 74 years, from an agricultural town who answered a Pain Questionnaire, the Fibromyalgia Survey Questionnaire, and Douleur Neuropathique 4 (DN4) to identify CNCP, FM, and NP, respectively. The estimated prevalence of CNCP was 34.7% (95% CI 32.6; 36.8), with an average duration of 32.3 months (SD ± 56.3), producing deep impairments in daily activities, sleep, and mood. We estimated a prevalence of 3.3% for FM (95% CI 2.5; 4.1) and 12% for NP (95% CI 10.6; 13.4). Female sex, fewer school years, and depressive symptoms were associated with FM and NP, whereas diabetes was only associated with NP. We standardized the results from our sample against the whole Chilean population and found no significant difference to our crude estimates. This is in line with studies from developed countries, highlighting the idea that despite genetic and environmental differences, the conditions that confer risk to CNCP remain stable.
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Smith TD, Yu Z, Balogun AO. Assessing the impact of job demands and hazardous workload activities on musculoskeletal symptoms in stone, sand, and gravel mining operations. Work 2023; 75:1393-1402. [PMID: 36776087 DOI: 10.3233/wor-220188] [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: 02/10/2023] Open
Abstract
BACKGROUND Musculoskeletal disorders (MSDs) and associated musculoskeletal symptoms (MSS) are problematic in stone, sand, and gravel mining. Research is needed to explore relationships between job demands, work-related hazards and MSS. OBJECTIVE An exploratory study was conducted in Indiana during 2019-2020 to examine associations between job demands, work-related hazards and MSS. METHODS Through convenience sampling, cross-sectional survey data from 459 workers were collected and analyzed using logistic multiple and binary logistic regression methods. Outcome variables were MSS to the low back, neck/shoulder, and wrist/hand. Predictor variables and MSS measures are based on the Dutch Musculoskeletal Questionnaire. RESULTS Increased odds of low back MSS were related to dynamic loads (OR = 2.14), pushing/pulling heavy loads (OR = 1.56), torso bending or twisting (OR = 2.36), bent, stooped, or twisted posture (OR = 2.04), uncomfortable postures (OR = 2.07), repetition (OR = 1.67) and vibrating tools (OR = 1.81). Increased odds of neck/shoulder MSS were related to dynamic loads (OR = 1.83), static loads (OR = 1.24), heavy lifting (OR = 1.50), pushing/pulling heavy loads (OR = 1.68), bending or twisting of the neck (OR = 1.82), twisted neck posture (OR = 1.77) and uncomfortable postures (OR = 1.81). Increased odds of wrist/hand MSS were related to dynamic loads (OR = 2.06), static loads (OR = 1.45), bending or twisting of the wrists/hands (OR = 10.52), extended reaching (OR = 3.05), repetition (OR = 5.25), awkward postures (OR = 4.47), working above shoulder level (OR = 2.47), and vibrating tools (OR = 1.78). CONCLUSION Hazards that increased the likelihood of MSS were identified. These hazards should be abated or controlled to prevent MSDs in stone, sand, and gravel mining. More applied research, including ergonomic assessments to further identify hazards that can be controlled or abated, is warranted.
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Affiliation(s)
- Todd D Smith
- Department of Applied Health Science, Indiana University School of Public Health - Bloomington, Bloomington, IN, USA
| | - Zuojin Yu
- Department of Health Sciences, College of Health Professions, Towson University, Towson, MD, USA
| | - Abdulrazak O Balogun
- Department of Safety and Occupational Health Applied Sciences, Keene State College, Keene, NH, USA
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de Araújo Vieira EM, da Silva JMN, Leite WKDS, Lucas REC, da Silva LB. Team Workload and Performance of Healthcare Workers with Musculoskeletal Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:742. [PMID: 36613063 PMCID: PMC9819703 DOI: 10.3390/ijerph20010742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 12/26/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
In healthcare professionals, musculoskeletal complaints are the most frequent health disorders with the greatest potential for productivity losses. The teamwork developed by these professionals can be a coping strategy, but it can also be one more demand for the maintenance of performance. For this reason, this research aimed to investigate the relationship between team workload and performance in healthcare workers with different intensities of musculoskeletal symptoms. A survey was conducted with health professionals from 24 institutions of the Brazilian public health system, recruited by stratified probability sampling. Through non-hierarchical cluster analysis, the sample was allocated into three groups based on the intensity of musculoskeletal symptoms. We analyzed the approximation between the variables of "team workload" and "performance" of the groups formed in the previous phase through multiple correspondence analysis. In the group with higher musculoskeletal symptom scores, there was lower performance and a worse team workload. As the intensity of symptoms decreased, team workload and performance became closer variables in a two-dimensional space, indicating that the relationship between team workload and performance is improved in situations of low musculoskeletal symptom intensity.
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Affiliation(s)
| | | | | | | | - Luiz Bueno da Silva
- Production Engineering Department, Universidade Federal da Paraíba, João Pessoa 58051-900, Brazil
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11
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Espinoza MA, Bilbeny N, Abbott T, Carcamo C, Zitko P, Zamorano P, Balmaceda C. Cost analysis of chronic pain due to musculoskeletal disorders in Chile. PLoS One 2022; 17:e0273667. [PMID: 36301984 PMCID: PMC9612497 DOI: 10.1371/journal.pone.0273667] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 08/14/2022] [Indexed: 11/07/2022] Open
Abstract
The magnitude of the cost of chronic pain has been a matter of concern in many countries worldwide. The high prevalence, the cost it implies for the health system, productivity, and absenteeism need to be addressed urgently. Studies have begun describing this problem in Chile, but there is still a debt in highlighting its importance and urgency on contributing to chronic pain financial coverage. This study objective is to estimate the expected cost of chronic pain and its related musculoskeletal diseases in the Chilean adult population. We conducted a mathematical decision model exercise, Markov Model, to estimate costs and consequences. Patients were classified into severe, moderate, and mild pain groups, restricted to five diseases: knee osteoarthritis, hip osteoarthritis, lower back pain, shoulder pain, and fibromyalgia. Data analysis considered a set of transition probabilities to estimate the total cost, sick leave payment, and productivity losses. Results show that the total annual cost for chronic pain in Chile is USD 943,413,490, corresponding an 80% to the five diseases studied. The highest costs are related to therapeutic management, followed by productivity losses and sick leave days. Low back pain and fibromyalgia are both the costlier chronic pain-related musculoskeletal diseases. We can conclude that the magnitude of the cost in our country's approach to chronic pain is related to increased productivity losses and sick leave payments. Incorporating actions to ensure access and financial coverage and new care strategies that reorganize care delivery to more integrated and comprehensive care could potentially impact costs in both patients and the health system. Finally, the impact of the COVID-19 pandemic will probably deepen even more this problem.
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Affiliation(s)
- Manuel A. Espinoza
- Department of Public health, Pontificia Universidad Católica de Chile, Santiago, Chile
- Health Technology Assessment Unit, Center of Clinical Research, Pontificia Universidad Católica de Chile, Santiago, Chile
- * E-mail:
| | | | - Tomas Abbott
- Health Technology Assessment Unit, Center of Clinical Research, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Pedro Zitko
- Department of Public health, Pontificia Universidad Católica de Chile, Santiago, Chile
- Health Services and Population Research Department, IoPPN. King’s College London, London, United Kingdom
| | - Paula Zamorano
- Health Technology Assessment Unit, Center of Clinical Research, Pontificia Universidad Católica de Chile, Santiago, Chile
- Centro de Innovación en Salud ANCORA UC, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carlos Balmaceda
- Department of Public health, Pontificia Universidad Católica de Chile, Santiago, Chile
- Health Technology Assessment Unit, Center of Clinical Research, Pontificia Universidad Católica de Chile, Santiago, Chile
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12
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Arévalo-Martínez A, Moreno-Manso JM, García-Baamonde ME, Blázquez-Alonso M, Cantillo-Cordero P. Psychopathological and neuropsychological disorders associated with chronic primary visceral pain: Systematic review. Front Psychol 2022; 13:1031923. [PMID: 36337545 PMCID: PMC9626977 DOI: 10.3389/fpsyg.2022.1031923] [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: 08/30/2022] [Accepted: 10/03/2022] [Indexed: 11/29/2022] Open
Abstract
The World Health Organization (WHO), in its last review of its International Classification of Diseases, established a new classification for chronic pain. Among the principal categories, of particular interest is chronic primary pain as a new type of diagnosis in those cases in which the etiology of the disease is not clear, being termed as chronic primary visceral pain when it is situated in the thorax, abdomen, or pelvis. Due to the novelty of the term, the objective of the systematic review was to examine the psychopathological and neuropsychological disorders associated with chronic primary visceral pain. We carried out a search of the scientific literature following the PRISMA directives using the Pubmed, Medline, PsycInfo and Scopus databases. A total of 33 articles were selected after applying the inclusion and exclusion criteria. The analysis of the studies showed that most persons with chronic primary visceral pain suffer from at least one psychological disorder; the most prevalent being anxiety, depressive or somatoform disorders. The most frequent psychopathological symptoms are anxiety, depression and somatization. Similarly, the findings are insufficient to determine the existence of deficits in the domains of executive functioning, memory and intelligence. However, the existence of attention biases does seem to be clear. This review supposes a starting point for conceptualizing chronic primary visceral pain. It is necessary to continue further research so as to obtain a better understanding of this pathology and the disorders associated.
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13
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Lasalvia P, Gil-Rojas Y, Rosselli D. Burden of disease of chronic pain in Colombia. Expert Rev Pharmacoecon Outcomes Res 2022; 22:1261-1267. [DOI: 10.1080/14737167.2022.2125872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Pieralessandro Lasalvia
- Department of Economic Studies, Neuroeconomix, Calle 45 No. 9-42, Bogotá, Colombia
- Faculty of Medicine, Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Carrera 7 No. 40 – 62, Piso 2, Hospital San Ignacio, Bogotá, Colombia
| | - Yaneth Gil-Rojas
- Department of Economic Studies, Neuroeconomix, Calle 45 No. 9-42, Bogotá, Colombia
| | - Diego Rosselli
- Department of Economic Studies, Neuroeconomix, Calle 45 No. 9-42, Bogotá, Colombia
- Faculty of Medicine, Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Carrera 7 No. 40 – 62, Piso 2, Hospital San Ignacio, Bogotá, Colombia
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14
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Firfirey F, September AV, Shamley D. ABCB1 and OPRM1 single-nucleotide polymorphisms collectively modulate chronic shoulder pain and dysfunction in South African breast cancer survivors. Pharmacogenomics 2022; 23:513-530. [PMID: 35727214 DOI: 10.2217/pgs-2022-0020] [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: 11/21/2022] Open
Abstract
Background: Chronic shoulder pain/disability is a well-recognized side effect of treatment for breast cancer, with ∼40% of patients experiencing this, despite receiving pain management. To manage acute and chronic pain, several opioids are commonly prescribed. Pharmacogenomics have implicated genes within the opioid signaling pathway, including ABCB1 and OPRM1, to contribute to an individual's variable response to opioids. Aim: To evaluate ABCB1 (rs1045642 G>A, rs1128503 G>A) and OPRM1 (rs1799971 A>G, rs540825 T>A) single-nucleotide polymorphisms (SNPs) in chronic shoulder pain/disability in BCS. Materials & methods: TaqManTM assays were used to genotype ABCB1 and OPRM1 SNPs within the BCS (N = 252) cohort. The Shoulder Pain and Disability Index was used to evaluate pain and disability features associated with shoulder pathologies. Participants end scores for each feature (pain, disability and combined [pain and disability]) were categorized into no-low (>30%) and moderate-high (≥30%) scores. Statistical analysis was applied, and significance was accepted at p < 0.05. Results: Of participants, 27.0, 19.0 and 22.0% reported moderate-high pain, disability and combined (pain and disability) scores, respectively. ABCB1:rs1045642-(A/A) genotype was significantly associated with disability (p = 0.028: no-low [14.9%] vs mod-high [4.3%]) and combined (pain and disability) (p = 0.011: no-low [15.9%] vs mod-high [5.7%]). The ABCB1:rs1045642-(A) allele was significantly associated with disability (p = 0.015: no-low [37.9%] vs mod-high [23.9%]) and combined (pain and disability) (p = 0.003: no-low [38.5%] vs mod-high [23.6%]). The inferred ABCB1 (rs1045642 G>A - rs1128503 G>A): A-G (p = 0.029; odds ratio [OR]: 0.0; 95% CI: 0.0-0.0) and the OPRM1 (rs1799971 A>G - rs540825 T>A): G-T (p = 0.019; OR: 0.33; 95% CI: 0.14-0.75) haplotypes were associated with disability and pain, respectively. Gene-gene interactions showed the ABCB1 (rs1045642 G>A) - OPRM1 (rs540825 T>A) combinations, (A-T) (p = 0.019; OR: 0.62; 95% CI: 0.33-1.16) and (G-A) (p = 0.021; OR: 1.57; 95% CI: 0.30-3.10) were associated with disability. Conclusion: The study implicated ABCB1 with shoulder pain and disability; and haplotype analyses identified specific genetic intervals within ABCB1 and OPRM1 to associate with chronic shoulder pain and disability. Evidence suggests that potentially gene-gene interactions between ABCB1 and OPRM1 contribute to chronic shoulder pain and disability experienced in this SA cohort.
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Affiliation(s)
- Firzana Firfirey
- Department of Human Biology, Division of Physiological Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, Western Cape, 7701, South Africa
| | - Alison V September
- Department of Human Biology, Division of Physiological Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, Western Cape, 7701, South Africa.,Department of Human Biology, Health through Physical Activity, Lifestyle & Sport Research Centre (HPALS), Faculty of Health Sciences, University of Cape Town, Cape Town, Western Cape, 7701, South Africa.,Department of Human Biology, International Federation of Sports Medicine (FIMS), Collaborative Centre of Sports Medicine, University of Cape Town, Cape Town, Western Cape, 7701, South Africa
| | - Delva Shamley
- Department of Human Biology, Division of Clinical Anatomy & Biological Anthropology, Anatomy Building, Medical School, University of Cape Town, Cape Town, Western Cape, 7701, South Africa
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15
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Ernstzen DV, Hillier SL, Louw QA. Synthesis of clinical practice guideline recommendations for the primary health care of chronic musculoskeletal pain. J Eval Clin Pract 2022; 28:454-467. [PMID: 34913219 DOI: 10.1111/jep.13644] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 11/28/2022]
Abstract
RATIONALE AND AIMS The prevalence of chronic musculoskeletal pain (CMSP) is high and rising. The multidimensional impact of CMSP on individuals necessitates multidisciplinary evidence-based strategies to prevent and manage chronic pain. Primary health care (PHC) is the first point of care in many healthcare systems and evidence implementation at this point is important. We aim to describe the process of development of a comprehensive list of evidence-based recommendations derived from different high-quality clinical practice guidelines (CPGs) to inform the PHC healthcare of adults with CMSP. METHOD A systematic review was conducted of CPGs that focussed on PHC management of CMSP in adults. CPGs were identified by searching 13 guideline clearinghouses and five online databases. Eligible CPGs were critically appraised using Appraisal of Guidelines Research and Evaluation, Version II (AGREE II). A stepwise systematic process was followed to identify a core set of recommendations. This process comprised the following: extract recommendations; analyze recommendations; synthesize recommendations by assimilating similar recommendations; determine the strength of the body of evidence underpinning the recommendations and produce a list of synthesized recommendations. RESULTS Six high-quality CPGs were identified, providing 156 recommendations. These were condensed to 42 statements covering topics about the approach to care, assessment, advice and education, referral, pharmacological management, physical therapy, electrotherapy, psychological therapy, complementary therapy and self-management. The set of recommendations encompasses a person-centered approach, collaborative decision making, a biopsychosocial approach, patient education and empowerment towards self-management. CONCLUSION The process of developing composite recommendations from multiple CPGs enables end-users to access comprehensive information on managing CMSP in PHC settings that is not available from one singular CPG. The content and evidence base for recommendations varied between CPGs. A similar stepwise process may be used to develop a core set of recommendations for other health conditions, where multiple, diverse CPGs exist.
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Affiliation(s)
- Dawn V Ernstzen
- Department of Health and Rehabilitation Sciences, Division of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Susan L Hillier
- Division of Health Sciences, University of South Australia, Adelaide, Australia
| | - Quinette A Louw
- Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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16
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Velez JC, Friedman LE, Barbosa C, Castillo J, Juvinao-Quintero DL, Williams MA, Gelaye B. Evaluating the performance of the Pain Interference Index and the Short Form McGill Pain Questionnaire among Chilean injured working adults. PLoS One 2022; 17:e0268672. [PMID: 35588123 PMCID: PMC9119477 DOI: 10.1371/journal.pone.0268672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 05/05/2022] [Indexed: 11/30/2022] Open
Abstract
Background Chronic pain can lead to economic instability, decreased job productivity, and poor mental health. Therefore, reliable identification and quantification of chronic pain is important for clinical diagnosis and treatment. Objective To determine the psychometric properties of the Spanish language versions of the Pain Interference Index (PII) and the Short Form McGill Pain Questionnaire (SF-MPG) among a population of working adults who experienced injury in Santiago, Chile. Methods A total of 1,975 participants with work-related injuries were interviewed to collect sociodemographic, occupational, and chronic pain characteristics. Construct validity and factorial structure of the PII and SF-MPG were assessed through exploratory factor analyses (EFA). Cronbach’s alpha was used to evaluate internal consistency. Results The PII mean score was 3.84 ± 1.43 among all participants. The SF-MPG median score was 11 [IQR: 6–16] in this study population. Cronbach’s alpha for the PII was 0.90 and 0.87 for the SF-MP. EFA resulted in a one factor solution for the PII. A two-factor solution was found for the SF-MPG. The two-factors for SF-MPG were sensory and affective subscales with Cronbach’s alpha of 0.82 and 0.714, respectively. When the two scales were combined, an EFA analysis confirmed the PII and SF-MPG measure different aspects of chronic pain. Conclusions The PII and SF-MPG had good construct validity and reliability for assessing different aspects of chronic pain among working Chilean adults.
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Affiliation(s)
- Juan Carlos Velez
- Departamento de Rehabilitación, Hospital del Trabajador, Santiago, Chile
| | - Lauren E. Friedman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Clarita Barbosa
- Multidisciplinary International Research Training (MIRT) Program, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Jessica Castillo
- Departamento de Rehabilitación, Hospital del Trabajador, Santiago, Chile
| | - Diana L. Juvinao-Quintero
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Michelle A. Williams
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- Multidisciplinary International Research Training (MIRT) Program, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- The Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital; Boston, MA, United States of America
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
- * E-mail:
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17
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Vega-Fernández G, Olave E, Lizana PA. Musculoskeletal Disorders and Quality of Life in Chilean Teachers: A Cross-Sectional Study. Front Public Health 2022; 10:810036. [PMID: 35425737 PMCID: PMC9002346 DOI: 10.3389/fpubh.2022.810036] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 03/07/2022] [Indexed: 12/17/2022] Open
Abstract
Introduction Teaching professionals have reported multiple conditions associated with low quality of life (QoL) perception. Various studies have also reported high prevalence of musculoskeletal disorders (MSD). In this context, there are few studies regarding the association between low QoL perception and MSD suffering in teachers. Objective Therefore, in this study the aim was evaluate MSD prevalence and its association with teachers' QoL perception. Participants and Methods A total sample of 544 Chilean teachers were included in a cross-sectional study. MSD prevalence was evaluated via the Standardized Nordic Questionnaire and QoL perception via the Short-Form 36 Health Survey Instrument. Multinomial logistic regression was applied to evaluate the association between MSD and QoL perception adjusted for gender and age. Results A total of 91% of teachers have had some MSD in the last 12 months, and 28.86% have had 6 or more painful regions. Females showed greater MSD prevalence than males. Teachers who reported no MSD had higher QoL scores compared to teachers with MSD. The group of teachers with the most MSD (≥p75) saw significant increases in the risk of having low scores in the physical (OR: 2.82) and mental components (OR: 2.65) of QoL. By contrast, teachers without MSD have a buffer effect for their QoL (physical OR: 0.2; mental OR: 0.44). Conclusions High MSD prevalence suggest that preventive and informative actions must be taken regarding these disorders to protect teachers' mental and physical health, considering the multiple risk factors to which teachers are exposed given their work conditions in Chile and worldwide.
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Affiliation(s)
- Gustavo Vega-Fernández
- Laboratory of Epidemiology and Morphological Sciences, Instituto de Biología, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile.,Programa de Magister en Ciencias Mención Morfología, Universidad de La Frontera, Temuco, Chile
| | - Enrique Olave
- Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | - Pablo A Lizana
- Laboratory of Epidemiology and Morphological Sciences, Instituto de Biología, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
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18
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Morris K, Nami M, Bolanos JF, Lobo MA, Sadri-Naini M, Fiallos J, Sanchez GE, Bustos T, Chintam N, Amaya M, Strand SE, Mayuku-Dore A, Sakibova I, Biso GMN, DeFilippis A, Bravo D, Tarhan N, Claussen C, Mercado A, Braun S, Yuge L, Okabe S, Taghizadeh-Hesary F, Kotliar K, Sadowsky C, Chandra PS, Tripathi M, Katsaros V, Mehling B, Noroozian M, Abbasioun K, Amirjamshidi A, Hossein-Zadeh GA, Naraghi F, Barzegar M, Asadi-Pooya AA, Sahab-Negah S, Sadeghian S, Fahnestock M, Dilbaz N, Hussain N, Mari Z, Thatcher RW, Sipple D, Sidhu K, Chopra D, Costa F, Spena G, Berger T, Zelinsky D, Wheeler CJ, Ashford JW, Schulte R, Nezami MA, Kloor H, Filler A, Eliashiv DS, Sinha D, DeSalles AAF, Sadanand V, Suchkov S, Green K, Metin B, Hariri R, Cormier J, Yamamoto V, Kateb B. Neuroscience20 (BRAIN20, SPINE20, and MENTAL20) Health Initiative: A Global Consortium Addressing the Human and Economic Burden of Brain, Spine, and Mental Disorders Through Neurotech Innovations and Policies. J Alzheimers Dis 2021; 83:1563-1601. [PMID: 34487051 DOI: 10.3233/jad-215190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Neurological disorders significantly impact the world's economy due to their often chronic and life-threatening nature afflicting individuals which, in turn, creates a global disease burden. The Group of Twenty (G20) member nations, which represent the largest economies globally, should come together to formulate a plan on how to overcome this burden. The Neuroscience-20 (N20) initiative of the Society for Brain Mapping and Therapeutics (SBMT) is at the vanguard of this global collaboration to comprehensively raise awareness about brain, spine, and mental disorders worldwide. This paper aims to provide a comprehensive review of the various brain initiatives worldwide and highlight the need for cooperation and recommend ways to bring down costs associated with the discovery and treatment of neurological disorders. Our systematic search revealed that the cost of neurological and psychiatric disorders to the world economy by 2030 is roughly $16T. The cost to the economy of the United States is $1.5T annually and growing given the impact of COVID-19. We also discovered there is a shortfall of effective collaboration between nations and a lack of resources in developing countries. Current statistical analyses on the cost of neurological disorders to the world economy strongly suggest that there is a great need for investment in neurotechnology and innovation or fast-tracking therapeutics and diagnostics to curb these costs. During the current COVID-19 pandemic, SBMT, through this paper, intends to showcase the importance of worldwide collaborations to reduce the population's economic and health burden, specifically regarding neurological/brain, spine, and mental disorders.
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Affiliation(s)
- Kevin Morris
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Mohammad Nami
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Iran.,Middle East Brain + Initiative, Los Angeles, CA, USA.,Neuroscience Center, Instituto de Investigaciones Científicas Servicios de Alta Tecnología, City of Knowledge, Panama City, Panama
| | - Joe F Bolanos
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Maria A Lobo
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Melody Sadri-Naini
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - John Fiallos
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Gilberto E Sanchez
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Teshia Bustos
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Nikita Chintam
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Marco Amaya
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Susanne E Strand
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Alero Mayuku-Dore
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Indira Sakibova
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Grace Maria Nicole Biso
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Alejandro DeFilippis
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Daniela Bravo
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Nevzat Tarhan
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Middle East Brain + Initiative, Los Angeles, CA, USA.,Department of Psychiatry, Faculty of Medicine, Uskudar University, Istanbul, Turkey
| | - Carsten Claussen
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Fraunhofer-Institute for Translational Research and Pharmacology, Hamburg, Germany
| | - Alejandro Mercado
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Department of Neurosurgery, Hospital Military Regional Mendoza, Mendoza, Argentina
| | | | - Louis Yuge
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Division of Bio-Environment Adaptation Sciences, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.,Cell Therapy Venture Company, Space Bio-Laboratories, Hiroshima, Japan
| | - Shigeo Okabe
- Brain Medical Science Collaboration Division, RIKEN Center for Brain Science Institution and Department: Cellular Neurobiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Konstantin Kotliar
- Department of Biomedical Engineering, Aachen University of Applied Sciences, Aachen, Germany
| | - Christina Sadowsky
- International Center for Spinal Cord Injury, Kennedy Krieger Institute-Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - P Sarat Chandra
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | | | - Vasileios Katsaros
- Department of Advanced Imaging Modalities, MRI Unit, General Anti-Cancer and Oncological Hospital of Athens "St. Savvas", Athens, Greece.,Departments of Neurosurgery and Neurology, National and Kapodistrian University of Athens, Athens, Greece.,Department of Neuroradiology, University College of London, London, UK
| | - Brian Mehling
- T-Neuro Pharma, Inc., Albuquerque, NM, USA.,StemVax LLC, Chesterland, OH, USA
| | - Maryam Noroozian
- Middle East Brain + Initiative, Los Angeles, CA, USA.,Cognitive Neurology and Neuropsychiatry Division, Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Abbasioun
- Middle East Brain + Initiative, Los Angeles, CA, USA.,Department of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Amirjamshidi
- Middle East Brain + Initiative, Los Angeles, CA, USA.,Department of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholam-Ali Hossein-Zadeh
- Middle East Brain + Initiative, Los Angeles, CA, USA.,National Brain Mapping Laboratory, Tehran, Iran
| | - Faridedin Naraghi
- Middle East Brain + Initiative, Los Angeles, CA, USA.,Iranian Society for Brain Mapping & Therapeutics, Tehran, Iran
| | - Mojtaba Barzegar
- Middle East Brain + Initiative, Los Angeles, CA, USA.,Intelligent Quantitative Bio-Medical Imaging, Tehran, Iran, and Medical Physics Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali A Asadi-Pooya
- Middle East Brain + Initiative, Los Angeles, CA, USA.,Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Sajad Sahab-Negah
- Middle East Brain + Initiative, Los Angeles, CA, USA.,Neuroscience Research Center, Mashhad University of Medical Sciences, Mashhad Iran.,Shefa Neuroscience Research Center, Khatam Alanbia Hospital, Tehran, Iran
| | - Saeid Sadeghian
- Middle East Brain + Initiative, Los Angeles, CA, USA.,Department of Pediatric Neurology, Golestan Medical, Educational, and Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Nesrin Dilbaz
- Department of Psychiatry, Faculty of Medicine, Uskudar University, Istanbul, Turkey
| | - Namath Hussain
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Loma Linda University, School of Medicine, Loma Linda, CA, USA
| | - Zoltan Mari
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - Robert W Thatcher
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Applied Neuroscience Research Institute, St. Petersburg, FL, USA.,Applied Neuroscience, Inc., St. Petersburg, Fl, USA
| | - Daniel Sipple
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA.,Fraunhofer-Institute for Translational Research and Pharmacology, Hamburg, Germany
| | - Kuldip Sidhu
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA.,CK Cell Technologies Pty Ltd, Norwest, NSW, Australia.,Faculty of Medicine, Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia.,Society for Brain Mapping and Therapeutics-Sydney, Sydney, NSW, Australia
| | | | - Francesco Costa
- IRCCS Humanitas Research Hospital, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | | | - Ted Berger
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,USC Department of Biomedical Engineering, Los Angeles, CA, USA
| | - Deborah Zelinsky
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,The Mind-Eye Institute, Northbrook, IL, USA
| | - Christopher J Wheeler
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Social Science Research Institute, Tokai University, Shibuya City, Tokyo, Japan
| | - J Wesson Ashford
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Reinhard Schulte
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Loma Linda University, School of Medicine, Loma Linda, CA, USA
| | - M A Nezami
- Sahel Oncology LLC, Newport Beach, CA, USA
| | - Harry Kloor
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Beyond Imagination, Los Angeles, CA, USA
| | - Aaron Filler
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA.,Institute for Nerve Medicine, Santa Monica, CA, USA
| | - Dawn S Eliashiv
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Department of Neurology, UCLA-David Geffen School of Medicine, Los Angeles, CA, USA
| | - Dipen Sinha
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA
| | - Antonio A F DeSalles
- Department of Neurosurgery, UCLA David Geffen School of Medicine, Los Angeles CA, USA.,NeuroSapiens - Rede D'Or São Luiz, Sao Paulo, Brazil.,Society for Brain Mapping and Therapeutics-Brazil, Sao Paulo, Brazil
| | - Venkatraman Sadanand
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Sergey Suchkov
- Applied Neuroscience, Inc., St. Petersburg, Fl, USA.,Society for Brain Mapping and Therapeutics-Russia, Moscow, Russia
| | - Ken Green
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Barish Metin
- Middle East Brain + Initiative, Los Angeles, CA, USA.,Department of Psychiatry, Faculty of Medicine, Uskudar University, Istanbul, Turkey
| | - Robert Hariri
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA.,Celularity Corporation, Warren, NJ, USA.,Weill Cornell School of Medicine, Department of Neurosurgery, New York, NY, USA
| | - Jason Cormier
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Blue Horizon International, Hackensack, NJ, USA
| | - Vicky Yamamoto
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA.,USC Keck School of Medicine, The USC Caruso Department of Otolaryngology-Head and Neck Surgery, Los Angeles, CA, USA.,USC-Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Babak Kateb
- Middle East Brain + Initiative, Los Angeles, CA, USA.,Loma Linda University, School of Medicine, Loma Linda, CA, USA.,National Center for Nanobioelectronics, Los Angeles, CA, USA.,Brain Technology and Innovation Park, Los Angeles, CA, USA
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19
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Bojke L, Soares M, Claxton K, Colson A, Fox A, Jackson C, Jankovic D, Morton A, Sharples L, Taylor A. Developing a reference protocol for structured expert elicitation in health-care decision-making: a mixed-methods study. Health Technol Assess 2021; 25:1-124. [PMID: 34105510 PMCID: PMC8215568 DOI: 10.3310/hta25370] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Many decisions in health care aim to maximise health, requiring judgements about interventions that may have higher health effects but potentially incur additional costs (cost-effectiveness framework). The evidence used to establish cost-effectiveness is typically uncertain and it is important that this uncertainty is characterised. In situations in which evidence is uncertain, the experience of experts is essential. The process by which the beliefs of experts can be formally collected in a quantitative manner is structured expert elicitation. There is heterogeneity in the existing methodology used in health-care decision-making. A number of guidelines are available for structured expert elicitation; however, it is not clear if any of these are appropriate for health-care decision-making. OBJECTIVES The overall aim was to establish a protocol for structured expert elicitation to inform health-care decision-making. The objectives are to (1) provide clarity on methods for collecting and using experts' judgements, (2) consider when alternative methodology may be required in particular contexts, (3) establish preferred approaches for elicitation on a range of parameters, (4) determine which elicitation methods allow experts to express uncertainty and (5) determine the usefulness of the reference protocol developed. METHODS A mixed-methods approach was used: systemic review, targeted searches, experimental work and narrative synthesis. A review of the existing guidelines for structured expert elicitation was conducted. This identified the approaches used in existing guidelines (the 'choices') and determined if dominant approaches exist. Targeted review searches were conducted for selection of experts, level of elicitation, fitting and aggregation, assessing accuracy of judgements and heuristics and biases. To sift through the available choices, a set of principles that underpin the use of structured expert elicitation in health-care decision-making was defined using evidence generated from the targeted searches, quantities to elicit experimental evidence and consideration of constraints in health-care decision-making. These principles, including fitness for purpose and reflecting individual expert uncertainty, were applied to the set of choices to establish a reference protocol. An applied evaluation of the developed reference protocol was also undertaken. RESULTS For many elements of structured expert elicitation, there was a lack of consistency across the existing guidelines. In almost all choices, there was a lack of empirical evidence supporting recommendations, and in some circumstances the principles are unable to provide sufficient justification for discounting particular choices. It is possible to define reference methods for health technology assessment. These include a focus on gathering experts with substantive skills, eliciting observable quantities and individual elicitation of beliefs. Additional considerations are required for decision-makers outside health technology assessment, for example at a local level, or for early technologies. Access to experts may be limited and in some circumstances group discussion may be needed to generate a distribution. LIMITATIONS The major limitation of the work conducted here lies not in the methods employed in the current work but in the evidence available from the wider literature relating to how appropriate particular methodological choices are. CONCLUSIONS The reference protocol is flexible in many choices. This may be a useful characteristic, as it is possible to apply this reference protocol across different settings. Further applied studies, which use the choices specified in this reference protocol, are required. FUNDING This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 37. See the NIHR Journals Library website for further project information. This work was also funded by the Medical Research Council (reference MR/N028511/1).
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Affiliation(s)
- Laura Bojke
- Centre for Health Economics, University of York, York, UK
| | - Marta Soares
- Centre for Health Economics, University of York, York, UK
| | - Karl Claxton
- Centre for Health Economics, University of York, York, UK
| | - Abigail Colson
- Department of Management Science, University of Strathclyde, Glasgow, UK
| | - Aimée Fox
- Centre for Health Economics, University of York, York, UK
| | | | - Dina Jankovic
- Centre for Health Economics, University of York, York, UK
| | - Alec Morton
- Department of Management Science, University of Strathclyde, Glasgow, UK
| | - Linda Sharples
- London School of Hygiene & Tropical Medicine, London, UK
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20
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Vega-Fernández G, Lera L, Leyton B, Cortés P, Lizana PA. Musculoskeletal Disorders Associated With Quality of Life and Body Composition in Urban and Rural Public School Teachers. Front Public Health 2021; 9:607318. [PMID: 34141698 PMCID: PMC8203816 DOI: 10.3389/fpubh.2021.607318] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 03/22/2021] [Indexed: 12/13/2022] Open
Abstract
Introduction: Teachers have been reported to be a labor group with high rates of musculoskeletal disorders (MSDs), stress, and strong deterioration of quality of life (QoL). However, little information exists about the association between MSD, QoL, and body composition in rural and urban teachers. Objective: The aim was to study the association of MSD with QoL perception and body composition of urban and rural teachers. Participants and Methods: Participants are comprised a representative sample of urban and rural public schoolteachers from the Valparaiso Region, Chile. MSDs were evaluated with the Standardized Nordic Questionnaire for Musculoskeletal Symptoms validated for the Chilean population. QoL perception was evaluated with the 36-Item Short-Form Survey (SF-36). Body composition was measured via bioimpedance. A logistic regression model was used to evaluate the association between MSD, QoL, and body composition, adjusted for age and gender. Results: A total of 88.9% (urban 90%; rural 87%) of teachers felt pain in some body area, 71.2% of them with limitations; 39% of teachers presented body fat obesity, with the highest rate in rural women. The body area with the greatest MSD prevalence was the neck and shoulders (68.6%). Significant differences were observed between teachers with >p75 of MSD (over six pain regions) and those with ≤p75 (six or fewer painful regions; p < 0.05) on six QoL scales and on physical health components (PCSs) and mental health (MCS) in urban teachers. However, rural teachers presented no differences. The association between teachers with >p75 MSD and low QoL perception was significant (p < 0.05) in PCS and MCS. Furthermore, the regression model presents a significant association between rural areas and low PCS perception. Conclusions: Urban and rural teachers present high rates of MSD and obesity. Teachers with higher rates of MSD have their mental and physical QoL affected, making workplace intervention in MSD necessary to prevent teacher health deterioration.
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Affiliation(s)
- Gustavo Vega-Fernández
- Laboratory of Morphological Sciences, Instituto de Biología, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile.,Programa de Magister en Ciencias Mención Morfología, Universidad de La Frontera, Temuco, Chile
| | - Lydia Lera
- Public Nutrition Unit, Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Bárbara Leyton
- Public Nutrition Unit, Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Pilar Cortés
- Laboratory of Morphological Sciences, Instituto de Biología, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Pablo A Lizana
- Laboratory of Morphological Sciences, Instituto de Biología, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
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21
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Roldán-Jiménez C, Pérez-Cruzado D, Neblett R, Gatchel R, Cuesta-Vargas A. Central Sensitization in Chronic Musculoskeletal Pain Disorders in Different Populations: A Cross-Sectional Study. PAIN MEDICINE 2021; 21:2958-2963. [PMID: 32232473 DOI: 10.1093/pm/pnaa069] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Chronic musculoskeletal pain disorders (CMPDs) are among the leading causes of disabilities across populations, resulting in high social and financial burden. This persistent pain condition may include the central sensitization (CS) phenomenon, which implies a wide range of symptoms and that may be taken into account in CMPD treatment. CS symptoms can be measured by the Central Sensitization Inventory (CSI). The aims of the study were to describe CS symptoms in patients suffering from several CMPDs and to analyze differences due to gender, age, and body mass index (BMI). DESIGN This cross-sectional study recruited a total of 395 Spanish participants suffering from several CMPDs. SETTING CS symptoms were measured with the Spanish Version of the CSI. The total score (0-100) and a cutoff score of 40 were recorded. SUBJECTS A total of 395 participants were included. RESULTS The mean CSI total score for the whole sample was 24.6 ± 12.0 points. CSI total score had subclinical values in the whole sample, whereas participants with scores >40 were found across different CMPDs, such as low back pain (37.8%) and neck pain (32.4%); 14.6% of females and 1.7% of males presented CSI scores >40. Patients showed significant differences in CSI cutoff point by gender (P = 0.010) and CSI total score by age (P = 0.014). CONCLUSIONS Given the high prevalence of clinically relevant CSI scores (>40) in people with a CMPD, especially low back pain and neck pain, we recommend that clinicians supplement their assessment with the CSI for improved decision-making during treatment.
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Affiliation(s)
- Cristina Roldán-Jiménez
- Department of Physiotherapy, Faculty of Health Science, University of Malaga, Malaga, Spain.,The Institute of Biomedical Research in Malaga (IBIMA), Malaga, Spain
| | - David Pérez-Cruzado
- Department of Physiotherapy, Faculty of Health Science, University of Malaga, Malaga, Spain.,Department of Health Science, University Católica San Antonio de Murcia, Murcia, Spain
| | | | - Robert Gatchel
- Center of Excellence for the Study of Health & Chronic Illnesses, Department of Psychology, College of Science, The University of Texas, Arlington, Texas, USA
| | - Antonio Cuesta-Vargas
- Department of Physiotherapy, Faculty of Health Science, University of Malaga, Malaga, Spain.,School of Clinical Science, Faculty of Health, Queensland University of Technology, Brisbane, Australia
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22
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Zitko P, Bilbeny N, Vargas C, Balmaceda C, Eberhard ME, Ahumada M, Rodríguez MF, Flores J, Markkula N, Espinoza MA. Different Alternatives to Assess the Burden of Disease Using Attributable Fraction on a Disability Variable: The Case of Pain and Chronic Musculoskeletal Disorders in Chile. Value Health Reg Issues 2021; 26:15-23. [PMID: 33765545 DOI: 10.1016/j.vhri.2020.12.007] [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: 01/23/2020] [Revised: 12/10/2020] [Accepted: 12/14/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To estimate the burden of disease through 4 complementary procedures to years lived with disability (YLDs) using the concept of attributable fraction and including analysis of subdomains of disability. METHODS We explored the burden on disability for 7 common musculoskeletal disorders (CMD) using the 2009 to 2010 Chilean National Health Survey, which included the Community Oriented Programme for the Control of Rheumatic Disease Core Questionnaire to identify cases with CMD, and an 8-domain questionnaire for health state descriptions. We calculated the proportion of disability attributable to pain in the general population and people with CMD. We also estimated the burden of CMD expressed as YLD and as the proportion of the disability in the general population attributable to people with CMD, with a particular focus in the pain domain of disability. Second order of uncertainty around point estimations was also characterized. RESULTS Pain domain of disability accounted for 23.4% of the total disability in the general population, and between 20% (fibromyalgia) to 27.1% (osteoarthritis of the hip) in people with some of the selected CMD. People with chronic musculoskeletal pain accounted for 21.2% of total disability from general population, which generated 1.2 million of YLD (6679 YLD/100 000 inhabitants). Chronic low back pain and osteoarthritis of the knee were in the top position of specific CMDs, explaining the highest national burden. CONCLUSION Pain is an essential component of disability in people with CMD and also in the general population. The approach used can be easily applied to other health conditions and other domains of disability.
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Affiliation(s)
- Pedro Zitko
- Unidad de Evaluación de Tecnologías Sanitarias, Centro de Invetsigación Clínica, Pontificia Universidad Católica de Chile, Chile; Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Chile; Health Services & Population Research Department, IoPPN, King's College London, England, UK
| | | | - Constanza Vargas
- Unidad de Evaluación de Tecnologías Sanitarias, Centro de Invetsigación Clínica, Pontificia Universidad Católica de Chile, Chile; Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney, Sydney, Australia
| | - Carlos Balmaceda
- Unidad de Evaluación de Tecnologías Sanitarias, Centro de Invetsigación Clínica, Pontificia Universidad Católica de Chile, Chile
| | | | | | | | - Javiera Flores
- Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Chile
| | - Niina Markkula
- Department of Psychiatry, Helsinki University and Helsinki University Hospital, Finland
| | - Manuel A Espinoza
- Unidad de Evaluación de Tecnologías Sanitarias, Centro de Invetsigación Clínica, Pontificia Universidad Católica de Chile, Chile; Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Chile.
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23
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Rehman Y, Ferguson H, Bozek A, Blair J, Allison A, Johnston R. Osteopathic Manual Treatment for Pain Severity, Functional Improvement, and Return to Work in Patients With Chronic Pain. J Osteopath Med 2020; 120:888-906. [PMID: 32946545 DOI: 10.7556/jaoa.2020.128] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Context Chronic non-cancer pain (CNCP) is associated with disability, poor quality of life (QOL), and failure to return to work (RTW). Osteopathic manipulative treatment (OMT) or osteopathic manual therapy (OMTh) are increasingly offered to patients with CNCP; however, the existing systematic reviews and meta-analyses in the literature that explore the effectiveness of OMTh have major limitations. Objective To systematically evaluate the quality of evidence documenting the effectiveness of OMTh for patients with CNCP using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, and to evaluate the efficacy of OMTh in patients with CNCP through a meta-analysis of pooled data from previous studies. Methods We searched online the databases Ovid, MEDLINE, Embase, OSTMED.DR, EMCare, Allied and Complementary Medicine Database (AMED), Physiotherapy Evidence Database (PEDro), and Cochrane Central Register of Controlled Trials (CENTRAL), as well as the bibliographic references of previous systematic review articles evaluating OMTh for pain severity, disability, QOL, or RTW outcomes. Eligibility included randomized controlled trials methodology, CNCP patients 18 years or older, use of previously validated assessment tools, use of OMTh as an active or combination intervention, and presence of a control or comparison group. We pooled studies based on the homogeneity between OMT comparator treatment and outcomes. Risk of bias was assessed with the Cochrane risk of bias tool and the quality of evidence was determined with GRADE. Results Sixteen randomized controlled trials (n=1158 patients) were eligible for data extraction. Moderate quality evidence showed that OMTh vs. standard care was significantly associated with a reduction in pain [standardized mean difference (95% CI)=[-.37 (-.58, -.17)] and disability [-.28 (-.46, -.10)], as well as improved QOL [.67 (.29, 1.05)]. Moderate quality evidence showed that OMTh plus exercise vs. exercise only was significantly associated with reduction in pain severity [-1.25 (-1.67, -.83)] and disability [-1.15 (-1.57, -.74)]. Moderate quality evidence showed that using visceral OMTh vs. general OMTh was significantly associated with reduction in pain severity [-.74 (-1.09, -.39)] and disability [-.52 (-.91, -.13)]. In comparison to physiotherapy, gabapentin, and OMTh plus gabapentin, OMTh did not show any significant effect for any of the outcomes. OMTh vs. standard care did not show significant improvement in RTW at 12 weeks, although the effect was significant at 8 weeks after OMTh. Conclusion Moderate quality evidence suggests that OMTh is effective for CNCP patients. There was a significant association between visceral OMTh and reduced pain severity and disability. More robust, high-quality randomized controlled trials with larger sample sizes are required to further explore the effectiveness of the OMTh in the management of CNCP.
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24
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Desplenter T, Zhou Y, Edmonds BP, Lidka M, Goldman A, Trejos AL. Rehabilitative and assistive wearable mechatronic upper-limb devices: A review. J Rehabil Assist Technol Eng 2020; 7:2055668320917870. [PMID: 32435505 PMCID: PMC7223206 DOI: 10.1177/2055668320917870] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 03/11/2020] [Indexed: 11/17/2022] Open
Abstract
Recently, there has been a trend toward assistive mechatronic devices that are wearable. These devices provide the ability to assist without tethering the user to a specific location. However, there are characteristics of these devices that are limiting their ability to perform motion tasks and the adoption rate of these devices into clinical settings. The objective of this research is to perform a review of the existing wearable assistive devices that are used to assist with musculoskeletal and neurological disorders affecting the upper limb. A review of the existing literature was conducted on devices that are wearable, assistive, and mechatronic, and that provide motion assistance to the upper limb. Five areas were examined, including sensors, actuators, control techniques, computer systems, and intended applications. Fifty-three devices were reviewed that either assist with musculoskeletal disorders or suppress tremor. The general trends found in this review show a lack of requirements, device details, and standardization of reporting and evaluation. Two areas to accelerate the evolution of these devices were identified, including the standardization of research, clinical, and engineering details, and the promotion of multidisciplinary culture. Adoption of these devices into their intended application domains relies on the continued efforts of the community.
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Affiliation(s)
- Tyler Desplenter
- Department of Electrical and Computer Engineering, University of Western Ontario, London, Canada
| | - Yue Zhou
- School of Biomedical Engineering, University of Western Ontario, London, Canada
| | - Brandon Pr Edmonds
- School of Biomedical Engineering, University of Western Ontario, London, Canada
| | - Myles Lidka
- Department of Electrical and Computer Engineering, University of Western Ontario, London, Canada
| | - Allison Goldman
- Department of Electrical and Computer Engineering, University of Western Ontario, London, Canada
| | - Ana Luisa Trejos
- Department of Electrical and Computer Engineering, University of Western Ontario, London, Canada.,School of Biomedical Engineering, University of Western Ontario, London, Canada.,Lawson Health Research Institute, London, Canada
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25
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Carregaro RL, Tottoli CR, Rodrigues DDS, Bosmans JE, da Silva EN, van Tulder M. Low back pain should be considered a health and research priority in Brazil: Lost productivity and healthcare costs between 2012 to 2016. PLoS One 2020; 15:e0230902. [PMID: 32236113 PMCID: PMC7112211 DOI: 10.1371/journal.pone.0230902] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/11/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Low Back Pain (LBP) is associated with an increase in disability-adjusted life years, and increased risk of disability retirement and greater absenteeism in Brazil. Hence, evidence on healthcare and lost productivity costs due to LBP is of utmost importance to inform decision-makers. METHODS Cost-of-illness study with top-down approach, and societal perspective. We extracted data from National databases, considering the period 2012-2016. Outpatient expenses included clinical, surgical, diagnosis, orthosis/prosthetics, and complementary actions. Inpatient care expenses included hospital and professional services, intensive care unit, and companion stay. For productivity losses, duration of work absence and associated information (work-related and non-work-related; value of the sickness absence benefit; age; gender; and economic activity) were analyzed. Lost productivity costs were calculated multiplying the absence from work (days) by the daily-benefit. RESULTS The societal costs amounted to US$ 2.2 billion, and productivity losses represented 79% of the costs. Total healthcare expenses were estimated to US$ 460 million. We found more than 880,000 diagnostic images. Individuals with LBP were in total 59 million days absent from work between 2012-2016. The mean lost days absent from work per person, for each year investigated was, respectively, 88; 84; 83; 87; and 100. Men were more days absent from work than women. In addition, rural workers presented greater absence from work compared to other professional activities. CONCLUSION Healthcare expenses and lost productivity costs due to LBP were substantial, hence, there is a need for improvement of health services and policies to deal with this increasing burden of illness. We found an extensive use of diagnostic imaging, which is rather discouraged by clinical guidelines. We assume that men were experiencing high levels of back pain disability compared with women, as they presented greater absenteeism and higher lost productivity costs.
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Affiliation(s)
- Rodrigo Luiz Carregaro
- School of Physical Therapy, Master in Rehabilitation Sciences, Universidade de Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil
- Núcleo de Evidências e Tecnologias em Saúde (NETecS), Universidade de Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil
- * E-mail:
| | - Caroline Ribeiro Tottoli
- School of Physical Therapy, Master in Rehabilitation Sciences, Universidade de Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil
- Núcleo de Evidências e Tecnologias em Saúde (NETecS), Universidade de Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil
| | | | - Judith E. Bosmans
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Everton Nunes da Silva
- Núcleo de Evidências e Tecnologias em Saúde (NETecS), Universidade de Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil
- School of Collective Health, Universidade de Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil
| | - Maurits van Tulder
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Physiotherapy & Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark
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26
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Chronic Pain Hurts the Brain: The Pain Physician's Perspective. Behav Neurol 2020; 2020:3786562. [PMID: 32273914 PMCID: PMC7115041 DOI: 10.1155/2020/3786562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 03/11/2020] [Indexed: 11/18/2022] Open
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27
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Velasco M. DOLOR MUSCULOESQUELÉTICO: FIBROMIALGIA Y DOLOR MIOFASCIAL. REVISTA MÉDICA CLÍNICA LAS CONDES 2019. [DOI: 10.1016/j.rmclc.2019.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Living with Chronic Pain: A Qualitative Study of the Daily Life of Older People with Chronic Pain in Chile. Pain Res Manag 2019; 2019:8148652. [PMID: 31065304 PMCID: PMC6466839 DOI: 10.1155/2019/8148652] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 03/06/2019] [Indexed: 12/17/2022]
Abstract
One of the main causes of chronic pain in older people is spine deformity, an abnormal curvature of the spine. The purpose of this study is to improve understanding of the experience of chronic pain produced by spinal deformity in older people and understand how cultural factors may affect this experience. A qualitative study was performed with 10 older people. Participants were encouraged to describe a typical day in their life, including the factors that affect their pain and how their quality of life had been affected since experiencing chronic pain. The semistructured interviews were transcribed and analyzed using open coding. Pain caused by spine deformity produces disability, affecting how older people perform their daily activities, causing them to adapt their households and physical positions to perform these tasks, albeit slowly or incompletely. Chronic pain also affects emotional states and social relationships because older people become unable to undertake physical activities that they performed in the past. The close relationship with adult children and friends, typical in Latin cultures, is a source of comfort and support. At a community level, adaptation of public services (such as public transportation) must be improved.
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