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- Liechti, Seraina, et al.
(author)
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Prognostic factors for quality of life after interdisciplinary pain rehabilitation in patients with chronic pain : a systematic review
- 2023
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In: Pain medicine. - : Oxford University Press (OUP). - 1526-2375 .- 1526-4637. ; 24:1, s. 52-70
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Journal article (peer-reviewed)abstract
- BACKGROUND AND OBJECTIVE: Health-related quality of life (hrQoL) is a core outcome in evaluating interdisciplinary pain rehabilitation (IPR). This systematic review aimed to identify prognostic factors for hrQoL at least six months after IPR in chronic pain patients.METHODS: A systematic search was conducted in MEDLINE, PsycINFO, EMBASE, CINAHL, Web of Science and Cochrane CENTRAL until September 2020. Included were prognostic studies on the outcome hrQoL in adults aged 18 to 67 years with chronic pain (excluding malignancies, systemic-, inflammatory or degenerative joint diseases) who had undergone IPR. Studies were assessed with The Quality in Prognostic Studies-tool. Potential prognostic factors at baseline for the domains pain, psychological and physical functioning were qualitatively synthesized for hrQoL. Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the level of evidence.RESULTS: Fourteen studies on 6668 participants (mean age 37.4-52.8y), with musculoskeletal pain/fibromyalgia and a pain duration ranging between 13.1 to 177.4 months were considered eligible. With a very low certainty of evidence, pain intensity, emotional distress and physical functioning at baseline were inconsistent for prediction of hrQoL and pain duration was not predictive. With low certainty of evidence, fewer pain sites, lower levels of negative cognitive behavioral factors, and higher levels of positive cognitive behavioral factors predicted a better outcome.CONCLUSIONS: The overall certainty of evidence was low to very low, making it difficult to reach definitive conclusions at present. Future studies with a predefined core set of predictors investigating hrQoL in patients with chronic pain after IPR are needed.
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| 2. |
- Rasmussen-Barr, Eva, et al.
(author)
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Summarizing the effects of different exercise types in chronic neck pain - a systematic review and meta-analysis of systematic reviews
- 2023
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In: BMC Musculoskeletal Disorders. - 1471-2474. ; 24:1
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Journal article (peer-reviewed)abstract
- BACKGROUND: To date, no consensus exists as to whether one exercise type is more effective than another in chronic neck pain. This systematic review and meta-analysis of systematic reviews aimed to summarize the literature on the effect of various exercise types used in chronic neck pain and to assess the certainty of the evidence.METHODS: We searched the databases Ovid MEDLINE, Embase, Cochrane Library, SportDiscus, and Web of Science (Core Collection) for systematic reviews and meta-analyses on adults between 18 and 70 years with chronic neck pain lasting ≥ 12 weeks which investigated the effects of exercises on pain and disability. The included reviews were grouped into motor control exercise (MCE), Pilates exercises, resistance training, traditional Chinese exercise (TCE), and yoga. Study quality was assessed with AMSTAR-2 and the level of certainty for the effects of the exercise through GRADE. A narrative analysis of the results was performed and in addition, meta-analyses when feasible.RESULTS: Our database search resulted in 1,794 systematic reviews. We included 25 systematic reviews and meta-analyses including 17,321 participants (overlap not accounted for). The quality of the included reviews ranged from critically low to low (n = 13) to moderate to high (n = 12). We found low to high certainty of evidence that MCE, Pilates exercises, resistance training, TCE, and yoga have short-term positive effects on pain and that all exercise types except resistance training, show positive effects on disability compared to non-exercise controls. We found low to moderate certainty of evidence for conflicting results on pain and disability when the exercise types were compared to other exercise interventions in the short-term as well as in intermediate/long-term apart for yoga, as no long-term results were available.CONCLUSION: Overall, our findings show low to high certainty of evidence for positive effects on pain and disability of the various exercise types used in chronic neck pain compared to non-exercise interventions, at least in the short-term. Based on our results, no optimal exercise intervention for patients with chronic neck pain can be recommended, since no large differences between the exercise types were shown here. Because the quality of the included systematic reviews varied greatly, future systematic reviews need to increase their methodological quality.TRIAL REGISTRATION: Prospero CRD42022336014.
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| 3. |
- Tseli, Elena, et al.
(author)
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Evaluation of content validity and feasibility of the eVISualisation of physical activity and pain (eVIS) intervention for patients with chronic pain participating in interdisciplinary pain rehabilitation programs
- 2023
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In: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 21:3
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Journal article (peer-reviewed)abstract
- BackgroundChronic pain negatively influences most aspects of life, including aerobic capacity and physical function. The "eVISualisation of physical activity and pain" (eVIS) intervention was developed to facilitate individualized physical activity for treatment in interdisciplinary pain rehabilitation programs (IPRPs). The objective of this study was to evaluate the content validity and feasibility of the eVIS intervention prior to an effectiveness trial. MethodsIn order to determine pre-clinical content validity, experts (n = 10) (patients, caregivers, researchers) participated in three assessment rounds using a Likert-scale survey where relevance, simplicity, and safety were rated, whereafter the intervention was revised. Item-content validity index (I-CVI), average, and overall CVI were used to quantify ratings. To determine content validity and feasibility in the clinical context, experts (n = 8) (patients and physiotherapists) assessed eVIS after a 2-3-week test trial, with the feasibility aspects acceptability, demand, implementation, limited efficacy-testing, and practicality in focus. Additional expert interviews (with physiotherapists, physicians) were conducted on two incomplete areas. ResultsThe intervention was iteratively revised and refined throughout the study. After three assessment and revision rounds, the I-CVI ratings for relevance, simplicity, and safety ranged between 0.88 and 1.00 (>= 0.78) in most items, giving eVIS "excellent" content validity. In the IPRP context, the intervention emerged as valid and feasible. Additional interviews further contributed to its content validity and clinical feasibility. ConclusionsThe proposed domains and features of the eVIS intervention are deemed valid in its content and feasible in the IPRP context. The consecutive step-by-step evaluation process enabled careful intervention development with revisions to be made in close collaboration with stakeholders. Findings implicate a robust base ahead of the forthcoming effectiveness trial.
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