| 41. |
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| 42. |
- Michaelson, Peter, et al.
(författare)
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Factors predicting pain reduction in chronic back and neck pain after multimodal treatment.
- 2004
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Ingår i: The Clinical Journal of Pain. - : Ovid Technologies (Wolters Kluwer Health). - 0749-8047 .- 1536-5409. ; 20:6, s. 447-454
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To determine whether treatment related pain reduction on the short- and long-term is predicted by different baseline variables, and with different accuracy, in patients with chronic low back pain as compared with those with chronic neck pain. DESIGN AND METHODS: A single blinded prospective cohort study based on patients with chronic musculoskeletal pain in the lower back (N = 167) or the neck (N = 136) who completed a 4-week multimodal rehabilitation program. At admission, each patient was evaluated on 17 potential predictors, including pain characteristics and physical, sociodemographic, and psychosocial-behavioral variables. Changes in self-reported pain intensity in the lower back or the neck between the pretreatment evaluation and those performed immediately after, and 12 months after the rehabilitation program, were assessed. RESULTS: Logistic regression models revealed that change in pain intensity could be predicted with good specificity but with poor sensitivity both for patients with chronic low back pain and chronic neck pain. Significant predictors among the neck pain patients were high endurance, low age, high pain intensity, few other symptoms, low need of being social, to do things with others, and to be helped, along with optimistic attitudes on how the pain will interfere with daily life. Among the low back pain patients, high pain intensity, low levels of pain severity, and high affective distress were important predictors. Variables such as sex, sick leave history, working status, accident, pain duration, and depressive symptoms demonstrated no predictive value. Short- and long-term pain outcome was equally predictable and predicted by almost the same variables. CONCLUSIONS: Patients who reported unchanged or increased pain after multimodal treatment could be predicted with good accuracy, whereas those who reported decreased pain were more difficult to identify. Treatment-related pain alteration in chronic low back pain seems to be predicted by partly different variables than in chronic neck pain.
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| 43. |
- Nordeman, Lena Margareta, et al.
(författare)
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Early access to physical therapy treatment for subacute low back pain in primary health care: a prospective randomized clinical trial.
- 2006
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Ingår i: The Clinical journal of pain. - : Ovid Technologies (Wolters Kluwer Health). - 0749-8047. ; 22:6, s. 505-11
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To evaluate the effects of early access (EA) to physical therapy treatment for patients with subacute low back pain compared to access with a 4-week waiting list. DESIGN: A prospective, randomized clinical trial. SETTING: Primary health care. PATIENTS: Sixty consecutive patients with subacute low back pain. INTERVENTIONS: Patients were randomized either to EA within 2 days for physical examination and individualized physical therapy treatment (n=32) or a control group with a 4-week waiting list (n=28). OUTCOME MEASURES: Self-administrated questionnaires were used for assessment at inclusion, at discharge, and at 6 months. Primary outcome measure was pain intensity assessed by Borg category scale for ratings of perceived pain. Secondary outcomes included the Orebro musculoskeletal pain screening questionnaire, the Roland and Morris disability questionnaire, sick-leave, visits to health care, and physical therapy. RESULTS: The results showed no significant differences in pain between the groups at discharge. At 6 months, the reduction of pain was significantly greater in the EA group compared to the control group (P=0.025). Changes in secondary outcome measures were not significantly different between groups. CONCLUSIONS: This study indicated that EA to physical therapy resulted in greater improvement in perceived pain at 6 months compared to later access. In this study, EA to physical therapy could be introduced by reorganization without additional resources.
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| 44. |
- Nordeman, Lena Margareta, et al.
(författare)
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Prevalence and characteristics of widespread pain in female primary health care patients with chronic low back pain.
- 2012
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Ingår i: The Clinical Journal of Pain. - 0749-8047. ; 28:1, s. 65-72
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To estimate the prevalence of widespread pain (WP) according to the American College of Rheumatology, 1990, in women with chronic low back pain (CLBP) consulting primary health care and to evaluate the differences in body function, activity, participation, environmental factors, health-related quality of life, and other health-related aspects between patients having CLBP with or without WP. Methods: A cross-sectional study of women with CLBP including clinical assessment and questionnaires was conducted. Patients were categorized as having CLBP with or without WP and differences between these groups were evaluated. Results: One hundred thirty patients were assessed. Twenty-eight percent (n=37) had WP. Patients with CLBP+WP showed more impaired physical performance (6-min walk test, handgrip strength), higher numbers of tender points, more severe pain, fatigue, and depression compared with CLBP (P<0.05). The CLBP+WP showed greater activity limitation (P=0.00047). Work disability was 35% (n=13/37) in CLBP+WP compared with 16% (n=15/93) in CLBP (P=0.032). Private social support was negatively impacted in CLBP+WP (P=0.010). The CLBP+WP showed lower health-related quality of life (SF-36) in the physical function, bodily pain, and vitality dimension (P<0.05). More severe clinical stress symptoms and risk for future disability were registered for the CLBP+WP (P<0.001). Discussion: Twenty-eight percent fulfilled the American College of Rheumatology 1990 criteria for WP. When WP was present, patients reported significantly more impaired body functions, more severe activity limitations, and participation restrictions. Environmental factors, health-related quality of life, and other health-related aspects were also negatively impacted. It is suggested that the presence of WP should be evaluated in female patients with CLBP.
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| 45. |
- Nordeman, Lena Margareta, et al.
(författare)
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Prognostic factors for work ability in women with chronic low back pain consulting primary health care: a 2-year prospective longitudinal cohort study
- 2014
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Ingår i: The Clinical Journal of Pain. - 0749-8047. ; 30:5, s. 391-398
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES:To investigate prognostic factors for future work ability in women with chronic low back pain (CLBP) consulting primary health care. METHODS:A 2-year prospective longitudinal cohort study of female patients with CLBP within the primary health care was conducted. Patients were assessed at the first assessment and after 2 years. Prognostic factors for work ability (yes/no) were analyzed by multivariate regression. RESULTS:A total of 130 patients were included at first assessment. After 2 years, 123 patients (95%) were followed up. The 6-minute walk test, depression, and earlier work ability predicted work ability at the 2-year follow-up. A nomogram was constructed to assess the probability of future work ability. DISCUSSION:The 6-minute walk test, work ability, and depression predicted work ability for women with CLBP after 2 years.
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| 46. |
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| 47. |
- Olaya-Contreras, Patricia, 1964, et al.
(författare)
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Cross-validation of the Depression, Anxiety, and Positive Outlook Scale (DAPOS) for Clinical Use
- 2011
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Ingår i: The Clinical journal of pain. - 0749-8047 .- 1536-5409. ; 27:4, s. 330-337
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The main objective of this study was to investigate different psychometric properties of the Swedish version of the Depression, Anxiety, and Positive Outlook Scale (DAPOS) in patients with chronic musculoskeletal pain in an orthopedic setting. METHODS: A total of 449 participants took part in the study, including 288 patients with chronic musculoskeletal pain and 161 participants in a reference group. Internal consistency, convergent validity, and measurement invariance of the constructs of DAPOS were investigated across sex and diagnostic groups. The Beck Depression Inventory and the Spielberger Anxiety Inventory were used for measures of convergent validity. Multigroup confirmatory factor analysis was performed to test measurement invariance of the theoretical constructs of DAPOS. RESULTS: Internal consistency was good for all 3 constructs, and correlations concerned with convergent validity were found to be acceptable to good. With regard to cross-validation, the 3 constructs of DAPOS were strictly measurement invariant with respect to sex. Across diagnostic groups, the constructs of anxiety and positive outlook were almost strictly measurement invariant, although there were some restrictions of measurement invariance for the construct of depression. DISCUSSION: To be able to rely on an instrument with as few items as DAPOS, the cross-validation of its constructs for sex and diagnostic groups is a valuable information, particularly when investigated in patients with musculoskeletal pain. Based on these results, we recommend that DAPOS could replace longer and more time-consuming screening tests in clinical settings.
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| 48. |
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| 49. |
- Persson, Anna K M, et al.
(författare)
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Prediction of Postoperative Pain from Electrical Pain Thresholds after Laparoscopic Cholecystectomy
- 2017
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Ingår i: Clinical Journal of Pain. - 0749-8047. ; 33:2, s. 126-131
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:: Early postoperative pain correlates to persisting pain, psychosocial distress, and delayed mobilization with thromboembolic and infectious complications. Electrical pain thresholds (EPT) have shown promising results in being able to predict postoperative pain, but the results are conflicting. The aim of this study was to test whether EPT levels can be used to predict postoperative pain in patients of both genders. METHODS:: One-hundred-and-eighty patients scheduled for laparoscopic cholecystectomy were included in this prospective clinical study. Individual levels of EPT were measured before surgery, and pain intensity was evaluated in the early postoperative period. RESULTS:: There were significant correlations between EPT and maximum postoperative pain intensity (rs=−0.21 P=0.009), time to first rescue opioid (rs=0.26, P=0.006) and total dose of rescue opioid (rs=−0.22, P=0.001). Interaction test showed significant influence of gender on the ability of EPT to predict postoperative pain intensity. Female patients with low EPT (
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| 50. |
- Peters, Madelon L., et al.
(författare)
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Happy Despite Pain : A Randomized Controlled Trial of an 8-week Internet-delivered Positive Psychology Intervention for Enhancing Well-being in Patients with Chronic Pain
- 2017
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Ingår i: The Clinical Journal of Pain. - : Lippincott Williams & Wilkins. - 0749-8047 .- 1536-5409. ; 33:11, s. 962-975
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: There is preliminary evidence for the efficacy of positive psychology interventions for pain management. The current study examined the effects of an internet-based positive psychology self-help program for patients with chronic musculoskeletal pain and compared it with an internet-based cognitive behavioural program.METHODS: A randomized controlled trial was carried out with three conditions: an internet-delivered positive psychology program, an internet-delivered cognitive behavioural program and waitlist control. A total of 276 patients were randomized to one of the three conditions and post treatment data were obtained from 206 patients. Primary outcomes were happiness, depression and physical impairments at post-treatment and at six months follow-up. Intention-to-treat analyses were carried out using mixed regression analyses.RESULTS: Both treatments led to significant increases in happiness and decreases in depression. Physical impairments did not significantly decrease compared to waitlist. Improvements in happiness and depression were maintained until six months follow-up. There were no overall differences in the efficacy of the two active interventions but effects appeared to be moderated by education. Patients with a higher level of education profited more from the positive psychology intervention than from the cognitive behavioural program.DISCUSSION: The results suggest that an internet-based positive psychology self-help intervention for the management of chronic pain is clinically useful. Because the self-help exercises as used in the current program do not require therapist involvement, dissemination potential is large. Further studies should examine whether it can best be used as stand-alone or add-on treatment combined with established pain treatment programs.
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