The Italian version of the Sickness Impact Profile-Roland Scale for chronic pain: cross-cultural adaptation, reliability, validity and sensitivity to change

Exercise Improves the Impact of Chronic Pain in Older Adults: Results of an RCT

Background:

Chronic Pain (CP) is a crucial determinant for disability in older adults. CP amplifies the impact of other common age-related diseases and increases cardiovascular risk. Physical exercise can improve CP. Randomized Controlled Trials (RCTs) with high-intensity exercise in older adults excluded people with Moderate Chronic Illness (MCI) and CP.

Objective:

This study aimed at evaluating in an RCT whether moderate exercise training can improve chronic pain in a sample of older adults, including people with MCI, and if any modification persists over time.

Methods:

A sample of 120 older adults was randomly selected for a moderate-intensity exercise program or cultural activities (control group). Chronic pain was assessed at t0, at t12 (end of the trial), and t48 weeks, by means of the Italian version of the SIP-Roland Scale.

Results:

Seventy-nine participants completed the follow-up (age 72.3±4.7, women 55.3%). At the end of RCT, an improvement in the SIP scale score was found in the exercise group (p=0.035), showing a lower score than the control group; this difference was not maintained at 48 weeks (p=0.235).

Conclusion:

Our study highlighted that a moderate-intensity exercise intervention reduced chronic pain in older adults, but this effect disappeared at follow-up after 36 weeks from the end of the training program. These findings suggested that such kinds of programs, easily accessible to old people even with MCI, should be implemented and supported over time, thus promoting active aging and preventing CP of age-related diseases.

Clinical Trial Registration: Clinical.Trials.gov.NCT03858114

Active elderly and health-can moderate exercise improve health and wellbeing in older adults? Protocol for a randomized controlled trial

Background

Aging is marked by a progressive rise in chronic diseases with an impact on social and healthcare costs. Physical activity (PA) may soothe the inconveniences related to chronic diseases, has positive effects on the quality of life and biological rhythms, and can prevent the decline in motor functions and the consequent falls, which are associated with early death and disability in older adults.

Methods

We randomized 120 over-65 males and females into groups of similar size and timing and will give each either moderate physical activity or cultural and recreational activities. Being younger than 65 years, inability to participate in physical activity for any medical reason, and involvement in a massive program of physical exercise are the exclusion criteria. The primary outcome measures are: quality of life, walking speed, and postural sway. Participants are tested at baseline, post-treatment, and 6-month (24 weeks) and 12-month (48 weeks) follow-ups.

Discussion

This study aims at improving the quality of life, wellness, and cognitive functioning in the elderly through a low-cost affordable program of moderate physical activity. Given the growing aging of the world population and the social and economic burden of disability in the elderly, our results might have a major impact on future practices.

Trial registration

ClinicalTrials.gov NCT03858114. Registered on 28 February 2019.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-021-05278-6.

The 27-item coping strategies questionnaire-revised: confirmatory factor analysis, reliability and validity in Italian-speaking subjects with chronic pain

BACKGROUND

Increasing attention is being devoted to cognitive-behavioural measures to improve interventions for chronic pain.

OBJECTIVE

To develop an Italian version of the Coping Strategies Questionnaire - Revised (CSQ-R), and to validate it in a study involving 345 Italian subjects with chronic pain.

METHODS

The questionnaire was developed following international recommendations. The psychometric analyses included confirmatory factor analysis; reliability, assessed by internal consistency (Cronbach's alpha) and test-retest reliability (intraclass correlation coefficients); and construct validity, assessed by calculating the correlations between the subscales of the CSQ-R and measures of pain (numerical rating scale), disability (Sickness Impact Profile - Roland Scale), depression (Center for Epidemiological Studies - Depression Scale) and coping (Chronic Pain Coping Inventory) (Pearson's correlation).

RESULTS

Confirmatory factor analysis revealed that the CSQ-R model had an acceptable data-model fit (comparative fit index and normed fit index ≥0.90, root mean square error of approximation ≤0.08). Cronbach's alpha was satisfactory (CSQ-R 0.914 to 0.961), and the intraclass correlation coefficients were good⁄excellent (CSQ-R 0.850 to 0.918). As expected, the correlations with the numerical rating scale, Sickness Impact Profile - Roland Scale, Center for Epidemiological Studies - Depression Scale and Chronic Pain Coping Inventory highlighted the adaptive and maladaptive properties of most of the CSQ-R subscales.

CONCLUSION

The CSQ-R was successfully translated into Italian. The translation proved to have good factorial structure, and its psychometric properties are similar to those of the original and other adapted versions. Its use is recommended for clinical and research purposes in Italy and abroad.

Development of the Italian version of the 42-item Chronic Pain Coping Inventory, CPCI-I: cross-cultural adaptation, factor analysis, reliability and validity

PURPOSE

The aim of this study was to translate and adapt the Italian version of the Chronic Pain Coping Inventory (CPCI) and validate the translation in subjects with chronic non-specific pain of the locomotor system.

METHODS

The questionnaire was developed following international recommendations. The psychometric analyses included factor analysis, reliability by internal consistency (Cronbach's alpha) and test-retest reliability (intraclass coefficient correlation, ICC), and construct validity by calculating the correlations between the subscales of the CPCI with measures of pain (numerical rating scale, NRS), disability (SIP-Roland Scale) and depression (CES-D) (Pearson's correlation).

RESULTS

The CPCI was satisfactorily administered to 270 subjects with chronic non-specific pain. Results of confirmatory factor analyses revealed that, of the CPCI-I 8 subscales, 6 demonstrated good data-model fit (CFI and NFI ≥ 0.90, RMSEA ≤ 0.08). Cronbach's alpha was satisfactory in all of the subscales (0.71-0.80); the ICCs were good/excellent in all of the subscales (0.80-0.91). The correlations with the NRS, SIP-Roland and CES-D were poor in most cases as only the CPCI-Guarding subscale moderately correlated with disability (r = 0.31).

CONCLUSION

The CPCI was successfully translated into Italian and proved to have a good factorial structure and psychometric properties similar to the original and adapted versions. The use of the Italian version of the CPCI is recommended for clinical and research purposes.

The Relationship between Beliefs about Pain and Functioning with Rheumatologic Conditions

Pain beliefs influence understanding of pain mechanisms and outcomes. This study in rheumatologic conditions sought to determine a relationship between beliefs about pain and functioning. Participants in Arthritis New Zealand's (ANZ) exercise and education programmes were used. Demographic data and validated instruments used included the Arthritis Impact Measurement Scale 2nd version-Short Form (AIMS2-SF) to measure functioning, and two scales of organic and psychological beliefs in Pain Beliefs Questionnaires (PBQ) to measure pain beliefs. 236 Members of ANZ were surveyed anonymously with AIMS2-SF and PBQ, with a 61% response rate; 144 responses were entered into the database. This study used α of 0.05 and a 1-β of 0.8 to detect for significant effect size estimated to be r = 0.25. Analysis revealed a significant relationship between organic beliefs scale of PBQ and functioning of AIMS2-SF, with an r value of 0.32 and P value of 0.00008. No relationship was found between psychological beliefs scale of PBQ and AIMS2-SF. Organic pain beliefs are associated with poorer functioning. Psychological pain beliefs are not. Beliefs might have been modified by ANZ programmes. Clinicians should address organic pain beliefs early in consultation. Causal links between organic pain beliefs and functioning should be clarified.