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Hage G, Buisseret F, Brismée JM, Dierick F, Detrembleur C, Hage R. Evaluating the additive diagnostic value of DidRen LaserTest: Correlating temporal and kinematic predictors and patient-reported outcome measures in acute-subacute non-specific neck pain. J Bodyw Mov Ther 2024; 39:201-208. [PMID: 38876626 DOI: 10.1016/j.jbmt.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 02/28/2024] [Accepted: 03/03/2024] [Indexed: 06/16/2024]
Affiliation(s)
- Guillaume Hage
- Laboratoire de Neuro Musculo Squelettique (NMSK), Institut de Recherche Expérimentale et Clinique (IREC), UCLouvain, 1200 Brussels, Belgium
| | - Fabien Buisseret
- Centre de Recherche et de Formation de la HELHa (CeREF), Chaussée de Binche 159, 7000 Mons, Belgium; Service de Physique Nucléaire et Subnucléaire, UMONS, Research Institute for Complex Systems, Place Du Parc 20, 7000 Mons, Belgium
| | - Jean-Michel Brismée
- Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Frédéric Dierick
- Centre de Recherche et de Formation de la HELHa (CeREF), Chaussée de Binche 159, 7000 Mons, Belgium; Laboratoire d'Analyse du Mouvement et de la Posture (LAMP), Centre National de Rééducation Fonctionnelle et de Réadaptation (Rehazenter), Rue André Vésale 1, 2674 Luxembourg, Luxembourg; Faculté des Sciences de La Motricité, UCLouvain, Place Pierre de Coubertin 1-2, 1348 Louvain-la-Neuve, Belgium
| | - Christine Detrembleur
- Laboratoire de Neuro Musculo Squelettique (NMSK), Institut de Recherche Expérimentale et Clinique (IREC), UCLouvain, 1200 Brussels, Belgium
| | - Renaud Hage
- Centre de Recherche et de Formation de la HELHa (CeREF), Chaussée de Binche 159, 7000 Mons, Belgium; Faculté des Sciences de La Motricité, UCLouvain, Place Pierre de Coubertin 1-2, 1348 Louvain-la-Neuve, Belgium; Traitement Formation Thérapie Manuelle (TFTM), Private Physiotherapy/Manual Therapy Center, Avenue des Cerisiers 211A, 1200 Brussels, Belgium; Haute école Libre de Bruxelles Ilya Prigogine, Section Kinésithérapie, 808, Route de Lennik, Bâtiment P, 1070 Brussels, Belgium.
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Uthaikhup S, Sremakaew M, Treleaven J, Jull G, Barbero M, Falla D, Cescon C. Changes in Multiple Aspects of Pain Outcomes After Rehabilitation: Analysis of Pain Data in a Randomized Controlled Trial Evaluating the Effects of Adding Sensorimotor Training to Manual Therapy and Exercise for Chronic Neck Pain. Clin J Pain 2024; 40:212-220. [PMID: 38297452 DOI: 10.1097/ajp.0000000000001194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/02/2024] [Indexed: 02/02/2024]
Abstract
OBJECTIVES To examine changes in pain outcomes to fully evaluate the effect of adding sensorimotor training to manual therapy and exercise in patients with chronic neck pain and sensorimotor deficits. Concordance was examined between pain distribution and pain intensity and patient-reported outcomes. METHODS Participants (n=152) were randomly allocated into 4 intervention groups: One group received local neck treatment (NT) comprising manual therapy and exercise and the other 3 groups received additional sensorimotor training (either joint position sense/oculomotor exercises, balance exercises or both). Treatment was delivered twice a week for 6 weeks. Pain and patient-reported outcomes were measured at baseline, posttreatment, and 3-, 6- and 12-month follow-ups. RESULTS There were greater changes in pain location, extent, and intensity at 6- and 12-month follow-ups in the sensorimotor training groups compared with the NT group ( P <0.05). A greater number of patients in the sensorimotor training groups gained ≥50% reduction in pain extent and intensity relative to the NT group at 6 and 12 months ( P <0.05). Clinical improvement in pain extent was concordant with pain intensity (adjusted kappa=056 to 0.66, %agreement=78.3 to 82.9, P <0.001) and disability (adjusted kappa=0.47 to 0.58, % agreement=73.7 to 79.0, P <0.01) at 3-, 6- and 12-month follow-ups, but not with function and well-being. The concordance tended to decline with time. DISCUSSION Multiple aspects of the pain experience improved in the longer term by adding sensorimotor training to NT for patients with neck pain and sensorimotor deficits. The concordance between pain and patient-reported outcomes was not always evident and varied over time, suggesting the need for multidimensional assessments of pain.
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Affiliation(s)
- Sureeporn Uthaikhup
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Munlika Sremakaew
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Julia Treleaven
- Department of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, Australia
| | - Gwendolen Jull
- Department of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, Australia
| | - Marco Barbero
- Department of Business Economics Health and Social Care, Rehabilitation Research Laboratory 2rLab, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Corrado Cescon
- Department of Business Economics Health and Social Care, Rehabilitation Research Laboratory 2rLab, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
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Aragón-Basanta E, Venegas W, Ayala G, Page A, Serra-Añó P. Relationship between neck kinematics and neck dissability index. An approach based on functional regression. Sci Rep 2024; 14:215. [PMID: 38167615 PMCID: PMC10761888 DOI: 10.1038/s41598-023-50562-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
Numerous studies use numerical variables of neck movement to predict the level of severity of a pathology. However, the correlation between these numerical variables and disability levels is low, less than 0.4 in the best cases, even less in subjects with nonspecific neck pain. This work aims to use Functional Data Analysis (FDA), in particular scalar-on-function regression, to predict the Neck Disability Index (NDI) of subjects with nonspecific neck pain using the complete movement as predictors. Several functional regression models have been implemented, doubling the multiple correlation coefficient obtained when only scalar predictors are used. The best predictive model considers the angular velocity curves as a predictor, obtaining a multiple correlation coefficient of 0.64. In addition, functional models facilitate the interpretation of the relationship between the kinematic curves and the NDI since they allow identifying which parts of the curves most influence the differences in the predicted variable. In this case, the movement's braking phases contribute to a greater or lesser NDI. So, it is concluded that functional regression models have greater predictive capacity than usual ones by considering practically all the information in the curve while allowing a physical interpretation of the results.
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Affiliation(s)
- Elisa Aragón-Basanta
- Camino de Vera s/n, Instituto Universitario de Ingeniería Mecánica y Biomecánica, Universitat Politècnica de València, 46022, Valencia, Spain.
| | - William Venegas
- Facultad de Ingeniería Mecánica, Escuela Politécnica Nacional, PO-Box 17-01-2759, Quito, Ecuador
| | - Guillermo Ayala
- Avda Vicent Andrés Estellés 1, Departament of Statistics and Operation Research, Universitat de València, 46100, Burjasot, Spain
| | - Alvaro Page
- Camino de Vera s/n, Instituto Universitario de Ingeniería Mecánica y Biomecánica, Universitat Politècnica de València, 46022, Valencia, Spain
| | - Pilar Serra-Añó
- Gascó Oliag 5, Departament of Physiotherapy, Universitat de València, 46010, Valencia, Spain
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Huang Z, Chen X, Gan X, Chen J. Prescription analgesic medication use among osteoarthritis patients. J Orthop Surg (Hong Kong) 2023; 31:10225536231202835. [PMID: 37724650 DOI: 10.1177/10225536231202835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/21/2023] Open
Abstract
OBJECTIVE Pharmacotherapy is the most common strategies to reduce pain for osteoarthritis (OA) patients. To analyze the trend and pattern of prescription analgesic medication use in American OA patients. Besides, our study also tried to figure out the demographic characteristics of opioid use among OA population which may helpful for managing the use of opioids. METHODS We included 2214 OA patients from 2007 to 2018. We extracted data from National Health and Nutrition Examination Survey (NHANES) database. We compared analgesics and anti-depression medications use by category between survey participants with OA and without. RESULTS For OA patients, NSAIDs, acetaminophen and gabapentinoid were the mostly highly used analgesics (10.2%, 9.0% and 8.9%, respectively). However, we also found that opioids use was very common in OA patients (7.7%) and the duration of opioids use was significantly long. In addition, the opioids use did not decrease from 2007 to 2018, while gabapentinoid increased rapidly from recent decade (From 5.0% to 12.1%). The common analgesic combination used by OA population was opioids with acetaminophen and gabapentinoid with selective serotonin reuptake inhibitors (SSRIs) (2.9% and 2.7%, respectively). CONCLUSION The use of gabapentinoid increased rapidly from recent decade, while opioids use did not decrease. The long-term excessive use of opioids was also a serious problem for OA pain control. More improvements such as focusing more on healthcare education and paying more attention on non-pharmacotherapy and the psychological situation of patients are needed.
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Affiliation(s)
- Zhenzhen Huang
- Department of Pharmacy, The Third People's Hospital of Cangnan, Wenzhou, China
| | - Xinxin Chen
- Department of Ultrasound, The People's Hospital of Cangnan, Wenzhou, China
| | - Xihong Gan
- Department of Nursing, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jiajia Chen
- Department of Nursing, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
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Bragatto MM, Lima Florencio L, Rodrigues A, Benatto MT, Dach F, Fernández-de-Las-Peñas C, Bevilaqua-Grossi D. Women with migraine presents similar altered performance in the craniocervical flexion test than women with chronic nonspecific neck pain: An observational study. Musculoskelet Sci Pract 2023; 66:102784. [PMID: 37268551 DOI: 10.1016/j.msksp.2023.102784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND Although patients with migraine show cervical muscle impairments previous studies investigating motor performance have not characterized the sample of patients with migraine according to the presence/absence of neck pain complaints. OBJECTIVE To verify if there are differences in the clinical and muscular performance of the superficial neck flexors and extensors during Craniocervical Flexion Test in women with migraine, considering the presence or absence of concomitant symptoms of neck pain. METHODS The cranio-cervical flexion test performance was assessed by its clinical stage test and by the surface electromyographic activity of the sternocleidomastoid, anterior scalene muscles upper trapezius and splenius capitis. It was assessed in 25 women with migraine without neck pain, 25 women with migraine and neck pain, 25 women with chronic neck pain and 25 pain-free control women. RESULTS Poorer performance of the cervical muscles was found during the execution of the cranio-cervical flexion test, in addition to higher muscle activity, especially in the sternocleidomastoid, splenius capitis, and upper trapezius muscles in the neck pain, migraine without neck pain, and migraine with neck pain groups in comparison with the results obtained for healthy women in the control group. No difference was observed between the groups of women experiencing pain. Analysis of the extensor/flexor muscle electromyographic ratio showed that there was no difference between the groups. CONCLUSION Poor cervical muscle performance was observed in both women with chronic nonspecific neck pain and women with migraine regardless of the presence of neck pain.
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Affiliation(s)
- Marcela Mendes Bragatto
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Lidiane Lima Florencio
- Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain.
| | - Amanda Rodrigues
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Mariana Tedeschi Benatto
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Fabíola Dach
- Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - César Fernández-de-Las-Peñas
- Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain
| | - Débora Bevilaqua-Grossi
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
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Sensory Interaction Balance and Limits of Stability in Neck Pain: Comparison of Traumatic and Non-traumatic Patients. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2022. [DOI: 10.30621/jbachs.1172228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background and Purpose: A variety of sensory-motor changes are reported in both the traumatic and non-traumatic neck pain. However, it is still unclear whether there is a significant difference between individuals with traumatic neck pain and those with non-traumatic in terms of postural control. The aim of this cross-sectional study was to investigate whether there was a difference between individuals with traumatic pain and non-traumatic neck pain in terms of postural control and disability.
Methods: Ninety-two patients with chronic neck pain were grouped according to the onset of pain. Clinical test of sensory interaction balance (CTSIB) and limits of stability (LOS) test were used for postural control assessment. The Numeric Rating Scale and Neck Pain Disability Index (NPDI) were used to measure pain intensity and disability, respectively. Mann-Whitney U test was used to compare groups.
Results: There were no significant differences between groups in terms of LOS, CTSIB and NPDI scores (p > 0.05).
Conclusion: The results of this study suggest that postural control and disability do not differ between patients with traumatic and non-traumatic neck pain. Therefore, from a clinical perspective, postural control and disability should be evaluated without considering trauma history in patients with neck pain.
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Luque-Suarez A, Falla D, Barbero M, Pineda-Galan C, Marco D, Giuffrida V, Martinez-Calderon J. Digital pain extent is associated with pain intensity but not with pain-related cognitions and disability in people with chronic musculoskeletal pain: a cross-sectional study. BMC Musculoskelet Disord 2022; 23:727. [PMID: 35906575 PMCID: PMC9338608 DOI: 10.1186/s12891-022-05700-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 07/26/2022] [Indexed: 11/17/2022] Open
Abstract
Background To evaluate whether digital pain extent is associated with an array of psychological factors such as optimism, pessimism, expectations of recovery, pain acceptance, and pain self-efficacy beliefs as well as to analyse the association between digital pain extent and pain intensity and pain-related disability in people with chronic musculoskeletal pain. Methods A descriptive cross-sectional study conducted in a primary health care setting was carried out including 186 individuals with chronic musculoskeletal pain. Patient-reported outcomes were used to assess psychological factors, pain intensity, and pain-related disability. Digital pain extent was obtained from pain drawings shaded using a tablet and analysed using novel customized software. Multiple linear regression models were conducted to evaluate the association between digital pain extent and the aforementioned variables. Results Digital pain extent was statistically significantly associated with pain intensity. However, digital pain extent was not associated with any psychological measure nor with pain-related disability. Discussion The results did not support an association between digital pain extent and psychological measures.
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Affiliation(s)
- Alejandro Luque-Suarez
- Facultad de Ciencias de La Salud, Departamento de Fisioterapia, Universidad de Malaga, Malaga, Spain.,Instituto de Investigación Biomédica de Málaga (IBIMA), Malaga, Spain
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Marco Barbero
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, Sciences and Arts of Southern Switzerland, University of Applied, Manno/Landquart, Switzerland.
| | - Consolacion Pineda-Galan
- Facultad de Ciencias de La Salud, Departamento de Fisioterapia, Universidad de Malaga, Malaga, Spain
| | - Derboni Marco
- Istituto Dalle Molle Di Studi Sull'Intelligenza Artificiale (IDSIA), Scuola Universitaria Professionale Della Svizzera Italiana (SUPSI), Università Della Svizzera Italiana (USI), Lugano, Switzerland
| | - Vincenzo Giuffrida
- Istituto Dalle Molle Di Studi Sull'Intelligenza Artificiale (IDSIA), Scuola Universitaria Professionale Della Svizzera Italiana (SUPSI), Università Della Svizzera Italiana (USI), Lugano, Switzerland
| | - Javier Martinez-Calderon
- Facultad de Ciencias de La Salud, Departamento de Fisioterapia, Universidad de Malaga, Malaga, Spain.,Instituto de Investigación Biomédica de Málaga (IBIMA), Malaga, Spain
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Ortego G, Lluch E, Herrero P, Boudreau SA, Doménech-García V. Profiling and Association over Time between Disability and Pain Features in Patients with Chronic Nonspecific Neck Pain: A Longitudinal Study. J Clin Med 2022; 11:jcm11051346. [PMID: 35268437 PMCID: PMC8911229 DOI: 10.3390/jcm11051346] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/17/2022] [Accepted: 02/25/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES To longitudinally investigate the relationships between neck/arm disability and pain profile measures in individuals with chronic nonspecific neck pain (NSNP) at baseline, one month, and six months after a standardized physiotherapy intervention. A secondary aim was to compare pain sensitivity of individuals with chronic NSNP at baseline to healthy controls. METHODS A total of sixty-eight individuals with chronic NSNP and healthy controls were recruited. Neck disability index (NDI), the 11-item disabilities of the arm, shoulder, and hand questionnaire (QuickDASH), temporal summation (TS), pressure pain thresholds (PPTs), pain intensity and pain extent were assessed in individuals with chronic NSNP. For the cross-sectional assessment, TS and PPTs were compared to healthy controls. RESULTS After following a standardized physiotherapy intervention, local and distal PPTs to the neck region decreased at one and six month follow-ups, respectively. Pain extent decreased at one and six months. Furthermore, a positive correlation between neck/arm disability and pain intensity was found at baseline, whereas moderate positive correlations (e.g., between NDI and pain extent) at baseline, one and six month follow-ups and negative correlations at six months (e.g., between arm disability and PPTs) were found. DISCUSSION Overall, these findings indicate that pain sensitivity can worsen following treatment despite reduced pain extent and unchanged neck disability and pain intensity scores over a six-month period in individuals with chronic NSNP.
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Affiliation(s)
- Gorka Ortego
- Faculty of Health Sciences, Universidad San Jorge, Campus Universitario, Autov. A23 km 299, 50830 Villanueva de Gállego, Zaragoza, Spain; (G.O.); (V.D.-G.)
| | - Enrique Lluch
- Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain;
- Physiotherapy in Motion, Multi-Speciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
- Brussels “Pain in Motion” International Research Group, Departments of Human Physiology and Rehabilitation Sciences, Vrije Universiteit Brussels, 1050 Ixelles, Belgium
| | - Pablo Herrero
- Department of Physiatry and Nursing, Faculty of Health Sciences, IIS Aragon, University of Zaragoza, 50009 Zaragoza, Spain
- Correspondence: ; Tel.: +34-646168248
| | - Shellie Ann Boudreau
- Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, 9220 Aalborg, Denmark;
| | - Victor Doménech-García
- Faculty of Health Sciences, Universidad San Jorge, Campus Universitario, Autov. A23 km 299, 50830 Villanueva de Gállego, Zaragoza, Spain; (G.O.); (V.D.-G.)
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The Spatial Extent of Pain Is Associated with Pain Intensity, Catastrophizing and Some Measures of Central Sensitization in People with Frozen Shoulder. J Clin Med 2021; 11:jcm11010154. [PMID: 35011895 PMCID: PMC8745240 DOI: 10.3390/jcm11010154] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/20/2021] [Accepted: 12/24/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this cross-sectional study was to explore the spatial extent of pain and its association with clinical symptoms, psychological features, and pain sensitization in people with frozen shoulder (FS). Forty-eight individuals with FS completed pain drawings (PDs) and reported their clinical symptoms including pain intensity (Visual Analogue Scale) and shoulder disability (Shoulder Pain and Disability Index). Moreover, pain sensitization measurements (pressure pain thresholds, temporal summation, conditioned pain modulation, and Central Sensitization Inventory (CSI)) were assessed. Psychological features were assessed by Pain Catastrophizing Scale (PCS) and Pain Vigilance and Awareness Questionnaire. Pain frequency maps were generated, Margolis rating scale was used for pain location, and Spearman correlation coefficients were computed. The mean (SD) pain extent was 12.5% (6.7%) and the most common painful area was the anterolateral shoulder region (100%). Women presented a more widespread pain distribution compared with men. Significant positive associations were obtained between pain extent and current pain intensity (rs = 0.421, p < 0.01), PCS (rs = 0.307, p < 0.05) and CSI (rs = 0.358, p < 0.05). The anterolateral region of the shoulder was the most common painful area in people with FS. Women with FS presented more extended areas of pain; and a more widespread distribution of pain was correlated with higher levels of pain, pain catastrophizing and pain sensitization.
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Van Looveren E, Cagnie B, Coppieters I, Meeus M, De Pauw R. Changes in Muscle Morphology in Female Chronic Neck Pain Patients Using Magnetic Resonance Imaging. Spine (Phila Pa 1976) 2021; 46:638-648. [PMID: 33290364 DOI: 10.1097/brs.0000000000003856] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Population-based cross-sectional study. OBJECTIVE The aim of this study was to gain a better understanding of changes in muscle morphology in patients with chronic idiopathic neck pain (CINP) and chronic whiplash-associated disorder (CWAD). SUMMARY OF BACKGROUND DATA Worldwide, neck pain (NP) is a common health problem with high socioeconomic burden. A high percentage of these patients evolves toward chronic symptoms. Efficacy of treatments for these complaints remains variable. In current literature, changes in muscle morphology (muscle fat infiltration and cross-sectional area) have been reported in patients with NP, both CWAD and CINP. However, no strong conclusions could be made. METHODS In this study, magnetic resonance imaging was used to obtain data on muscle morphology from 14 cervical flexor and extensor muscles in 117 female subjects with NP (CWAD = 37; CINP = 45) and healthy controls (HC = 35). RESULTS The CWAD group had a significantly larger muscle fat infiltration in some extensor (semispinalis and splenius capitis, trapezius, obliquus capitis inferior) and flexor (sternocleidomastoid) muscles compared to the CINP and/or HC group. A significantly larger (muscle) cross-sectional area was found in some extensor (levator scapulae, semispinalis capitis, trapezius) and flexor (longus colli, longus capitis, sternocleidomastoid) muscles in the HC group compared to the CINP and/or CWAD group. No clear associations were found between group differences and factors as pain duration, kinesiophobia, and disability. CONCLUSION The results in this study suggest changes in muscle morphology in both NP cohorts. These results show some similarities with earlier findings in this research domain. Further studies based on controlled longitudinal designs are needed to facilitate data compilation, to draw stronger conclusions, and to integrate them into the treatment of patients with chronic NP.Level of Evidence: 4.
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Affiliation(s)
- Eveline Van Looveren
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium
- Pain in Motion International Research Group
| | - Barbara Cagnie
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | - Iris Coppieters
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium
- Pain in Motion International Research Group
- Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
| | - Mira Meeus
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
- Pain in Motion International Research Group
- Department of Rehabilitation Sciences and Physiotherapy (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Robby De Pauw
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
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11
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Pitance L, De Longhi B, Gerard E, Cayrol T, Roussel N, Cescon C, Falla D, Barbero M. Digital pain drawings are a useful and reliable tool for assessing patients with temporomandibular disorders. J Oral Rehabil 2021; 48:798-808. [PMID: 33783832 DOI: 10.1111/joor.13168] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Temporomandibular disorders (TMD) are characterised by complex symptomatology and their assessment can be enhanced using pain drawings (PD). OBJECTIVES To evaluate the location and extent of pain in people TMD using digital PD, and to explore their association with clinical features. Reliability of pain extent and pain location using PD was also assessed. METHODS Forty volunteers with TMD completed two consecutive digital PDs. Clinical features were captured from self-reported questionnaire. Additionally, secondary hyperalgesia was measured using the pressure pain threshold (PPT). The correlation between pain extent and clinical features was investigated using Spearman rank correlation coefficients. Reliability of pain extent was evaluated using intraclass correlation coefficient (ICC) and Bland-Altman plots. The Jaccard index was computed to assess the reliability of pain location. RESULTS Analysis of the PDs indicated that people with TMD commonly experience pain in other body regions including the neck, the shoulder and the low back. Except for PPT and pain catastrophising, all other clinical features were significantly correlated with pain extent. The ICCs of pain extent for all body charts were very high (ICCs 95% CI from 0.73 to 0.96), and Bland-Altman plots showed mean biases close to zero with narrow limits of agreement. The reliability of pain location was also supported by Jaccard index mean scores above 0.68. CONCLUSIONS People with TMD showed widespread pain, and pain extent was associated with pain intensity, neck and headache-related disability, depression, anxiety, hyperventilation and central sensitivity. The reliability of measuring pain extent and pain location was confirmed.
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Affiliation(s)
- Laurent Pitance
- Institute of Experimental and Clinical Research, Health Sciences division, Université Catholique de Louvain, Neuro-Musculo-Skeletal-Lab (NMSK), Brussels, Belgium.,Oral and Maxilofacial Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Benjamin De Longhi
- Department of Physical Therapy, Institut Parnasse-ISEI, Brussels, Belgium
| | - Eve Gerard
- Oral and Maxilofacial Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Timothee Cayrol
- Institute of Experimental and Clinical Research, Health Sciences division, Université Catholique de Louvain, Neuro-Musculo-Skeletal-Lab (NMSK), Brussels, Belgium
| | - Nathalie Roussel
- Department of Rehabilitation Sciences and Physiotherapy (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Corrado Cescon
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno/Landquart, Switzerland
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Marco Barbero
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno/Landquart, Switzerland
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12
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Berger AA, Liu Y, Mosel L, Champagne KA, Ruoff MT, Cornett EM, Kaye AD, Imani F, Shakeri A, Varrassi G, Viswanath O, Urits I. Efficacy of Dry Needling and Acupuncture in the Treatment of Neck Pain. Anesth Pain Med 2021; 11:e113627. [PMID: 34336626 PMCID: PMC8314077 DOI: 10.5812/aapm.113627] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/22/2021] [Accepted: 03/26/2021] [Indexed: 12/16/2022] Open
Abstract
CONTEXT Neck pain is a common phenomenon and affects a large segment of the population. Chronic neck pain, lasting more than 3 months, likely occurs in 10% - 30% of patients with acute neck pain and affects up to 288 million cases globally, carrying a significant cost in terms of quality of life, disability, and healthcare dollars. Here we review neck pain background, acupuncture and the evidence that exist to support acupuncture use in chronic neck pain. RESULTS Neck pain not only affects quality of life directly, but also contributes to depression, job dissatisfaction and reduced productivity. Unfortunately, neck pain is strongly linked to office and computer work and is likely to continue increasing in prevalence. Traditional treatments, such as analgesics, physical therapy, exercise, and non-invasive therapy bring some relief, and invasive therapy is indicated if anatomical pathologies exist. Acupuncture is a form of integrative medicine, originally described and practiced in traditional Chinese medicine and now expanded to include methods including acupressure, dry needling, and others. Traditionally, it focused on restoring the patient's flow of Qi by puncturing specific points along the meridians. It has previously been shown to be effective in other forms of chronic pain and disability. Clinical trials studying acupuncture for neck pain have shown significant reduction in both pain and associated symptoms. These therapies are reviewed in this text. CONCLUSIONS Neck pain is a common and significant global problem. Acupuncture, dry needling, and cupping were all shown to be effective in alleviating pain both immediately after treatment, as well as provide long-lasting relief. These treatments are generally safe and inexpensive and should be considered as part of a multimodal approach for the treatment of neck pain. More head-to-head studies will provide better data to support a choice of a specific treatment over another.
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Affiliation(s)
- Amnon A. Berger
- Department of Anesthesiology, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Yao Liu
- Department of Anesthesiology, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Luke Mosel
- Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA, USA
| | - Kristin A. Champagne
- School of Medicine, Louisiana State University Health Shreveport, Shreveport, LA, USA
| | - Miriam T. Ruoff
- School of Medicine, Louisiana State University Health Shreveport, Shreveport, LA, USA
| | - Elyse M. Cornett
- Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA, USA
| | - Alan David Kaye
- Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA, USA
| | - Farnad Imani
- Pain Research Center, Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Asadollah Shakeri
- Department of Anesthesiology and Pain Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | | | - Omar Viswanath
- Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA, USA
- Department of Anesthesiology, College of Medicine-Phoenix, University of Arizona, Phoenix, AZ, USA
- Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE, USA
- Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ, USA
| | - Ivan Urits
- Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA, USA
- Southcoast Physician Group Pain Medicine, Wareham, MA, USA
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13
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Johansson MM, Barbero M, Peolsson A, Falla D, Cescon C, Folli A, Dong HJ. Pain Characteristics and Quality of Life in Older People at High Risk of Future Hospitalization. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030958. [PMID: 33499309 PMCID: PMC7908626 DOI: 10.3390/ijerph18030958] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 12/11/2022]
Abstract
This study deals with how pain characteristics in conjunction with other factors affect quality of life (QoL) in a vulnerable primary care population. We recruited vulnerable older people (75+, n = 825) living in south-eastern Sweden. A postal questionnaire included pain aspects, QoL (EQ-5D-3L, RAND-36 physical functioning, attitudes toward own aging, and life satisfaction), functional status, social networks, and basic demographic information. Pain extent and localization was obtained by digitalization of pain drawings reported on standard body charts. Most respondents were experiencing pain longer than 3 months (88.8%). Pain frequency varied mostly between occasionally (33.8%) and every day (34.8%). A minority reported high pain intensity (13.6%). The lower back and lower legs were the most frequently reported pain locations (>25%). Multiple linear regression model revealed three characteristics of pain (intensity, frequency, and extent) remained inversely associated with the EQ-5D-3L index score (R2 = 0.57). Individually, each of these pain characteristics showed a negative impact on the other three dimensions of QoL (R2 = 0.23–0.59). Different features of pain had impact on different dimensions of QoL in this aging population. A global pain assessment is useful to facilitate individual treatment and rehabilitation strategies in primary care.
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Affiliation(s)
- Maria M Johansson
- Unit of Clinical Medicine, Division of Prevention, Rehabilitation and Community Medicine, Department of Acute Internal Medicine and Geriatrics and Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 83 Linköping, Sweden
- Correspondence: ; Tel.: +46-72-208-97-08
| | - Marco Barbero
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, CH-6928 Manno/Landquart, Switzerland; (M.B.); (C.C.); (A.F.)
| | - Anneli Peolsson
- Unit of Physiotherapy, Division of Prevention, Rehabilitation and Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 83 Linköping, Sweden;
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham B15 2TT, UK;
| | - Corrado Cescon
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, CH-6928 Manno/Landquart, Switzerland; (M.B.); (C.C.); (A.F.)
| | - Anna Folli
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, CH-6928 Manno/Landquart, Switzerland; (M.B.); (C.C.); (A.F.)
| | - Huan-Ji Dong
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 83 Linköping, Sweden;
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14
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Koetsier E, van Kuijk SMJ, Melli G, Dukanac J, Barbero M, van Zundert J, Joosten EA, Maino P. Dorsal Root Ganglion Stimulation for the Management of Intractable Painful Polyneuropathy: A Prospective Pilot Study. Neuromodulation 2020; 24:685-694. [PMID: 33340192 DOI: 10.1111/ner.13336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/22/2020] [Accepted: 10/19/2020] [Indexed: 01/24/2023]
Abstract
OBJECTIVES Dorsal root ganglion stimulation (DRGS) is a promising neurostimulation modality in the treatment of painful polyneuropathy. The aim of this prospective pilot study was to investigate the effect of DRGS on pain intensity in patients with intractable painful polyneuropathy. MATERIALS AND METHODS Nine patients with chronic, intractable painful polyneuropathy in the lower limbs were recruited. In each subject, between two and four DRGS leads were placed at the level of the L5 and S1 dorsal root ganglion. If trial stimulation was successful, a definitive implantable pulse generator (IPG) was implanted. Pain intensity was scored using an 11-point numeric rating scale (NRS) and reported as median and interquartile range (IQR), and compared to baseline values using the Wilcoxon signed-rank test. Additionally, patients' global impression of change (PGIC), pain extent, presence of neuropathic pain, physical functioning, quality of life, and mood were assessed. RESULTS Eight out of nine patients had a successful trial phase, of which seven received an IPG. Daytime pain decreased from a median (IQR) NRS score of 7.0 (5.9-8.3) to 2.0 (1.0-3.5) and 3.0 (1.6-4.9) in the first week and at six months after implantation, respectively. Similar effects were observed for night time and peak pain scores. CONCLUSIONS The results of this study suggest that DRGS significantly reduces both pain intensity and PGIC in patients with intractable painful polyneuropathy in the lower extremities. Large-scale clinical trials are needed to prove the efficacy of DRGS in intractable painful polyneuropathy.
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Affiliation(s)
- Eva Koetsier
- Pain Management Center, Neurocenter of Southern Switzerland, Lugano, Switzerland.,Division of Anaesthesiology, Department of Acute Medicine, Regional Hospital of Lugano, Lugano, Switzerland
| | - Sander M J van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Giorgia Melli
- Laboratory for Biomedical Neurosciences, Neurocenter of Southern Switzerland, Torricella-Taverne, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.,Neurology Department, Neurocenter of Southern Switzerland, Lugano, Switzerland
| | - Jasmina Dukanac
- Pain Management Center, Neurocenter of Southern Switzerland, Lugano, Switzerland
| | - Marco Barbero
- Pain Management Center, Neurocenter of Southern Switzerland, Lugano, Switzerland.,Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Landquart, Manno/Landquart, Switzerland
| | - Jan van Zundert
- Department of Anesthesiology and Pain Management, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Anesthesiology and Multidisciplinary Pain Centre, Ziekenhuis Oost-Limburg, Genk/Lanaken, Belgium
| | - Elbert A Joosten
- Department of Anesthesiology and Pain Management, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Translational Neuroscience, School of Mental Health and Neuroscience (MHeNS), University of Maastricht, Maastricht, The Netherlands
| | - Paolo Maino
- Pain Management Center, Neurocenter of Southern Switzerland, Lugano, Switzerland.,Division of Anaesthesiology, Department of Acute Medicine, Regional Hospital of Lugano, Lugano, Switzerland
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15
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Galve Villa M, S Palsson T, Cid Royo A, R Bjarkam C, Boudreau SA. Digital Pain Mapping and Tracking in Patients With Chronic Pain: Longitudinal Study. J Med Internet Res 2020; 22:e21475. [PMID: 33104012 PMCID: PMC7652695 DOI: 10.2196/21475] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/25/2020] [Accepted: 08/31/2020] [Indexed: 01/01/2023] Open
Abstract
Background Digital pain mapping allows for remote and ecological momentary assessment in patients over multiple time points spanning days to months. Frequent ecological assessments may reveal tendencies and fluctuations more clearly and provide insights into the trajectory of a patient’s pain. Objective The primary aim of this study is to remotely map and track the intensity and distribution of pain and discomfort (eg, burning, aching, and tingling) in patients with nonmalignant spinal referred pain over 12 weeks using a web-based app for digital pain mapping. The secondary aim is to explore the barriers of use by determining the differences in clinical and user characteristics between patients with good (regular users) and poor (nonregular users) reporting compliance. Methods Patients (N=91; n=53 women) with spinal referred pain were recruited using web-based and traditional in-house strategies. Patients were asked to submit weekly digital pain reports for 12 weeks. Each pain report consisted of digital pain drawings on a pseudo–three-dimensional body chart and pain intensity ratings. The pain drawings captured the distribution of pain and discomfort (pain quality descriptors) expressed as the total extent and location. Differences in weekly pain reports were explored using the total extent (pixels), current and usual pain intensity ratings, frequency of quality descriptor selection, and Jaccard similarity index. Validated e-questionnaires were completed at baseline to determine the patients’ characteristics (adapted Danish National Spine Register), disability (Oswestry Disability Index and Neck Disability Index), and pain catastrophizing (Pain Catastrophizing Scale) profiles. Barriers of use were assessed at 6 weeks using a health care–related usability and acceptance e-questionnaire and a self-developed technology-specific e-questionnaire to assess the accessibility and ease of access of the pain mapping app. Associations between total extent, pain intensity, disability, and catastrophizing were explored to further understand pain. Differences between regular and nonregular users were assessed to understand the pain mapping app reporting compliance. Results Fluctuations were identified in pain reports for total extent and pain intensity ratings (P<.001). However, quality descriptor selection (P=.99) and pain drawing (P=.49), compared using the Jaccard index, were similar over time. Interestingly, current pain intensity was greater than usual pain intensity (P<.001), suggesting that the timing of pain reporting coincided with a more intense pain experience than usual. Usability and acceptance were similar between regular and nonregular users. Regular users were younger (P<.001) and reported a larger total extent of pain than nonregular users (P<.001). Conclusions This is the first study to examine digital reports of pain intensity and distribution in patients with nonmalignant spinal referred pain remotely for a sustained period and barriers of use and compliance using a digital pain mapping app. Differences in age, pain distribution, and current pain intensity may influence reporting behavior and compliance.
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Affiliation(s)
- Maria Galve Villa
- Center for Neuroplasticity and Pain, Center for Sensory Motor Interaction, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Thorvaldur S Palsson
- Center for Sensory Motor Interaction, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Albert Cid Royo
- Center for Neuroplasticity and Pain, Center for Sensory Motor Interaction, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Carsten R Bjarkam
- Department of Neurosurgery, Institute of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Shellie A Boudreau
- Center for Neuroplasticity and Pain, Center for Sensory Motor Interaction, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
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16
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Huang JF, Meng Z, Zheng XQ, Qin Z, Sun XL, Zhang K, Tian HJ, Wang XB, Gao Z, Li YM, Wu AM. Real-World Evidence in Prescription Medication Use Among U.S. Adults with Neck Pain. Pain Ther 2020; 9:637-655. [PMID: 32940899 PMCID: PMC7648792 DOI: 10.1007/s40122-020-00193-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Indexed: 12/29/2022] Open
Abstract
Introduction Neck pain is a common condition that leads to serious pain, disability, and increased healthcare costs worldwide. Pharmacotherapy is one of the most common strategies to reduce neck pain in patients. The aim of this study was to analyze the real-world pattern of drugs prescribed for patients with neck pain in the USA. Methods Data on individuals who reported current neck pain in the 2009−2010 US National Health and Nutrition Examination Survey (NHANES) and with a history of persistent pain for at least 6 weeks or 3 months were extracted from the NHANES database. Those included in the study were divided into three groups based on the duration of pain: the without neck pain group (Group A); subacute group (Group B) with a history of 6 weeks of neck pain; and the chronic neck pain group (Group C) with a history of 3 months of neck pain. The use and duration of medication prescribed for Group A, B, and C patients were compared. Results The analysis revealed that opioid use was significantly more prevalent in the subacute and chronic neck pain group than in the without neck pain group (Group A) (adjusted odds ratio [aOR] 4.20, 95% confidence interval [CI] 2.07–8.52 and aOR 7.00, 95% CI 4.32–11.33, respectively). The factors strongly associated with higher opioid use included older age, low education level, and low family income. In the chronic neck group, opioids, followed in decreasing order of frequency by acetaminophen and nonsteroidal anti-infammatory drugs, were the most common analgesics used in combination with other analgesics. Conclusion Our analysis of the data shows that the long-term excessive use of opioids and the underutilization of other analgesics are two major issues in the treatment of neck pain in the USA. Possible improvements include improved education of patients by healthcare professionals on the use of opioids and more consideration given to non-pharmacotherapy options. Our results reveal the potential problem in pharmacotherapy choices for neck pain treatment and may help improve the current clinical practice in the USA and other countries.
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Affiliation(s)
- Jin-Feng Huang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, Zhejiang, People's Republic of China
| | - Zhou Meng
- Department of Medicine, University of Maryland Medical Center Midtown Campus, Baltimore, MD, 21201, USA
| | - Xuan-Qi Zheng
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, Zhejiang, People's Republic of China
| | - Zongshi Qin
- Li Ka Shing Faculty of Medicine, School of Chinese Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong, China
| | - Xiao-Lei Sun
- Department of Orthopaedics, Tianjin Hospital, Tianjin, 300210, People's Republic of China
| | - Kai Zhang
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedics, Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
| | - Hai-Jun Tian
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedics, Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
| | - Xiao-Bing Wang
- Department of Rheumatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Ze Gao
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Yan Michael Li
- Department of Neurosurgery and Oncology, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY, 14642, USA.
| | - Ai-Min Wu
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, Zhejiang, People's Republic of China.
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17
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Uthaikhup S, Barbero M, Falla D, Sremakaew M, Tanrprawate S, Nudsasarn A. Profiling the Extent and Location of Pain in Migraine and Cervicogenic Headache: A Cross-sectional Single-Site Observational Study. PAIN MEDICINE 2020; 21:3512-3521. [DOI: 10.1093/pm/pnaa282] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
Objectives
The primary aim was to quantify and compare the location and extent of pain in people with either episodic migraine, chronic migraine, or cervicogenic headache. A secondary aim was to examine the associations between pain extent and headache features, quality of life, and psychological distress for each headache type.
Design
A cross-sectional, single-site, observational study.
Setting
Headache outpatient clinic.
Subjects
From a sample of 390 patients, 114 patients with migraine or cervicogenic headache (48 episodic migraine, 30 chronic migraine, 36 cervicogenic headache) were eligible for the study.
Methods
Pain location and extent were determined using a novel approach for digital pain drawing acquisition and analysis. Headache features included intensity and history duration. Quality of life was measured using the SF-36 and psychological distress using the Hospital Anxiety and Depression Scale.
Results
Overall, pain was most frequently reported in the frontal and temporal regions in patients with either episodic or chronic migraine, whereas pain was most frequent in the suboccipital region in patients with cervicogenic headache. A larger pain extent was moderately correlated with higher headache intensity (rs = 0.53, P = 0.003) and poorer quality of life (rs ranged from –0.36 to –0.40, P < 0.05) in patients with chronic migraine, whereas pain extent was associated with longer headache duration in those with cervicogenic headache (rs = 0.35, P = 0.04). No correlation was found between pain extent and psychological features for any headache type (P > 0.05).
Conclusions
Despite some differences, there was a large symptomatic overlap between headache types, highlighting the limitations of using pain location in the differential diagnosis of headache.
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Affiliation(s)
- Sureeporn Uthaikhup
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Marco Barbero
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Munlika Sremakaew
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Surat Tanrprawate
- The Northern Neuroscience Center, Chiang Mai University, Chiang Mai, Thailand
| | - Angkana Nudsasarn
- The Northern Neuroscience Center, Chiang Mai University, Chiang Mai, Thailand
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18
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Clinical Significance and Diagnostic Value of Pain Extent Extracted from Pain Drawings: A Scoping Review. Diagnostics (Basel) 2020; 10:diagnostics10080604. [PMID: 32824746 PMCID: PMC7460462 DOI: 10.3390/diagnostics10080604] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 01/11/2023] Open
Abstract
The current scoping review aimed to map current literature investigating the relationship between pain extent extracted from pain drawings with clinical, psychological, and psycho-physiological patient-reported outcome measures in people with pain. Electronic databases were searched for cross-sectional cohort studies that collected pain drawings using digital technology or a pen-on-paper approach and assessed for correlations between pain extent and clinical, psychological or psycho-physical outcomes. Data were extracted by two different reviewers. The methodological quality of studies was assessed using the Newcastle–Ottawa Quality Assessment Scale. Mapping of the results included: 1, description of included studies; 2, summary of results; and 3, identification of gaps in the existing literature. Eleven cross-sectional cohort studies were included. The pain disorders considered were heterogeneous, ranging from musculoskeletal to neuropathic conditions, and from localized to generalized pain conditions. All studies included pain and/or pain-related disability as clinical outcomes. Psychological outcomes included depression and anxiety, kinesiophobia and catastrophism. Psycho-physical measures included pressure or thermal pain thresholds. Ten studies were considered of high methodological quality. There was heterogeneity in the associations between pain extent and patient-reported outcome measures depending on the pain condition. This scoping review found that pain extent is associated with patient-reported outcome measures more so in patients presenting with musculoskeletal pain, e.g., neck pain or osteoarthritis, rather than for those with neuropathic pain or headache.
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19
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Minetto MA, Busso C, Giannini A, Meiburger K, Massazza G, Maffulli N. Cross-cultural adaptation and validation of the Victorian Institute of Sports Assessment for gluteal tendinopathy questionnaire in Italian and investigation of the association between tendinopathy-related disability and pain. Eur J Phys Rehabil Med 2020; 56:764-770. [PMID: 32638573 DOI: 10.23736/s1973-9087.20.06209-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The Victorian Institute of Sports Assessment for gluteal tendinopathy (VISA-G) questionnaire has recently been proposed as a condition-specific patient reported outcome measurement tool to assess the tendinopathy-related disability. AIM The aim was to evaluate the reliability of the Italian version of the VISA-G questionnaire and its construct validity and to investigate the association between tendinopathy-related disability and pain. DESIGN It consists in a cross-sectional study. SETTING The location of the study was a university laboratory. POPULATION We evaluated patients with gluteal tendinopathy (N.=38) and healthy controls (N.=38). METHODS Subjects were asked to fill the VISA-G questionnaire twice to evaluate its reliability. The construct validity was evaluated by comparing the VISA score with the Oswestry Disability Index score. Moreover, pain intensity, extent and location were also investigated. RESULTS The VISA-G scores showed non-significant changes in the median values and the values of intraclass correlation coefficient showed very high correlation between the first and second administration (ICC>0.90 in both populations). No significant correlations were found between VISA-G score and either pain extent (R=-0.05, P=0.76), or resting pain intensity (R=-0.13, P=0.45), or palpation pain intensity (R= 0.01, P=0.97). Conversely, a high (and significant) negative correlation was obtained between VISA-G score and Oswestry Disability Index score (R=-0.80, P<0.0001). CONCLUSIONS These results indicated that the VISA-G Italian version presents excellent test-retest reliability. CLINICAL REHABILITATION IMPACT The evaluation of gluteal tendinopathy-related disability through VISA-G can be useful for the prognostic assessment and/or follow-up of tendinopathy patients in combination with the pain drawing assessment of pain extent.
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Affiliation(s)
- Marco A Minetto
- Division of Physical Medicine and Rehabilitation, Department of Surgical Sciences, University of Turin, Turin, Italy -
| | - Chiara Busso
- Division of Physical Medicine and Rehabilitation, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Alessandro Giannini
- Division of Physical Medicine and Rehabilitation, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Kristen Meiburger
- BioLab, Department of Electronics and Telecommunications, Polytechnic of Turin, Turin, Italy
| | - Giuseppe Massazza
- Division of Physical Medicine and Rehabilitation, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, School of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy.,Center for Sports and Exercise Medicine, Bart's and London School of Medicine and Dentistry, Queen Mary University, London, UK.,School of Pharmacy and Bioengineering, School of Medicine, Keele University, Stoke on Trent, UK
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20
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Grande-Alonso M, Muñoz-García D, Cuenca-Martínez F, Delgado-Sanz L, Prieto-Aldana M, La Touche R, Gil-Martínez A. Relationship between healthcare seeking and pain expansion in patients with nonspecific chronic low back pain. PeerJ 2020; 8:e8756. [PMID: 32195061 PMCID: PMC7067182 DOI: 10.7717/peerj.8756] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 02/16/2020] [Indexed: 11/20/2022] Open
Abstract
Objectives Low back pain (LBP) is the most prevalent musculoskeletal problem, which implies a high rate of chronicity. The chronicity of symptoms can lead to pain expansion. The main objective of this study was to assess whether there were differences between patients with nonspecific chronic LBP (CLBP) who sought healthcare compared to those who did not in terms of pain expansion. Methods Ninety individuals participated in the study and were divided into three groups: 30 patients who sought care; 30 patients who did not seek care; and 30 asymptomatic individuals. The primary variable analyzed was pain expansion. Secondary physical and psychological variables were assessed later, and a regression analysis was performed. Results Patients who sought help showed significant differences in pain expansion and pain intensity compared with the group who did not seek help, with a medium effect size (0.50–0.79). The regression model for the care-seeking group showed that dynamic balance with the left leg and depression were predictors of percentage pain surface area (34.6%). The combination of dynamic balance, range of movement in flexoextension and depression were predictors of widespread pain (48.5%). Conclusion Patients who soughtcare presented greater pain expansion than patients whodidnot. A combination of functional and psychological variables can significantly predict pain expansion in patients with nonspecific CLBP who seek help.
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Affiliation(s)
- Mónica Grande-Alonso
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Daniel Muñoz-García
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Ferran Cuenca-Martínez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Laura Delgado-Sanz
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - María Prieto-Aldana
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Alfonso Gil-Martínez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain.,CranioSPain Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
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Akıncı B, Zorlutuna B, Gürlek S. KRONİK BOYUN AĞRISI TEDAVİSİNDE ÇENE KASLARI EGZERSİZLERİ İLE BOYUN İZOMETRİK EGZERSİZLERİNİN ETKİNLİKLERİNİN KARŞILAŞTIRILMASI: RANDOMİZE, KONTROLLÜ ÇALIŞMA. DÜZCE ÜNIVERSITESI SAĞLIK BILIMLERI ENSTITÜSÜ DERGISI 2020. [DOI: 10.33631/duzcesbed.590675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Smartphone Application with Virtual Reality Goggles for the Reliable and Valid Measurement of Active Craniocervical Range of Motion. Diagnostics (Basel) 2019; 9:diagnostics9030071. [PMID: 31295869 PMCID: PMC6787724 DOI: 10.3390/diagnostics9030071] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 06/28/2019] [Accepted: 07/09/2019] [Indexed: 11/23/2022] Open
Abstract
Objective: This study aimed to determine the intra-rater and inter-rater reliability and validity of a hybrid device, combining virtual reality goggles, a magnetometer and an inclinometer application for smartphones, to measure craniocervical range. Summary of Background Data: Accurate evaluation of craniocervical range of motion is important for early detection of certain diseased conditions and monitoring the progress of interventions. The universal goniometer is widely used for the measurement but it requires experienced practitioners. Whether a combination of virtual reality goggles and smartphone applications can provide the same or better performance compared with the goniometer is still unknown. Methods: Forty-one healthy adults from the department of physical medicine and rehabilitation were recruited for craniocervical range examination (flexion, extension, side-bending to the right or left and rotating to the right or left) by using the hybrid device and universal goniometer. Using the hybrid device, repeated measurements were performed twice by a primary rater and once by a second rater. The primary rater also conducted a measurement using the universal goniometer in the same cohort. The intra-rater and inter-rater reliability (intra-class correlation coefficient (ICC)) were calculated using the two-way random effect model, whereas the validity was examined by the Pearson correlation coefficient and Bland-and-Altman plot. The interval between the first and second sessions of the measurement for intra-rater reliability was set at 30 min. Results: Excellent intra-rater (ICC ≥ 0.925) and inter-rater (ICC ≥ 0.880) reliability was noted for the hybrid device. The minimal detectable changes from intra-observer and inter-observer comparisons ranged between 4.12° and 7.42° in all six directions. The Bland-and-Altman plot revealed small mean differences (≤1.68°) between the hybrid device and universal goniometer. Both instruments had highly correlated measurements of craniocervical motion (r values ≥ 0.918). Conclusion: For healthy participants, excellent intra-rater and inter-rater reliability was noted for the hybrid device, and the measurements were consistent with the universal goniometer measurements. Future studies are needed to examine whether the device can perform similarly for patients with neck disorders.
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Li L, Huang Q, Barbero M, Liu L, Nguyen T, Xu A, Ji L. Proteins and Signaling Pathways Response to Dry Needling Combined with Static Stretching Treatment for Chronic Myofascial Pain in a RAT Model: An Explorative Proteomic Study. Int J Mol Sci 2019; 20:ijms20030564. [PMID: 30699921 PMCID: PMC6387358 DOI: 10.3390/ijms20030564] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 01/24/2019] [Accepted: 01/25/2019] [Indexed: 01/09/2023] Open
Abstract
A quantitative proteomic analysis of the response to dry needling combined with static stretching treatment was performed in a rat model of active myofascial trigger points (MTrPs). 36 rats were divided into a model group (MG), a stretching group (SG) and a dry needling combined with stretching group (SDG). We performed three biological replicates to compare large-scale differential protein expression between groups by tandem mass tag (TMT) labeling technology based on nanoscale liquid chromatography mass spectrometry analysis (LC–MS/MS). Hierarchical clustering, Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment and protein-protein interaction network analyses were performed for the general characterization of overall enriched proteins. For validation of the results of TMT, the candidate proteins were verified by parallel reaction monitoring (PRM) analysis. 285 differentially expressed proteins between groups were identified and quantified. Tight junction pathway played a dominant role in dry needling combined with static stretching treatment for the rat model of active MTrPs. Three candidate proteins, namely actinin alpha 3, calsequestrin-1 and parvalbumin alpha, were further validated, consistent with the results of LC–MS/MS. This is the first proteomics-based study to report the therapeutic mechanism underlying dry needling and static stretching treatment for MTrPs. Further functional verification of the potential signaling pathways and the enriched proteins is warranted.
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Affiliation(s)
- Lihui Li
- Department of Sport Medicine and Rehabilitation Center, Shanghai University of Sport, Shanghai 200438, China.
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, 6928 Manno, Switzerland.
| | - Qiangmin Huang
- Department of Sport Medicine and Rehabilitation Center, Shanghai University of Sport, Shanghai 200438, China.
| | - Marco Barbero
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, 6928 Manno, Switzerland.
| | - Lin Liu
- Sport and Health Science Department, Nanjing Sport Institute, Nanjing 210014, China.
| | - Thitham Nguyen
- Faculty of Sport Science, Ton Duc Thang University, Ho Chi Minh City 71000, Viet Nam.
| | - Anle Xu
- Department of Sport Medicine and Rehabilitation Center, Shanghai University of Sport, Shanghai 200438, China.
| | - Lijuan Ji
- Department of Sport Medicine and Rehabilitation Center, Shanghai University of Sport, Shanghai 200438, China.
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