A functional intervention within a cognitive approach to chronic cervical radiculopathy : Description of the non-surgical treatment arm in a randomised controlled trial evaluating the effectiveness of surgery.

BACKGROUND: Most patients with cervical radiculopathy improve within the first months without treatment or with non-surgical treatment. A systematic review concluded that these patients improve, regardless of their intervention. Still, many patients are offered surgery, despite limited evidence regarding the indications for surgical treatments. The aim of this article is to describe the intervention that is going to be followed in the non-surgical treatment arm of a randomised controlled trial (RCT) comparing the effectiveness of surgical and non-surgical treatment for patients with cervical radiculopathy. METHODS: The non-surgical intervention is a functional intervention within a cognitive approach founded on previous experiences, and current recommendations for best practice care of musculoskeletal pain and cervical radiculopathy. It is based on the biopsychosocial rather than a biomedical perspective, comprises an interdisciplinary approach (physicians, physiotherapy specialists), and includes brief intervention and graded activities. The intervention consists of 6 sessions over 12 weeks. The primary goals are first, to validate the patients´ symptoms and build a therapeutic alliance, second, to explore the understanding and promote alternatives, and third, to explore problems and opportunities based on patients´ symptoms and function. Motivational factors toward self-management are challenging. We will attempt shared decision-making in planning progress for the individual patient and emphasise learning of practical self-help strategies and encouragement to stay active (reinforcing the positive natural course). General physical activities such as walking will be promoted along with simple functional exercises for the neck- and shoulder region. We will also explore social activity, comorbidities, pain location, sleep, and work-related factors. The health providers will set individualised goals together with each patient. DISCUSSION: The aim of the intervention is to describe a functional intervention within a cognitive approach for patients with chronic cervical radiculopathy. The effectiveness of the present program will be compared to surgery in a randomised controlled trial.

Craniocervical Pain, Sleep Quality, Depressive Symptoms, and Physical Activity in Healthcare Workers During COVID-19 Pandemic.

BACKGROUND: An increase in the workload and use of personal protective equipment by healthcare workers was observed during the COVID-19 pandemic. Due to the connections between craniocervical structures, symptoms such as neck pain and temporomandibular symptoms could be influenced by the use of PPE. AIMS: To assess the prevalence of craniocervical pain, sleep quality, physical activity, and depressive symptoms and relationship among craniocervical symptoms in healthcare workers before and during the COVID-19 pandemic in Brazil. DESIGN: Cross-sectional study. PARTICIPANTS: Healthcare workers. SETTINGS: An online questionnaire included a self-report of craniocervical pain intensity [orofacial pain, neck pain, and headache (Numerical Rating Scale)], sleep quality (Pittsburgh Sleep Quality Index), depressive symptoms (Patient Health Questionnaire two items) and physical activity (self-report). METHODS: The sample analysis was performed by descriptive statistics, the paired t-test was used to compare symptoms intensity before and during the pandemic. The relationship between dependent and independent samples was assessed through McNemar test, Pearson's chi-squared test, and Student's independent t-test. A value of p < .05 was adopted as statistical significance. RESULTS: Overall, 147 participants replied the questionnaires. Headache, neck pain, and orofacial pain complaints increased during the pandemic in healthcare workers (p < 0.001). Craniocervical pain was correlated with poor sleep quality, probable depression, and physical activity during the pandemic (p < 0.05). CONCLUSION: Healthcare workers self-reported more craniocervical pain during the COVID-19 pandemic compared to before the pandemic. In addition, poor sleep quality, depressive symptoms, and physical inactivity were associated with craniocervical symptoms during this period.

Longitudinal Changes and Associations Between Quantitative Sensory Testing and Psychological Factors in Whiplash-Associated Disorders: A Systematic Review and Meta-Analyses-Based Data Synthesis.

Whiplash-associated disorders (WAD) represent a multifactorial condition often accompanied by altered nociceptive processing and psychological factors. This systematic review on acute and chronic WAD aimed to investigate the relationship between quantitative sensory testing (QST) and psychological factors and quantify whether their trajectories over time follow a similar pattern to disability levels. Eight databases were searched until October 2022. When 2 prospective studies examined the same QST or psychological variable, data synthesis was performed with random-effects meta-analysis by pooling within-group standardized mean differences from baseline to 3-, 6-, and 12-month follow-ups. From 5,754 studies, 49 comprising 3,825 WAD participants were eligible for the review and 14 for the data synthesis. Altered nociceptive processing in acute and chronic WAD, alongside worse scores on psychological factors, were identified. However, correlations between QST and psychological factors were heterogeneous and inconsistent. Furthermore, disability levels, some QST measures, and psychological factors followed general positive improvement over time, although there were differences in magnitude and temporal changes. These results may indicate that altered psychological factors and increased local pain sensitivity could play an important role in both acute and chronic WAD, although this does not exclude the potential influence of factors not explored in this review. PERSPECTIVE: Acute WAD show improvements in levels of disability and psychological factors before significant improvements in nociceptive processing are evident. Facilitated nociceptive processing might not be as important as psychological factors in chronic WAD-related disability, which indicates that chronic and acute WAD should not be considered the same entity although there are similarities. Nonetheless, pressure pain thresholds in the neck might be the most appropriate measure to monitor WAD progression.

Chronic neck and low back pain from personal experiences: a written narrative approach.

Background: Chronic neck and low back pain are very common and have detrimental effects for people and society. In this study, we explore the experiences of individuals with neck and/or back pain using a written narrative methodology. Materials & methods: A total of 92 individuals explained their pain experience using written narratives. Narratives were analyzed through thematic analysis and text data mining. Results: Participants wrote about their experience in terms of pain characteristics, diagnosis process, pain consequences, coping strategies, pain triggers, well-being and future expectations. Text data mining allowed us to identify concurrent networks that were basically related with pain characteristics, management and triggers. Conclusion: Written narratives are useful to understand individuals' experiences from their point of view.

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Psychophysiological responses to a multimodal physiotherapy program in fighter pilots with flight-related neck pain: A pilot trial.

BACKGROUND: The physical and cognitive demands of combat flying may influence the development and persistence of flight-related neck pain (FRNP). The aim of this pilot study was to analyse the effect of a multimodal physiotherapy program which combined supervised exercise with laser-guided feedback and interferential current therapy on psychophysiological variables in fighter pilots with FRNP. METHODS: Thirty-one fighter pilots were randomly assigned to two groups (Intervention Group: n = 14; Control Group: n = 17). The intervention consisted of 8 treatment sessions (twice per week) delivered over 4 weeks. The following primary outcomes were assessed: perceived pain intensity (Numeric Pain Rating Scale-NPRS) and Heart Rate Variability (HRV; time-domain, frequency-domain and non-linear variables). A number of secondary outcomes were also assessed: myoelectric activity of the upper trapezius and sternocleidomastoid, pain catastrophizing (Pain Catastrophizing Scale-PCS) and kinesiophobia (TSK-11). RESULTS: Statistically significant differences (p≤0.05) within and between groups were observed for all outcomes except for frequency domain and non-linear HRV variables. A significant time*group effect (one-way ANOVA) in favour of the intervention group was found for all variables (p<0.001). Effect sizes were large (d≥0.6). CONCLUSIONS: The use of a multimodal physiotherapy program consisting of supervised exercise with laser-guided feedback and interferential current appears to show clinical benefit in fighter pilots with FRNP. TRIAL REGISTRATION: ClinicalTrials.gov: NCT05541848.

Higher Neck Pain Intensity and Pain Catastrophizing Soon After A Whiplash Injury Partially Explain the Presence of Persistent Headache: A Prospective Study.

OBJECTIVE: To understand whether pain-related factors soon after a whiplash injury can explain the presence of chronic headache. MATERIALS AND METHODS: A prospective study with a follow-up of 6 months was performed, including 42 patients with acute whiplash-associated disorders. Neck pain intensity, the Neck Disability Index, the Tampa Scale of Kinesiophobia, the Pain Catastrophizing Scale, and the Anxiety State-Trait Scale were assessed at baseline. Differences in clinical characteristics between those with and without headache at 6 months were determined. The relative risk of presenting with headache was evaluated. A logistic regression model was performed to assess which factors at baseline could explain the presence of headache at 6 months. RESULTS: At 6 months, one-third of the sample presented with chronic headache. Significant differences were found for several outcome measures when people with and without headache were compared ( P <0.001). The highest relative risk of presenting with headache was found for moderate/severe levels of pain catastrophizing during the acute phase (RR=15.00, 95% CI=3.93, 57.22). The level of neck pain intensity and pain catastrophizing at baseline partially explained the presence of headache at 6 months ( R2 =0.627). DISCUSSION: The risk of presenting with persistent headache attributed to a whiplash injury is increased when people present with higher neck pain intensity and pain catastrophizing soon after a whiplash injury. Evaluating neck pain intensity and pain catastrophizing at baseline may assist in identifying those more likely to develop chronic headache, potentially providing an opportunity for early targeted interventions.

Translation and validation of Neck Bournemouth Questionnaire to Brazilian Portuguese / Tradução e validação do Neck Bournemouth Questionnaire para o português do Brasil

Abstract Objective: To translate the Neck Bournemouth Questionnaire to Brazilian Portuguese, cross-culturally adapt, and to verify its validity and its reliability. Methods: The development of the Brazilian version of Neck Bournemouth Questionnaire (Brazil-NBQ) was based on the guideline proposed by Guillemin. The applied process consisted of translation, back-translation, committee review and pre-test. Sixty-one volunteers presenting neck pain participated in this study. Thirty-five of them participated during pre-testing phase to verify the instrument comprehension, and the remaining 26 took part during psychometric analysis. Psychometric evaluation included interrater and intrarater reliability and construct validity (correlation among Brazil-NBQ, SF-36, Numerical rating score and Neck Disability Index). Results: Some terms and expressions were changed to obtain cultural equivalence for Brazil-NBQ during the translation phase. The NBQ showed an intrarater ICC of 0.96 and interrater ICC of 0.87. Construct validity analysis showed moderate correlations with SF-36 and strong correlation with Numerical rating score and Neck Disability Index. Conclusion: Neck Bournemouth Questionnaire was translated and culturally adapted to Portuguese language, and it demonstrated to be valid and reliable to evaluate patients’ neck pain.

Resumo Objetivo: Traduzir o Neck Bournemouth Questionnaire para o português do Brasil, adaptá-lo culturalmente e verificar a sua validade e confiabilidade. Métodos: O desenvolvimento da versão brasileira do Neck Bournemouth Questionnaire (NBQ-Brasil) foi baseado nas diretrizes propostas por Guillemin. O processo aplicado consistiu em tradução, retrotradução, revisão por um comitê e pré-teste. Participaram deste estudo 61 voluntários que apresentavam dor cervical; 35 deles participaram durante a fase de pré-teste para verificar a compreensão do instrumento e os 26 restantes durante a análise psicométrica. A avaliação psicométrica incluiu a análise da confiabilidade interavaliadores e intra-avaliador e da validade do construto (correlação entre o NBQ-Brasil, o SF-36, a escala numérica de dor e o Neck Disability Index). Resultados: Alguns termos e algumas expressões foram alterados para se obter equivalência cultural com o NBQ-Brasil durante a fase de tradução. O NBQ mostrou uma CCI intra-avaliador de 0,96 e CCI interavaliadores de 0,87. A análise da validade do construto mostrou correlações moderadas com o SF-36 e correlação forte com a escala numérica de dor e o Neck Disability Index. Conclusão: O Neck Bournemouth Questionnaire foi traduzido e adaptado culturalmente para o idioma português e demonstrou ser válido e confiável para avaliar a dor cervical dos pacientes.

Programa de entrenamiento en coherencia cardiaca para la reducción del estrés en personal sanitario con cervicalgia crónica: un estudio piloto / Training program in cardiac coherence for stress reduction in healthcare personnel with chronic neck pain: a pilot study

La presente nota clínica tiene por objetivo divulgar los resultados de un trabajo piloto para valorar las potencialidades de un entrenamiento en coherencia cardiaca (CC) para la reducción del estrés en personal sanitario con cervicalgia crónica. Para ello, 8 enfermeras participaron en un programa de entrenamiento en CC y se evaluadas pre/post en los siguientes factores: dolor (EVA), inteligencia emocional (TMMS-24), sintomatología ansioso-depresiva (escalas Hamilton y Goldberg) y estrés laboral (NSS). Tras el entrenamiento se observó una disminución significativa en las puntuaciones de dolor y su sintomatología asociada (contracturas, dolor por movilidad y parestesias), así como en la sintomatología depresiva. Asimismo, se observaron mayores puntuaciones en inteligencia emocional (escala de percepción) (AU)

This case report aims to disseminate the results of a pilot study exploring the potentialities of training program in cardiac coherence (CC) for reducing stress in nurses with chronic neck pain. For this purpose, 8 nurses participated in a training program in CC and were evaluated pre/post on the following factors: pain (VAS), emotional intelligence (TMMS-24), anxious depressive symptoms (Hamilton & Goldberg scales) and job related stress (NSS). After the training, a significant decrease in pain scores and associated symptoms (spasms, pain due to mobility and paresthesias) as well as depressive symptoms was observed. Also, higher scores were observed in emotional intelligence (perception scale) (AU)

The physical, social and emotional aspects are the most affected in the quality of life of the patients with cervical dystonia / Os aspectos físicos, sociais e emocionais são os mais afetados na qualidade de vida dos pacientes com distonia cervical

Objective : Describe the functional, clinical and quality of life (QoL) profiles in patients with cervical dystonia (CD) with residual effect or without effect of botulinum toxin (BTX), as well as verify the existence of correlation between the level of motor impairment, pain and QoL. Method : Seventy patients were assessed through the Craniocervical dystonia questionnaire-24 (CDQ-24) and the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). Results : The greater the disability, pain and severity of dystonia, the worse the QoL (p<0.0001). Greater severity relates to greater disability (p<0.0001). Pain was present in 84% of the sample, being source of disability in 41%. The most frequent complaints were: difficulty in keeping up with professional and personal demands (74.3%), feeling uneasy in public (72.9%), hindered by pain (68.6%), depressed, annoyed or bitter (47.1%), lonely or isolated (32.9%). Conclusion : The physical, social and emotional aspects are the most affected in the QoL of these patients. .

Objetivo : Descrever o perfil funcional, clínico e de qualidade de vida (QV) de pacientes com distonia cervical (DC) com efeito residual ou sem efeito da toxina botulínica (BTX), bem como verificar a existência de correlação entre o nível de comprometimento motor, dor e QV. Método : Setenta pacientes foram avaliados através do Craniocervical dystonia questionnaire-24 (CDQ 24) e Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). Resultados : Quanto maior a incapacidade, dor e gravidade da distonia pior a QV (p<0,0001). A maior gravidade está relacionada à maior incapacidade (p<0,0001). A dor esteve presente em 84% da amostra sendo fonte de incapacidade em 41%. Dificuldade em manter-se com as demandas profissionais e pessoais (74,3%), sentir-se desconfortável em público (72,9%), prejudicado pela dor (68,6%), deprimido, irritado ou amargurado (47,1%), solitário ou isolado (32,9%) foram as queixas mais frequentes. Conclusão : Os domínios físico, social e emocional são os mais prejudicados na QV desses pacientes. .

Influencia de la personalidad en el dolor cervical postraumático / Influence of the personality in the cervical posttraumatic pain

El dolor cervical postraumático es una de las afecciones más comunes en la consulta diaria del médico forense. Se trata de procesos que en principio no revisten gravedad, pero que resultan muy invalidantes, pues dan lugar a una disminución de la actividad del lesionado en todos los ámbitos de la vida diaria. Basándonos en esto, presentamos un estudio con una muestra de 50 lesionados, aquejados de cervicalgias agudas de origen traumático, y determinamos los principales rasgos de personalidad de cada uno de ellos utilizando el Cuestionario EPQ-A de Eysenck para la valoración de la personalidad y el Inventario Multidimencional de Dolor West-Haven-Yale (WHYMPI). Los resultados obtenidos indican que las mujeres con dolor cervical postraumático presentan mayores grados de neuroticismo y menores de sinceridad, mientras que los hombres presentan igualmente una baja sinceridad. En cuanto a la valoración del dolor, los resultados muestran que conforme reciben tratamiento experimentan una disminución en la gravedad del dolor y en la influencia del dolor en la vida diaria (AU)

Posttraumatic cervical pain, is one of the most common pathologies in the daily consultation of forensic doctor. These processes are in principle not serious, but resulting in disability, which leads to a decreased activity of the injured person in all the areas of daily life. Based on this, we present a study with a sample of 50 injured persons, suffering from acute cervical pain of traumatic origin and we determine the principal feature of personality of each one of them, using the Questionnaire EPQ-A of Eysenck for the valuation of the personality and a Multidimensional Pain Inventory West-Haven-Yale (WHYMPI). From the obtained results we determine that women with posttraumatic cervical pain present mayor levels of neuroticism and minors of sincerity, whereas men present similar low levels of sincerity. As for the valuation of the pain, the results indicate us that treated accordingly, experience a decrease in both the severity of pain as a decrease in the influence of pain on daily life of the injured person (AU)

Relación entre el perfil clínico y la tensión neural en personas con dolor cervical crónico / Relationship between clinical profile and neural tension in people with chronic neck pain

Introducción y objetivos: El dolor cervical crónico (DCC) confluye con una gran variedad de signos y síntomas, tales como la tensión neural y las alteraciones conductuales. Este estudio pretende evaluar la relación entre la tensión neural y el perfil clínico de los pacientes con DCC. Materiales y métodos: Se llevó a cabo un estudio observacional de corte transversal. Se incluyeron 25 pacientes con DCC y 25 personas sin dolor. Se evaluó el perfil clínico incluyendo las variables físicas (dolor, discapacidad), y las variables psicológicas y/o comportamentales (ansiedad, depresión, calidad de vida, miedo al movimiento y conductas de miedo-evitación). La tensión neural se midió a través de pruebas de neurodinamia. Resultados: Los sujetos con DCC presentaron una alteración significativa de la tensión neural, en comparación con las personas sin dolor. Se halló una correlación significativa entre los test de neurodinamia y las conductas y creencias sobre el dolor, así como su interferencia en la vida diaria. Adicionalmente se mostró una relación significativa entre las creencias y actitudes sobre el dolor y la intensidad e interferencia del mismo, la discapacidad y el estado de salud percibido. Conclusiones: Los pacientes con DCC muestran peores resultados que el grupo sin dolor en los test de neurodinamia del miembro superior. La neurodinamia se relaciona con las variables psicológicas y comportamentales medidas

Introduction and objectives: Chronic neck pain includes a wide variety of signs and symptoms, such as neural tension and behavioural changes. The aim of this study was to evaluate the relationship between neural tension and the clinical profile of patients with chronic neck pain. Materials and methods: We carried out a cross-sectional observational study. We included 25 patients with chronic neck pain and 25 without pain. The clinical profile was evaluated including physical variables (pain, disability), and psychological and / or behavioural variables (anxiety, depression, quality of life, fear of movement and fear-avoidance behaviours). Neural tension was measured through neurodynamic tests. Results: The subjects with chronic neck pain had worse neural tension results compared with the controls. A significant correlation was found between the neurodynamic tests and the psychological and behavioural variables. Additionally, there was a significant relationship between beliefs and attitudes about pain and daily life interference, disability and perceived health status. Conclusions: The patients with chronic neck pain had worse results than the painless group in the upper limb neurodynamic tests. Neurodynamics related to the psychological and behavioural variables

Physical and psychosocial risk factors for musculoskeletal disorders in Brazilian and Italian nurses / Fatores de risco físico e psicossocial para distúrbios musculoesqueléticos em enfermeiras brasileiras e italianas

As part of the international CUPID investigation, we compared physical and psychosocial risk factors for musculoskeletal disorders among nurses in Brazil and Italy. Using questionnaires, we collected information on musculoskeletal disorders and potential risk factors from 751 nurses employed in public hospitals. By fitting countryspecific multiple logistic regression models, we investigated the association of stressful physical activities and psychosocial characteristics with site-specific and multisite pain, and associated sickness absence. We found no clear relationship between low back pain and occupational lifting, but neck and shoulder pain were more common among nurses who reported prolonged work with the arms in an elevated position. After adjustment for potential confounding variables, pain in the low back, neck and shoulder, multisite pain, and sickness absence were all associated with somatizing tendency in both countries. Our findings support a role of somatizing tendency in predisposition to musculoskeletal disorders, acting as an important mediator of the individual response to triggering exposures, such as workload.

Como parte da pesquisa internacional CUPID, comparamos os fatores de risco físico e psicossocial para distúrbios osteomusculares entre enfermeiras no Brasil e na Itália. Foram coletados dados com questionários sobre distúrbios osteomusculares e seus fatores de risco potenciais com 751 enfermeiros de hospitais públicos. Com modelos de regressão logística específicas para cada país, investigamos a associação entre atividades físicas estressantes e as características psicossociais, com dores em sítios específicos e múltiplos, assim como ausências motivadas por doença. Não encontramos clara relação entre dor lombar e levantamento de pesos, porém dores no pescoço e ombros foram as mais relatadas entre as enfermeiras que realizam trabalho prolongado, com braços elevados. As dores na lombar, pescoço, ombros e em múltiplos sítios foram associadas à tendência somatizante e à ausência por doença em ambos os países. Nossos achados reforçam o papel da tendência somatizante como fator predisponente para distúrbios osteomusculares, atuando como um importante mediador da resposta individual.

Calidad de vida y discapacidad por dolor cervical en jóvenes universitarios de la facultad de ciencias médicas

INTRODUCCIÓN: La consulta por dolor cervical (DC) es muy frecuente en elprimer nivel de atención, y afecta a dos tercios o más de la población general enalgún momento de su vida. Se experimenta por primera vez en la infancia o laadolescencia tomando un curso episódico, convirtiéndose en un predictor de lamorbilidad de esta dolencia en el adulto. OBJETIVOS: Determinar la fiabilidad yvalidez del instrumento, describir la intensidad y prevalencia de DC, establecer laCalidad de Vida Referida a Salud (CVRS), la discapacidad cervical y su influenciaen actividades de la vida diaria, y analizar la relación entre intensidad y discapacidadpor DC, y la CV en la población de estudio. MATERIAL Y MÉTODO: Estudioobservacional, descriptivo y correlacional, de diseño transversal, en alumnos del 2doaño de la FCM, de quienes se valoró: CVRS, discapacidad cervical y dolor. Lasvariables fueron estudiadas por el método de datos categorizados y análisis deregresión. Se consideró una significación de 0,05. RESULTADOS: Participaron 465estudiantes de 20,8±0,11 años, de los cuales el 57,73% fueron mujeres. Losinstrumentos demostraron alta validez y fiabilidad. La prevalencia puntual de DC fuedel 86,06%, con una intensidad del entre leve y moderada sin diferencias entre lossexos. La CVRS mostró ser mejor percibida en varones, sin cambios en el últimoaño. El 39,87% de la población tenía discapacidad leve y moderada, mayormente enmujeres, en actividades de lectura, concentración, generando cefalea. El análisismultivariado asoció las variables estudiadas de manera coherente, destacado losestados de mayor o menor CVRS percibida, con los diferentes grados dediscapacidad y la presencia o no de DC. CONCLUSIÓN: La población de estudiopresenta una prevalencia elevada de dolor cervical de intensidad baja a moderada,sobre todo en mujeres. El DC y su rol emocional podrían afectar capacidades básicasen los estudiantes que condicionarían el desempeño de su rol académico.

INTRODUCTION: The query for neck pain (NP) is very common in primary care,affecting two-thirds or more of the general population at some point in their lives. Itis first experienced in childhood or adolescence taking an episodic course, becominga predictor of morbidity of this medical condition in adults. OBJECTIVES: Todetermine the reliability and validity of the instrument, describe the intensity andprevalence of neck pain (NP), found Health-Related to Quality of Life (HRQoL),neck disability and their influence on activities of daily living, analyze therelationship between intensity and disability DC, and HRQoL in the studypopulation. MATERIAL AND METHODS: Observational, descriptive andcorrelational study, with cross-sectional design, in the 2nd year students of the FCM,who are assessed: HRQOL, disability and cervical pain. The variables were studiedby the method of categorical data and regression analysis, a significance of 0.05 wasconsidered. RESULTS: A total of 465 students from 20.8 ± 0.11 years, of which57.73% were women. The instruments demonstrated high validity and reliability.The point prevalence of NP was 86.06%, with an intensity of mild and moderatepain, with no difference between the sexes. The HRQoL proved to be betterperceived in males, unchanged over the last year. The 39.87% of the population hadmild to moderate disabilities, mostly in women, in reading activities, concentration,causing headache. Multivariate analysis associated variables studied consistentlyhighlighted states of varying perceived HRQoL, with varying degrees of disabilityand the presence or absence of NP. CONCLUSION: The study population has ahigh prevalence of neck pain of low to moderate intensity, especially in women. TheNP and emotional role could affect basic skills in students that condition theperformance of their academic role.

Spanish version of the avoidance-endurance questionnaire: factor structure and psychometric properties

To analyze the factorial structure and psychometric properties of the Spanish adaptation of the AEQ, and to validate it by reporting relevant pain-related variables, which were not investigated in the original study. One hundred and fifty Spanish patients diagnosed with chronic back and neck pain were referred by physicians from different pain clinics in Spain; all the patients filled out the questionnaires at their clinic. A series of principal components analyses (PCA) was performed to develop the Spanish version of the AEQ. Reliability and validity were also calculated. The PCAs revealed five fear-avoidance scales (Kaiser-Meyer-Olkin measures were between .60 and .88, and Bartlett’s tests were significant, p < .01): the Depression scale (DS), Anxiety scale (AS), Catastrophizing scale (CS), Helplessness/hopelessness scale (HHS), and Avoidance of Social and Physical Activities scale (ASPAS), and three endurance-related responses scales: Pain Persistence Behaviour and Distraction scale (PPDS), Ignoring Pain scale (IPS), and Humor scale (HS). All the scales showed high internal consistency (α > .73) and suitable validity (p < .05). New results associated with pain-related cognitive/affective and behavioural responses are discussed. This instrument will probably help clinicians to identify Spanish patients at a high risk of chronicity and to develop treatments tailored to the different profiles in order to improve secondary and tertiary prevention in back and neck pain (AU)

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Personality traits and sick leave in workers diagnosed with nonorganic neck pain

Previous research has suggested that personality can influence the perception and reporting of physical symptoms, such as pain. To assess the relationship between the course of nonorganic neck pain and the individual’s personality, we studied the association between two indicators of neck pain prognosis, such as the duration of sick leave associated with neck pain and sick leave recurrence, and 15 personality traits in a sample of 64 workers suffering from disabling neck pain without any signs of physical abnormalities in the neck area. The TEA Personality Test (TPT), a selfreport instrument designed to evaluate personality traits related to organizational behaviors, was used. Compared to the normative data, the study sample obtained high scores in the Depression, Anxiety and Emotional Instability scales, thus suggesting a personality profile primarily characterized by high neuroticism-related scores. Controlling for age, gender, and any rehabilitation undergone, we found a positive relationship between Depression and the duration of sick leave (in weeks). Moreover, lower scores on the TPT personality trait Dynamism and activeness were associated with higher likelihood of sick leave recurrence. These findings highlight the need for further research into the role played by personality at the onset and in the maintenance of nonorganic neck pain. Furthermore, they suggest that a complementary psychological approach may be useful to nonorganic neck pain management (AU)

Diversos estudios de investigación sugieren que la personalidad se relaciona con la percepción y quejas de síntomas físicos, tales como el dolor. Con el objetivo de explorar la relación entre la evolución del dolor cervical sin alteración orgánica y la personalidad del individuo, analizamos la asociación entre dos indicadores del pronóstico de dolor cervical, tales como la duración y la recurrencia de la baja laboral, y 15 rasgos de personalidad en una muestra de 64 trabajadores en situación de baja laboral con diagnóstico de dolor cervical sin alteración orgánica. Para la evaluación de los rasgos de personalidad utilizamos el cuestionario de personalidad de TEA, TPT. Este instrumento evalúa específicamente rasgos de personalidad que son relevantes en el contexto laboral. En comparación con los datos normativos referentes a población española proporcionados en el manual del cuestionario, nuestra muestra de estudio obtuvo puntuaciones significativamente más elevadas en Depresión, Ansiedad y Labilidad emocional. Estos datos sugieren un perfil de personalidad en estos trabajadores con tendencia al neuroticismo. Controlando el efecto de la edad, el género y el hecho de haber realizado rehabilitación para el problema de dolor, encontramos una relación positiva entre las puntuaciones en la escala Depresión y la duración de la baja. De otro lado, puntuaciones más bajas en la escala Dinamismo y actividad se relacionó con una mayor probabilidad de recurrencia de la baja laboral. Estos resultados preliminares enfatizan la necesidad de explorar de manera más detallada el rol que juega la personalidad del individuo en la aparición y el mantenimiento del dolor cervical sin alteración orgánica. Así mismo, nuestros datos sugieren que un abordaje psicosocial, complementario al tratamiento médico que reciben estos pacientes, podría resultar útil para el manejo del dolor cervical (AU)

Simulación en patología dolorosa crónica del raquis cervical (cervicalgia/esguince cervical) / Detection of malingering in chronic painful condition of the cervical spine (neck pain/whiplash injury)

Se presenta una aproximación a la situación actual de la detección de simulación en la patología dolorosa del raquis cervical, basada en la idea central de la convergencia de datos que proceden de diferentes fuentes de información. La evaluación del paciente ha de ser multimétodo, multisistema y multidisciplinar, utilizando diferentes pruebas médicas y psicológicas actualmente contrastadas. En aquéllas ocasiones en las que el clínico sospecha la existencia de simulación (por ejemplo en el caso de algunos esguinces cervicales), la dificultad radica en definir en primer lugar si existe o no un patrón de exageración de síntomas, y en segundo lugar si el paciente es o no un simulador. Se plantea un protocolo de actuación para esta sospecha en el caso de cervicalgia/esguince cervical. Cuantas más pruebas independientes entre sí evidencien un patrón similar de exageración de síntomas, mayor certeza tendrá el evaluador a la hora de expresar sus conclusiones(AU)

An updated review of the literature on detection of malingering in chronic painful condition of the cervical spine is addressed. The detection of malingering is mainly based on the convergence of different sources of information. Indeed, patient assessment must use multiple methods, examine multiple systems and be multidisciplinary oriented, by using different empirical-based medical and psychological tests, instruments and procedures. In the presence of simulation suspect by the clinician (e.g. some whiplash injury cases), two aspects must be clarified in order to determine the presence of: (1) pattern of symptom exaggeration, and (2) malingering. In order to do this, a clinical multidisciplinary protocol is presented and detailed for the assessment of malingering in cases of neck pain/whiplash injury. The key aspect that the clinician must take into account is, that the more independent the tests, strategies and procedures show patterns of symptom exaggeration, the more certain will be our conclusions(AU)

Variables psicosociales y de personalidad asociadas a la cervicalgia recurrente / Psychosocial and personality variables related to recurrent cervicalgia

El objetivo del presente estudio es evaluar la relación existente entre variables de personalidad y bienestar en pacientes diagnosticados de cervicalgia. Para ello, se seleccionó una muestra de sujetos con diagnóstico y baja laboral por cervicalgia procedentes de dos mutuas de accidentes de trabajo de la ciudad de Murcia. Los resultados indican que la mitad de los sujetos de la muestra tiene una estructura de personalidad desadaptativa, con un claro perfil “neurótico”. Este perfil se caracteriza por inestabilidad emocional, escasos recursos para afrontar las situaciones de estrés y dificultades para adaptarse e implicarse activamente en el trabajo. El 61,9% de los participantes muestra una estructura de personalidad inapropiada para tener éxito laboral. Así mismo, el 49,1% perciben claramente un malestar psicológico que se focaliza en la presencia de síntomas somáticos. La presencia de sintomatología ansioso-depresiva es un indicador de mal pronóstico con relación a la duración de la baja. El perfil de personalidad “neurótica” y la presencia de cuadros depresivos se relacionan con la recurrencia de los cuadros cervicálgicos. Con respecto a la prevención, los resultados sugieren que la evaluación y el tratamiento de aspectos psicopatológicos serían importantes para reducir las bajas laborales, minimizar su duración y evitar las recurrencias

The objective of the present work is to evaluate the relationship between personality variables and wellness among patients diagnosed with cervicalgia. A sample of subjects with cervicalgia and on sick-leave was recruited from two sickness and accident insurance companies at the city of Murcia. About half of the sample showed not to have a well-adapted personality, with a clear “neurotic” profile. This profile was characterised by emotional instability, poor resources to cope with stress and difficulties to be adapted and involved into the work life. 61.9% of participants showed a personality structure non-efficient to achieve work success. In this way, 49.1% reported some psychological discomfort, which was often expressed in soma to form symptoms. Regarding the sick-leave length, the presence of anxious- depressive symptoms was an indicator of worse prognosis. The “neurotic” personality profile and the depressive symptoms were related to the neck pain recurrence. With relation to prevention, our results suggest that taking into account the evaluation and treatment of psychopathological aspects may be of help to minimize the number of sick-leaves, reduce their length and prevent their recurrence

Personalidad y funcionamiento psicosocial en pacientes con cervicalgia aguda / Personality and psychosocial functioning in patients with acute cervical pain

Objetivo: El presente estudio ha pretendido analizar la correlación entre personalidad e influencia del dolor en la vida cotidiana de pacientes con problemas cervicales agudos de tipo musculoesquelético. Método: Fueron estudiados 50 pacientes que solicitaban tratamiento por dolor cervical agudo; los pacientes fueron evaluados al principio del tratamiento fisioterapéutico, utilizando el Cuestionario de Personalidad de Eysenck (EPQ-A) y el Inventario Multidimensional de West Haven-Yale para el Dolor (WHYMPI), el cual fue aplicado también al final del tratamiento. Resultados: Los datos del WHYMPI demostraron la efectividad global del tratamiento. Por otro lado, la influencia del dolor en la vida de los pacientes apareció correlacionada directamente con los niveles de neuroticismo detectados por el EPQ, mientras que el nivel de actividad diaria estaba directamente asociado con la extraversión y negativamente asociado con el psicoticismo. Conclusiones: Estos resultados confirman la correlación existente entre rasgos de personalidad específicos y nivel de funcionamiento personal en varias áreas psicosociales en los pacientes con trastornos musculoesqueléticos, y justifica la necesidad de una valoración psicológica/psicopatológica en estos pacientes (AU)