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1.
Sci Rep ; 12(1): 12042, 2022 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-35835830

RESUMO

The Pain Catastrophizing Scale (PCS) is a widely studied tool to assess pain catastrophizing for chronic low back pain (LBP). Short forms of the PCS exist, but their measurement precision at individual level is unclear. This study aimed to analyze the Rasch psychometric characteristics of the PCS and three of its short forms (two 4-item and one 6-item) in a sample of 180 Italian-speaking patients with chronic LBP, and compare their measurement precision at the individual level. We performed a Rasch analysis on each version of the PCS and calculated test information functions (TIFs) to examine conditional measurement precision. Rasch analysis showed appropriate rating category functioning, unidimensionality, and acceptable fit to the Rasch model for all PCS versions. This represented a prerequisite for performing further advanced psychometric analyses. According to TIFs, the PCS full scale showed-at any score level-higher measurement precision in estimating individual pain catastrophizing than its short forms (which had unacceptably high standard errors of measurement). Our results show acceptable conditional precision of the PCS full scale in estimating pain catastrophizing. However, further studies are needed to confirm its diagnostic accuracy at individual level. On the other hand, the study warns against use of the three PCS short forms for clinical decision-making at the individual level.


Assuntos
Dor Crônica , Dor Lombar , Catastrofização , Dor Crônica/diagnóstico , Humanos , Itália , Dor Lombar/diagnóstico , Medição da Dor/métodos , Psicometria/métodos , Reprodutibilidade dos Testes , Inquéritos e Questionários
2.
Behav Neurol ; 2022: 9770047, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35880039

RESUMO

Background: Fibromyalgia syndrome (FMS) is a chronic musculoskeletal pain condition characterized by widespread pain, sleep problems (i.e., insomnia and unrefreshing sleep), fatigue, cognitive, and emotional difficulties. Although pain has been proposed the factor mostly impacting in the FMS patients' function, emotional and psychological FMS-associated factors are also known to exert a negative impact in quality of life and functional capacity. Nonetheless, the relationship between these factors and functional limitations in FMS patients is considered to be complex and not clearly defined. Therefore, the present study is aimed at assessing the associations between FMS functional capacity, FMS symptoms (pain, fatigue, insomnia, depression, and state and trait anxiety), and associated psychological factors such as pain catastrophizing, as well as the possible mediating role of these latter in the relationship between pain and FMS functional capacity. Method: 115 women diagnoses with FMS completed a set of self-administered questionnaires to evaluate the clinical and psychological variables of the study. Results: FMS functional capacity was positively associated with the majority of FMS symptoms except state anxiety. Regression analyses confirmed a greater prediction for FMS functional capacity by depression, fatigue, and pain catastrophizing, in this sequence. Both, pain catastrophizing and depression were important factors mediating the association between clinical pain (total and intensity) and FMS functional capacity. Conclusions: Findings support a key role of pain catastrophizing and depression in the disability associated to pain in FMS. Treatment goals directed to lessen depression and pain catastrophizing levels should be promoted to reduce the impact of pain in FMS patients' daily function.


Assuntos
Fibromialgia , Distúrbios do Início e da Manutenção do Sono , Catastrofização/psicologia , Doença Crônica , Depressão/psicologia , Fadiga/psicologia , Feminino , Fibromialgia/complicações , Fibromialgia/diagnóstico , Humanos , Dor/psicologia , Medição da Dor , Qualidade de Vida/psicologia , Distúrbios do Início e da Manutenção do Sono/complicações
3.
Pain Res Manag ; 2022: 2201501, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35757293

RESUMO

Background: Fear of pain (FOP) has been recognized as an influential moderator and determinant of the perception and disability of chronic pain. However, studies on FOP in postoperative acute pain are few and inconsistent. Objective: To explore whether FOP is related to pain intensity after thoracic surgery and provide a reference for FOP study in postoperative pain. Methods: From February to March 2022, 89 patients completed Chinese Version of Fear of Pain-9 Items (FOP-9), Chinese version of the Brief Pain Inventory (BPI, including least, worst, and average pain) and Simplified Chinese version of the Pain Catastrophizing Scale (PCS). Correlation analyses and mediation analyses were used for exploring the relationship between factors. Results: Mediation analyses showed that the total effects of FOP-9 on BPI all were significant (least pain: effect = 0.085, p=0.013, 95% CI = 0.019∼0.151; worst pain: effect = 0.116, p=0.004, 95% CI = 0.037∼0.196; average pain: effect = 0.102, p=0.005, 95% CI = 0.031∼0.174) indicating that FOP-9 was a predictor to BPI. The 95% bias-corrected bootstrap confidence interval of estimate of indirect effect between FOP-9 and least pain/average pain through PCS was -0.036∼0.024 and -0.003∼0.069 (all contain zero), which indicated that PCS is not a mediator between FOP-9 and least pain/average pain. However, the estimate of indirect effect between FOP-9 and worst pain through PCS were 0.048 (95% CI = 0.095∼0.088), and direct effect was not statistically significant (95% CI = -0.017∼0.153), indicating that PCS acted as a complete intermediary between FOP-9 and worst pain. FOP-9 and PCS showed significant positive prediction effect on worst pain. Conclusions: Both trait FOP and state FOP were associated with higher postoperative pain reports after thoracic surgery. Trait FOP influences postoperative pain through the mediating effect of state FOP.


Assuntos
Medo , Dor Pós-Operatória , Catastrofização , Humanos , Medição da Dor , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/etiologia , Transtornos Fóbicos , Inquéritos e Questionários , Toracoscopia
4.
PLoS One ; 17(6): e0269785, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35709207

RESUMO

INTRODUCTION: Previous studies into Low Back Pain (LBP) assessed the effects of physical interventions or face-to-face (FTF) education mostly in western cultures. The present study aimed to compare the effects of multimedia and FTF pain management education (PME) on pain intensity and pain catastrophizing among participants with chronic LBP. METHODS: This double-blind randomized controlled clinical trial was conducted on ninety participants with chronic LBP randomly allocated to either multimedia, FTF, or control groups. Participants in the multimedia group received PME through watching seven educational CDs at home and their counterparts in the FTF group received the same educations in seven weekly FTF educational sessions. Pain intensity (using a numerical rating scale) and pain catastrophizing (using the Pain Catastrophizing Scale) were assessed before, immediately after, and one month after the study intervention. The effects of the interventions were assessed using the repeated-measures multivariate analysis of variance (MANOVA). Effect size and minimal detectable change (MDC) were reported for both variables. The regression model used in the present study was Generalized Estimating Equations (GEE). FINDINGS: The findings of MANOVA showed the significant effects of time on pain intensity and pain catastrophizing (P<0.001). The Tukey's test showed that before and immediately after the intervention, the mean scores of pain intensity and pain catastrophizing in the FTF and PME groups were significantly different from the control group (P<0.001 and P = 0.001, respectively). MDC did not show clinically significant changes in the mean score of pain intensity and GEE revealed significant difference among the groups. CONCLUSION: The findings suggested that multimedia PME is as effective as FTF education in reducing pain intensity and pain catastrophizing among participants with LBP. Future studies into the effects of education on LBP are recommended to consider longitudinal designs, a reliable cutoff score for pain catastrophizing, and participants' physical ability. IRCT REGISTRATION CODE: IRCT20180313039074N1.


Assuntos
Dor Crônica , Dor Lombar , Catastrofização , Dor Crônica/terapia , Humanos , Dor Lombar/terapia , Multimídia , Manejo da Dor , Medição da Dor
5.
BMC Musculoskelet Disord ; 23(1): 507, 2022 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-35643440

RESUMO

BACKGROUND: Pain catastrophizing in preoperative total knee arthroplasty (TKA) patients is associated with several poorly characterised factors in the literature. This study investigated the current state and associated factors of preoperative pain catastrophizing in patients undergoing TKA. METHODS: This descriptive cross-sectional study was conducted at the orthopedics ward of two tertiary hospitals in Lanzhou, China. Pain catastrophizing was measured using the Chinese versions of the Pain Catastrophizing Scale, Short Form-36 (physical function domain), Numerical Rating Scale, Oxford Knee Score, Hospital Anxiety and Depression Scale, and Life Orientation Test-Revised. RESULTS: The study included 360 participants. Preoperative TKA pain catastrophizing in all patients was high, with a mean score of 24.92 (SD: 12.38). The stepwise multiple linear regression analysis revealed anxiety (ß = 0.548, P < 0.01), education level (ß = - 0.179, P < 0.01), physical function (ß = - 0.156, P < 0.01), and pain intensity during activity (ß = 0.105, P = 0.015) as associated factors for pain catastrophizing, possibly explaining 51.2% of the total variation (F = 95.149, P < 0.01). CONCLUSION: Anxiety was the most relevant factor for pain catastrophizing in patients with preoperative TKA. Lower education levels, poor physical function, and stronger pain intensity during the activity were also associated with pain catastrophizing.


Assuntos
Artroplastia do Joelho , Osteoartrite do Joelho , Artroplastia do Joelho/efeitos adversos , Catastrofização , China/epidemiologia , Estudos Transversais , Humanos , Osteoartrite do Joelho/complicações , Dor/cirurgia
6.
Eur J Psychotraumatol ; 13(1): 2078563, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35695844

RESUMO

Background: The coronavirus disease 2019 (COVID-19) pandemic has affected college students' mental health and caused post-traumatic stress symptoms (PTSS). Event centrality is thought to play a key role in the development of PTSS, but it is not yet clear by what mechanism. Theoretically, event centrality may affect the retrieval of traumatic memories and further prompt post-traumatic cognitions to understand events, and so may in turn be associated with PTSS in college students. However, few empirical studies have examined the mediating role of post-traumatic cognitions in the relationship between event centrality and PTSS, especially among college students during the COVID-19 pandemic. Objectives: The objective of this study was to examine the mediating roles of post-traumatic cognitive factors (e.g. attention to negative information, catastrophizing, and rumination) in the relationship between event centrality and PTSS among college students during the COVID-19 pandemic. Methods: We recruited 1153 college students who completed the pandemic experiences scale, the centrality of event scale, the attention to positive and negative information scale, the cognitive emotion regulation questionnaire, and the PTSD Checklist for DSM-5 during the COVID-19 pandemic in May 2020. Results: In this sample of college students, event centrality directly predicted PTSS, and PTSS was also indirectly predicted by event centrality through attention to negative information, catastrophizing, and rumination. Conclusions: These findings support the existing literature on the relationship between event centrality, proposed cognitive variables, and PTSS, and shed light on the mechanisms underlying PTSS. Our findings also highlight the importance and applicability of targeted cognitive interventions for PTSS in college students during the COVID-19 pandemic. HIGHLIGHTS: The COVID-19 pandemic has caused post-traumatic stress symptoms among college students.Event centrality is a risk factor of post-traumatic stress symptoms among college students during the COVID-19 pandemic.Attention to negative information, catastrophizing and rumination mediate the relationship between event centrality and post-traumatic stress symptoms.


Antecedentes: La pandemia de enfermedad coronavirus 2019 (COVID-19) ha afectado la salud mental de los estudiantes universitarios y causado síntomas de estrés postraumático (PTSS por sus siglas en ingles). Se cree que la centralidad del evento juega un rol importante en el desarrollo de PTSS, pero aún no está claro por qué mecanismo. Teóricamente, la centralidad del evento podría afectar la recuperación de los recuerdos traumáticos y estimular cogniciones postraumáticas para comprender los eventos y así su vez, podría estar asociada con PTSS en estudiantes universitarios. Sin embargo, pocos estudios empíricos han examinado el rol mediador de las cogniciones postraumáticas en la relación entre centralidad del evento y PTSS, especialmente entre estudiantes universitarios durante la pandemia de COVID-19.Objetivos: El objetivo de este estudio fue examinar los roles mediadores de los factores cognitivos postraumáticos (ej.: atención a información negativa, catastrofización y rumiación) en la relación entre centralidad del evento y PTSS entre los estudiantes universitarios durante la pandemia de COVID 19. Método: Reclutamos 1.153 estudiantes universitarios que completaron la escala de experiencias pandémicas, la escala de centralidad del evento, la escala de atención a la información positiva y negativa, el cuestionario de regulación cognitiva de las emociones y la lista de chequeo de TEPT para el DSM-5 durante la pandemia de COVID-19 en mayo del 2020.Resultados: En esta muestra de estudiantes universitarios, la centralidad del evento predijo directamente PTSS, y PTSS fueron tambien predichos indirectamente tambien por la centralidad del evento través de la atención a la información negativa, catastrofización y rumiación.Conclusiones: Estos hallazgos apoyan la literatura existente en la relación entre centralidad del evento, las variables cognitivas propuestas y PTSS y arrojan luz sobre los mecanismos subyacentes a PTSS. Nuestros hallazgos destacan tambien la importancia y aplicabilidad de las intervenciones cognitivas dirigidas a los PTSS en estudiantes universitarios durante la pandemia de COVID-19.


Assuntos
COVID-19 , Transtornos de Estresse Pós-Traumáticos , COVID-19/epidemiologia , Catastrofização , Humanos , Pandemias , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Estudantes/psicologia
7.
Clin J Pain ; 38(8): 520-527, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35696711

RESUMO

OBJECTIVES: The Parent Risk Screening Measure (PRISM) rapidly assesses parent distress, psychosocial function, and behaviors associated with child pain-related dysfunction in parents of youth with chronic pain. Recognizing the importance of parent pain-related cognitions and responses to pain during the acute pain period, the current study examined the utility of the PRISM in screening parents of youth with acute pain. METHODS: Participants were 175 parent-youth dyads taking part in a larger study examining risk and resilience in youth with acute musculoskeletal pain. Parents completed the PRISM and a battery of measures reporting on their child's pain-related disability and cognitions and behaviors in response to their child's pain. Youth reported on their pain, pain-related disability, pain-related fear, catastrophizing, and pain self-efficacy. RESULTS: PRISM total scores ( M =2.55, SD=2.77) were correlated with many parent and child report measures (eg, protectiveness, catastrophizing, and pain-related fear), with higher scores associated with greater symptoms. Using published PRISM cutoffs, 86.9% of parents were classified as low and 13.13% as elevated risk. t tests revealed significant differences between elevated and low-risk groups on several measures. Moreover, youth of parents in the elevated risk group were more likely to meet clinical cutoffs on pain catastrophizing and fear avoidance measures. DISCUSSION: Findings suggest the PRISM is useful in screening for parent distress and behaviors associated with elevated pain symptomatology in a pediatric acute musculoskeletal pain sample. The important next steps are to identify the ideal time for administering the PRISM and to examine the associations among PRISM scores and pain outcomes over time.


Assuntos
Dor Aguda , Dor Crônica , Dor Musculoesquelética , Adolescente , Catastrofização/psicologia , Criança , Dor Crônica/psicologia , Humanos , Dor Musculoesquelética/diagnóstico , Dor Musculoesquelética/psicologia , Medição da Dor , Relações Pais-Filho , Pais/psicologia , Fatores de Risco
8.
Phys Ther Sport ; 56: 1-7, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35691244

RESUMO

OBJECTIVE: Patellofemoral pain (PFP) is a common musculoskeletal condition, which has a negative effect on physical activity and function. Currently, it is unknown how and why individuals with PFP modify their physical activity. The purpose of this qualitative study was to explore the experience of knee pain on physical activity and everyday life in individuals experiencing PFP. DESIGN: Qualitative phenomenological interview study. SETTING: University. PARTICIPANTS: Sixteen patients experiencing PFP. MAIN OUTCOME MEASURES: Semi-structured interviews were used to explore the pain experience on physical activity and daily living. RESULTS: Patients with PFP attempted various strategies to remain physically active, such as identifying pain thresholds, activity modification, and pushing through their pain. Despite these various strategies to stay active, pain influenced their social life and patients demonstrated both fear avoidance beliefs and pain catastrophizing. Patients with PFP also reported barriers to seek care for their knee pain, such as negative past experiences with health care professionals and care not aligned with the best evidence available. CONCLUSION: Clinicians treating PFP should be aware of biologic, psychological, and social aspects when evaluating and intervening with patients.


Assuntos
Síndrome da Dor Patelofemoral , Catastrofização , Medo/psicologia , Humanos , Dor , Pesquisa Qualitativa
9.
Anesth Analg ; 135(2): 394-405, 2022 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-35696706

RESUMO

BACKGROUND: Behavioral pain treatments may improve postsurgical analgesia and recovery; however, effective and scalable options are not widely available. This study tested a digital perioperative behavioral medicine intervention in orthopedic trauma surgery patients for feasibility and efficacy for reducing pain intensity, pain catastrophizing, and opioid cessation up to 3 months after surgery. METHODS: A randomized controlled clinical trial was conducted at an orthopedic trauma surgery unit at a major academic hospital to compare a digital behavioral pain management intervention ("My Surgical Success" [MSS]) to a digital general health education (HE) intervention (HE; no pain management skills). The enrolled sample included 133 patients; 84 patients were randomized (MSS, n = 37; HE, n = 47) and completed study procedures. Most patients received their assigned intervention within 3 days of surgery (85%). The sample was predominantly male (61.5%), White (61.9%), and partnered (65.5%), with at least a bachelor's degree (69.0%). Outcomes were collected at 1-3 months after intervention through self-report e-surveys and electronic medical record review; an intention-to-treat analytic framework was applied. Feasibility was dually determined by the proportion of patients engaging in their assigned treatment and an application of an 80% threshold for patient-reported acceptability. We hypothesized that MSS would result in greater reductions in pain intensity and pain catastrophizing after surgery and earlier opioid cessation compared to the digital HE control group. RESULTS: The engagement rate with assigned interventions was 63% and exceeded commonly reported rates for fully automated Internet-based e-health interventions. Feasibility was demonstrated for the MSS engagers, with >80% reporting treatment acceptability. Overall, both groups improved in the postsurgical months across all study variables. A significant interaction effect was found for treatment group over time on pain intensity, such that the MSS group evidenced greater absolute reductions in pain intensity after surgery and up to 3 months later (treatment × time fixed effects; F [215] = 5.23; P = .024). No statistically significant between-group differences were observed for time to opioid cessation or for reductions in pain catastrophizing ( F [215] = 0.20; P = .653), although the study sample notably had subclinical baseline pain catastrophizing scores (M = 14.10; 95% confidence interval, 11.70-16.49). CONCLUSIONS: Study findings revealed that a fully automated behavioral pain management skills intervention (MSS) may be useful for motivated orthopedic trauma surgery patients and reduce postsurgical pain up to 3 months. MSS was not associated with reduced time to opioid cessation compared to the HE control intervention.


Assuntos
Analgésicos Opioides , Catastrofização , Analgésicos/uso terapêutico , Analgésicos Opioides/uso terapêutico , Estudos de Viabilidade , Feminino , Humanos , Masculino , Medição da Dor , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/etiologia
10.
Inflammopharmacology ; 30(3): 1119-1128, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35505266

RESUMO

OBJECTIVES: To evaluate the effect of 4 weeks of treatment with Janus kinase inhibitors (JAKis) on central sensitization (CS) and pain catastrophizing, and to determine the pain-related variables predictive of disease activity improvement, in patients with active rheumatoid arthritis (RA). METHODS: Consecutive RA patients with active disease starting a JAKi have been enrolled in this prospective observational study. Patients have been assessed at baseline and after 4 weeks of treatment. The evaluation was comprehensive of disease activity [Simplified Disease Activity Index (SDAI) and ultrasonographic (US) score] and of questionnaires aimed at investigating primarily CS [Central Sensitization Inventory (CSI)] and pain catastrophizing [Pain Catastrophizing Scale (PCS)]. Differences (Δ values) between the final and baseline were studied with the t test, Δ values of the variables were correlated with each other using Pearson's test, and predictor variables for improvement in SDAI were also investigated using multivariate regression analysis. RESULTS: A total of 115 patients were evaluated. Overall, all variables demonstrated significant improvement between baseline and final except the US score. In particular, CSI decreased from 36.73 to 32.57 (p < 0.0001), PCS decreased from 32.46 to 28.72 (p = 0.0001). ΔSDAI showed a significant correlation with both ΔPCS and ΔCSI (r = 0.466 and 0.386, respectively, p < 0.0001). ΔPCS was the only variable predictive of an improvement in SDAI (coefficient = 0.500, p = 0.0224). CONCLUSION: JAKis would appear to have a positive effect on pain-related variables, particularly CS and pain catastrophizing, for the genesis of which extra-synovial mechanisms are responsible.


Assuntos
Artrite Reumatoide , Inibidores de Janus Quinases , Artrite Reumatoide/tratamento farmacológico , Catastrofização/tratamento farmacológico , Sensibilização do Sistema Nervoso Central/fisiologia , Humanos , Inibidores de Janus Quinases/farmacologia , Inibidores de Janus Quinases/uso terapêutico , Dor/tratamento farmacológico
11.
Eur J Pain ; 26(7): 1569-1580, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35634793

RESUMO

BACKGROUND: Quantitative data on longitudinal associations between catastrophizing and pain or physical function are patchy. The study aimed to quantify the prognostic value of catastrophizing for pain and function in fibromyalgia and low back pain before and after rehabilitation. METHODS: The associations of state and change on the Multidimensional Pain Inventory (MPI) Pain severity scale, the Short Form 36 (SF-36) Physical functioning scale and the Six-Minute Walking Distance (6MWD) with the Coping Strategies Questionnaire (CSQ) Catastrophizing scale were quantified by multiple regression modelling to adjust for confounders. RESULTS: Sex- and age-matched cohorts (n = 71 each) were compared. Pain and catastrophizing were worse in fibromyalgia than in low back pain, whereas the function levels were comparable. Baseline catastrophizing predicted pain change by adjusted correlations of 0.552 (fibromyalgia) and 0.450 (low back pain), self-rated function by 0.403 and 0.308, and the 6MWD by 0.270 and - 0.072. The change in catastrophizing was associated to the change in pain by 0.440 (fibromyalgia) and 0.614 (low back pain), self-rated function by 0.122 and 0.465, and the 6MWD by 0186 and 0.162. CONCLUSIONS: Catastrophizing (pain-related worrying) was a potential prognostic factor, especially for pain and somewhat less for self-rated physical function but it was only weakly predictive for the walking distance in both conditions, independently of potential confounders, such as sex, age, baseline severity and others. Reduction of maladaptive coping should be integrated into the management of chronic pain. SIGNIFICANCE: Our study showed surprisingly high associations between state and change in catastrophizing to pain relief and functional improvement in chronic pain patients. This is supported by clinical experience and research data, even if the construct and measurement of catastrophizing is under debate. Our findings and those of literature point to more pessimistic self-rating of pain and catastrophizing in fibromyalgia when compared to other conditions. This might obscure positive effects on pain and function achieved by adaptive coping in fibromyalgia.


Assuntos
Catastrofização , Dor Crônica , Fibromialgia , Dor Lombar , Dor Crônica/psicologia , Dor Crônica/reabilitação , Fibromialgia/psicologia , Fibromialgia/reabilitação , Humanos , Dor Lombar/psicologia , Dor Lombar/reabilitação , Prognóstico
12.
Orthopedics ; 45(4): 197-202, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35394381

RESUMO

Total knee arthroplasty (TKA) is among the most successful types of surgery for the treatment of knee osteoarthritis (OA). However, nearly 20% of patients report unexpected pain after surgery. Recently, some studies have proposed that pain after TKA is related to pain catastrophizing (PC) and central sensitization (CS). However, there is no study comparing PC and CS for the same patient with knee OA requiring TKA. Thus, the goal of this study was to confirm the association between PC and CS among patients with knee OA awaiting primary TKA. This study was conducted with the clinical data of 153 patients collected between July 2019 and February 2021. Both PC and CS were evaluated with the Pain Catastrophizing Scale (PCS) and the Central Sensitizing Inventory (CSI). Patients with PCS scores higher than 30 were classified as high-level catastrophizing. Patients with CSI scores higher than 40 were classified as central sensitized. The distribution of PC and CS levels was confirmed, and the correlation between PC and CS was analyzed. A significant correlation was found between PCS and CSI scores, with Pearson's correlation coefficient of 0.606. Participants with high-level catastrophizing were 2.07 times more likely to belong to the central sensitized group compared with those who did not show high-level catastrophizing. Participants in the central sensitized group were 3.02 times more likely to belong to the high-level catastrophizing group than those who were not central sensitized. In conclusion, many patients with knee OA awaiting primary TKA had high-level catastrophizing, and a significant association was found between PC and CS. [Orthopedics. 2022;45(4):197-202.].


Assuntos
Artroplastia do Joelho , Osteoartrite do Joelho , Catastrofização , Sensibilização do Sistema Nervoso Central , Humanos , Osteoartrite do Joelho/complicações , Osteoartrite do Joelho/cirurgia , Medição da Dor , Dor Pós-Operatória , Estudos Prospectivos
13.
Clin Rehabil ; 36(9): 1199-1213, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35466696

RESUMO

BACKGROUND: Contemporary management of chronic low back pain involves combined exercise and pain education. Currently, there is a gap in the literature for whether any exercise mode better pairs with pain education. The purpose of this study was to compare general callisthenic exercise with a powerlifting style programme, both paired with consistent pain education, for chronic low back pain. We hypothesised powerlifting style training may better compliment the messages of pain education. METHODS: An 8-week single-blind randomised controlled trial was conducted comparing bodyweight exercise (n = 32) with powerlifting (n = 32) paired with the same education, for people with chronic low back pain. Exercise sessions were one-on-one and lasted 60-min, with the last 5-15 min comprising pain education. Pain, disability, fear, catastrophizing, self-efficacy, anxiety, and depression were measured at baseline, 8-weeks, 3-months, and 6-months. RESULTS: No significant between-group differences were observed for pain (p≥0.40), or disability (p≥0.45) at any time-point. Within-group differences were significantly improved for pain (p ≤ 0.04) and disability (p ≤ 0.04) at all time-points for both groups, except 6-month disability in the bodyweight group (p = 0.1). Behavioural measures explained 39-60% of the variance in changes in pain and disability at each time-point, with fear and self-efficacy emerging as significant in these models (p ≤ 0.001). CONCLUSIONS: Both powerlifting and bodyweight exercise were safe and beneficial when paired with pain education for chronic low back pain, with reductions in pain and disability associated with improved fear and self-efficacy. This study provides opportunity for practitioners to no longer be constrained by systematic approaches to chronic low back pain.


Assuntos
Dor Crônica , Dor Lombar , Catastrofização , Dor Crônica/terapia , Exercício Físico , Terapia por Exercício , Humanos , Dor Lombar/terapia , Método Simples-Cego
14.
J Athl Train ; 57(4): 312-318, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35439311

RESUMO

Chronic musculoskeletal pain continues to constitute a rising cost and burden on individuals and society on a global level, thus driving the demand for improved management strategies. The biopsychosocial model has long been a recommended approach to help manage chronic pain, with its consideration of the person and his or her experiences, psychosocial context, and societal considerations. However, the biomedical model continues to be the basis of athletic therapy and athletic training programs and therefore clinical practice. For more than 30 years, psychosocial factors have been identified in the literature as outcome predictors relating to chronic pain, including (but not limited to) catastrophizing, fear avoidance, and self-efficacy. Physical assessment strategies such as validated outcome measures can be used by the athletic therapist and athletic trainer to determine the presence or severity (or both) of nonbiogenic pain. Knowledge of these predictors and strategies allows the athletic therapist and athletic trainer to frame the use of exercise (eg, graded exposure), manual therapy, and therapeutic modalities in the appropriate way to improve clinical outcomes. Through changes in educational curricula content, such as those recommended by the International Association for the Study of Pain, athletic therapists and athletic trainers can develop profession-specific knowledge and skills that will enhance their clinical practice and enable them to better assist those living with chronic musculoskeletal pain conditions.


Assuntos
Dor Crônica , Dor Musculoesquelética , Esportes , Catastrofização , Dor Crônica/terapia , Medo , Feminino , Humanos , Masculino , Dor Musculoesquelética/terapia , Esportes/educação
15.
Psychosom Med ; 84(6): 738-746, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35412513

RESUMO

OBJECTIVE: There is growing evidence that open-label placebo (OLP) may be an efficacious treatment of chronic and functional conditions. However, patient-level predictors of response to OLP have not been clearly identified. The aim of this study is to evaluate the psychological predictors of response to OLP and to compare this to double-blind placebo (DBP) and no-pill control (NPC). METHODS: This study is a secondary analysis of data collected in a 6-week randomized controlled trial evaluating placebo effects in irritable bowel syndrome (IBS). The primary outcome was change in IBS severity. Hierarchical linear regression identified predictors of placebo response in general and compared them between those randomized to OLP, DBP, and NPC. Predictor variables included personality traits, generalized anxiety, depression, visceral sensitivity (a measure of symptom-specific anxiety), and pain catastrophizing. RESULTS: A total of 210 participants (mean age = 42.3 years, 73.3% female) were included. Regression models revealed that visceral sensitivity was a predictor of response to OLP and NPC but not DBP. Interestingly, the effects were opposite, with high visceral sensitivity predicting less improvement in NPC and more improvement in OLP. Pain catastrophizing was a negative predictor of response to OLP (i.e., high pain catastrophizing was associated with less improvement in OLP). Neither visceral sensitivity nor pain catastrophizing played a significant role for response to DBP. CONCLUSIONS: IBS participants who score low on the Pain Catastrophizing Scale but high on the Visceral Sensitivity Index seem to benefit particularly from OLP. Our study suggests that different psychological mechanisms may be involved in DBP and OLP interventions.


Assuntos
Síndrome do Intestino Irritável , Adulto , Ansiedade/tratamento farmacológico , Ansiedade/psicologia , Catastrofização , Método Duplo-Cego , Feminino , Humanos , Síndrome do Intestino Irritável/tratamento farmacológico , Masculino , Resultado do Tratamento
16.
Eur J Pain ; 26(6): 1256-1268, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35364620

RESUMO

BACKGROUND: Whiplash is a common traffic-related injury with up to 50% of those affected continuing to experience symptoms one-year post-injury. Unfortunately, treatments have not proven highly effective in preventing and treating chronic symptomatology. The overall aim of this study was to test the effectiveness of an early values-based cognitive-behavioural therapeutic intervention (V-CBT) delivered within 6 months post-injury in preventing chronic symptomatology compared to wait list controls. METHODS: The study was a two-armed randomized controlled trial. Participants (n = 91) experienced pain, disability and at least one psychological risk factor (e.g. enhanced pain-catastrophizing) after a whiplash trauma no later than 6 months prior. Participants were randomized to 10 sessions of V-CBT starting 1 week (group A) or 3 months (group B) post-randomization. The primary outcome was pain-related disability, while secondary outcomes were pain intensity, neck-pain related disability, depression, anxiety, PTSD symptoms, pain-catastrophizing and kinesiophobia. These were evaluated at baseline and at 3, 6, 9 and 12 months post-randomization. RESULTS: At 3 months, group A demonstrated clinically important effects on all outcomes that were significantly better than group B (waitlist). When group B received the intervention at 6 months, they also demonstrated clinically important effects on all outcomes. However, there was a significant difference at 12 months for the primary outcome, in which group B increased their disability levels, while group A remained stable. CONCLUSIONS: While this indicates that an intervention window for early prevention of disability after whiplash injury may exist, this needs to be tested in a truly early intervention. SIGNIFICANCE: An early Values-based Cognitive Behavioural Therapeutic intervention delivered within 6 months post-injury (mean days 117) was effective in reducing pain-related disability and psychological distress compared to the control group that received the intervention later after a three months wait-list period. The effects were sustained at 12 months follow-up. The early intervention was significantly more effective in reducing pain-related disability compared to the control group, indicating that an intervention window for early prevention of disability after whiplash injury may exist.


Assuntos
Terapia Cognitivo-Comportamental , Traumatismos em Chicotada , Catastrofização/prevenção & controle , Doença Crônica , Humanos , Cervicalgia/etiologia , Cervicalgia/prevenção & controle , Traumatismos em Chicotada/complicações , Traumatismos em Chicotada/diagnóstico , Traumatismos em Chicotada/terapia
17.
Phys Ther ; 102(6)2022 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-35485191

RESUMO

OBJECTIVE: Given the economic burden of work-related neck pain and disability, it is important to understand its time course and associated risk factors to direct better management strategies. This study aimed to identify the 1-year trajectories of work-related neck disability in a high-risk occupation group such as sonography and to investigate which baseline biopsychosocial factors are associated with the identified trajectories. METHODS: A longitudinal study was conducted among 92 sonographers with neck disability assessed at 3 time points-baseline, 6 months, and 12 months-using the Neck Disability Index. Baseline biopsychosocial measures included individual characteristics (demographics and physical activity levels), work-related physical and psychosocial factors (eg, ergonomic risk, workplace social support, job satisfaction), general psychological features (depression, anxiety, pain catastrophizing, and fear-avoidance beliefs), and quantitative sensory testing of somatosensory function (cold and pressure pain thresholds at neck and tibialis anterior, and temporal summation). RESULTS: Two distinct trajectories of neck disability were identified, including a "low-resolving disability" trajectory showing slow improvement toward no disability (64.8%) and a "moderate-fluctuating disability" trajectory characterized by persistent moderate disability with a small fluctuation across time (35.2%). The trajectory of moderate-fluctuating disability was associated with more severe symptoms, lower vigorous physical activity, higher ergonomic risk, remote cold hyperalgesia, widespread mechanical hyperalgesia, heightened pain facilitation, and several psychosocial factors such as anxiety, depression, lower job satisfaction, and lower workplace social support at baseline. CONCLUSION: Over one-third of sonographers were at risk of developing a moderate-fluctuating disability trajectory. This unfavorable trajectory was associated with low physical activity level, poor ergonomics, psychosocial distress, and central sensitization at baseline. IMPACT: This study has important implications for the management of neck disability in workers. Addressing modifiable factors including low vigorous physical activity, poor ergonomics, anxiety, depression, and lack of workplace social support may improve the trajectory of work-related neck disability.


Assuntos
Pessoas com Deficiência , Cervicalgia , Ansiedade , Catastrofização/psicologia , Humanos , Hiperalgesia , Estudos Longitudinais , Cervicalgia/psicologia
18.
Psicothema ; 34(2): 323-331, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35485547

RESUMO

BACKGROUND: The factor structure of the Pain Catastrophizing Scale (PCS) has rarely been adequately analyzed (e.g., performing principal component analyses rather than factorial approximations). We aimed to evaluate the psychometric properties of the PCS through a variety of exploratory and confirmatory factorial approaches. METHOD: Three hundred ninety-four Chilean patients with musculoskeletal pain were included (age, M = 49.61, SD = 18.00; 71.57% women). Eight factorial models were proposed to analyze the structure of the data. In addition, validity evidence of the PCS based on relationships with other variables were analyzed considering pain intensity and kinesiophobia. RESULTS: The results suggest a unidimensional structure. Models with more than one dimension exhibited undesirable factor loadings or inadequate indices of fit. Based on these results, a short version of the scale composed of 4 items is proposed (PCS-4). The PCS-4 scores demonstrated high levels of invariance between sex, chronicity, and education groups and also were associated with pain and kinesiophobia. CONCLUSIONS: The results of the PCS-4 Spanish version showed evidence of reliability and validity for adequately measuring pain catastrophizing in Chileans who suffer from musculoskeletal pain. The PCS-4 is a short form that should be explored in future studies (e.g., in other Spanish-speaking populations).


Assuntos
Dor Musculoesquelética , Catastrofização , Feminino , Humanos , Masculino , Medição da Dor/métodos , Psicometria/métodos , Reprodutibilidade dos Testes
19.
BMC Psychol ; 10(1): 97, 2022 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-35399087

RESUMO

BACKGROUND: Socioeconomic disadvantages in the childhood environment might strongly influence beliefs and behavior characterizing the adult years. When children experience unpredictable and adverse situations, they develop an unpredictability schema with the core belief that situations are unpredictable. METHODS: In two studies, we examined the association of childhood socioeconomic disadvantages with self-reported pain sensitivity, pain catastrophizing, and pain-related fear. Multidimensional survey measures were used to assess environmental conditions experienced in childhood. In addition, participants completed the Pain Catastrophizing Scale, Pain Sensitivity Questionnaire, Body Awareness Questionnaire, Unpredictability Schema Questionnaire, and Fear of Pain Questionnaire. In Study 1 (N = 252), in separate models, we examined pain sensitivity and pain catastrophizing of a community sample of pain-free young individuals in association with their childhood experiences. In Study 2 (N = 293), in a new sample, but with a wider age range, we examined the association of early life socioeconomic disadvantages with pain-related fear. In both studies, the predictions were tested with Structural Equation Modeling. Our models constituted a path from childhood socioeconomic status and household unpredictability to pain variables via the factors of family resources, unpredictability schemas, and body awareness. RESULTS AND CONCLUSIONS: The findings converged on the conclusion that individuals experiencing disadvantageous early life conditions tended to have an elevated level of pain catastrophizing, higher perceived sensitivity to pain, and higher level of pain-related fear. These associations were mediated by an unpredictability schema and body awareness.


Assuntos
Catastrofização , Transtornos Fóbicos , Adulto , Criança , Medo , Humanos , Dor , Inquéritos e Questionários
20.
Artigo em Inglês | MEDLINE | ID: mdl-35409880

RESUMO

Walking is one of the most beneficial treatments for fibromyalgia patients. However, adherence to walking behavior is low due to the initially associated symptoms (including pain and fatigue). Although the association of catastrophism with greater symptoms is known, the results regarding fatigue have not always been consistent. Nevertheless, it is unknown whether the association between catastrophism and fatigue could, in turn, be conditioned by whether the patients walk or not. Therefore, our goal was to explore the moderating effect of walking on the association between catastrophizing and fatigue in patients with fibromyalgia. A cross-sectional study was carried out with 203 women with fibromyalgia. We used the Multidimensional Fatigue Inventory to assess fatigue and the Pain Catastrophizing Scale to assess pain catastrophizing (differentiating between its three dimensions). An ad hoc item was used to evaluate walking (moderator). Lower scores for fatigue and pain catastrophizing were found among patients who walked versus those who did not. Walking moderated the relationship between rumination and fatigue (Beta = 0.16, t = 1.96, p = 0.049) and between magnification and fatigue (Beta = 0.22, t = 21.83, p = 0.047). Helplessness showed no direct or interaction effect for fatigue. Nevertheless, higher rumination and magnification were associated with higher fatigue only in patients who walked. Therefore, to promote adherence to walking and reduce the effects of catastrophizing on fatigue, it seems necessary to manage rumination and magnification among patients who walk.


Assuntos
Catastrofização , Fibromialgia , Estudos Transversais , Fadiga/complicações , Feminino , Fibromialgia/terapia , Humanos , Caminhada
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