Medicine and Health Sciences Commons^™

A Literature Review Of Current Treatments For The Hypermobility Subtype Of Ehlers-Danlos Syndrome, John Gericke, Mary Zsolway, Chelsea Reyes, Pooja Patel, Saad Ahmed, Julia Hwang, Venkateswar Venkataraman

Rowan-Virtua Research Day

Purpose: The purpose of this study is to compare pharmacologic intervention, neurocognitive therapy, physical therapy, and orthotics in treating the hypermobility subtype of Ehlers-Danlos Syndrome (hEDS) and determine which has the most positive effect on symptoms.

Introduction: Ehlers-Danlos Syndrome is an inheritable connective tissue disorder which results from a genetic mutation that alters the body’s ability to produce collagen. The most common subtype of Ehlers-Danlos Syndrome is hEDS, which leads to hypermobility and hyperextensibility and can cause frequent joint dislocations.

Methods: A review of literature was performed to compare each treatment based on reported results. The types of studies reviewed …

Development And Validation Of The Pain Resilience And Optimism Scale (Pros), Wonjin Seo

Electronic Thesis and Dissertation Repository

Numerous self-report questionnaires have been used in pain research to explore patients' experiences. However, these questionnaires often employ negatively worded items that can potentially worsen patients' distress. In response to the emergence of positive psychology, this thesis aimed to develop a new questionnaire that adopts a positive and strengths-focused approach, incorporating resilience, to replace the negative items found in existing tools such as the Pain Catastrophizing Scale (PCS). First, the effectiveness of the Connor-Davidson Resilience Scale (CD-RISC) in measuring resilience following trauma was assessed through a systematic review using the COnsensus-based Standards for the selection of health status Measurement INstruments …

"My Back Is Fit For Movement": A Qualitative Study Alongside A Randomized Controlled Trial For Chronic Low Back Pain, Rodrigo Rn Rizzo, Benedict Wand, Hayley B. Leake, Edel O'Hagan, Matthew K. Bagg, Samantha Bunzli, Adrian C. Traeger, Sylvia M. Gustin, G. Lorimer Moseley, Saurab Sharma, Aidan Cashin, James Mcauley

Physiotherapy Papers and Journal Articles

A new wave of treatments has emerged to target nervous system alterations and maladaptive conceptualizations about pain for chronic low back pain. The acceptability of these treatments is still uncertain. We conducted a qualitative study alongside a randomized controlled trial to identify perceptions of facilitators or barriers to participation in a non-pharmacological intervention that resulted in clinically meaningful reductions across 12 months for disability compared to a sham intervention. We conducted semi-structured interviews with participants from the trial's active arm after they completed the 12-week program. We included a purposeful sample (baseline and clinical characteristics) (n = 20). We used …

Pne – Lots Of Talk, Superficial Results, Aidan Keller, Michael Ray, Taylor Baugher

Honors Projects

Objective: A narrative review (NR) of meta-analyses (MA) and systematic reviews (SR) that assess the effectiveness or efficacy of pain neuroscience education (PNE) on various outcome measures in individuals with chronic musculoskeletal (MSK) pain. Methods: This was a mixed methodology review involving systematic searches across 4 databases (PubMed, ScienceDirect, CENTRAL (Cochrane), and Google Scholar). Inclusion criteria stipulated MAs and SRs that assessed the effectiveness or efficacy of PNE on CP population. Quantitative eligibility criteria included randomized controlled trials (RCTs), adults (18+ years of age), English or Spanish speaking individuals, and reporting of chronic pain (persistent or recurrent pain lasting ≥ …

Introducing A Physical Therapist-Led Acceptance And Commitment Therapy Training For Pain: A Clinical Perspective, Joseph Tatta

Internet Journal of Allied Health Sciences and Practice

Purpose: Mounting evidence supports the use of cognitive and behavioral techniques as part of physical therapist practice. These methods are used within a physical therapist’s multimodal treatment approach for the management of pain and to facilitate health behavior change. There is a multitude of evidence-based cognitive behavioral techniques to choose from including newer approaches based on Acceptance and Commitment Therapy. Yet few studies have examined physical therapists’ perceptions to learning and implementing ACT into clinical practice. The purpose of this manuscript is to present a clinical perspective of physical therapists learning about and incorporating Acceptance and Commitment Therapy in clinical …

Multimodal Approach To Chronic Pain Management And Prevention Of Opioid Use Disorder, Hannah Elston

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background. Chronic pain (CP) is a major public health problem that affects one-third of the population and can interfere with the activities of daily life and cause decreased quality of life. Patients with CP have been increasingly prescribed opioids, contributing to the rise in the opioid epidemic. Due to the long-term nature of CP, the use of opioids as the sole treatment for CP can cause tolerance and increased dosages overtime which can lead to addiction and potentially overdose. Therefore, CP treatment should include multimodal approaches to treatment to prevent opioid misuse, opioid use disorder (OUD), and overdose. Multimodal treatments …

The Fit-For-Purpose Model: Conceptualizing And Managing Chronic Nonspecific Low Back Pain As An Information Problem, Benedict M. Wand, Aidan G. Cashin, James H. Mcauley, Matthew K. Bagg, Gemma M. Orange, G. Lorimer Moseley

Physiotherapy Papers and Journal Articles

Chronic nonspecific low back pain (CNSLBP) is a complex and multifaceted problem. The following Perspective Piece tries to help make sense of this complexity by describing a model for the development and maintenance of persistent low back pain that integrates modifiable factors across the biopsychosocial spectrum. The Fit-for-Purpose model (FFPM) posits the view that chronic nonspecific low back pain represents a state in which the person in pain holds strong and relatively intransient internal models of an immutably damaged, fragile, and unhealthy back, and information that supports these models is more available and trustworthy than information that counters them. This …

Early Post-Immobilization Pain At Rest, Movement Evoked Pain, And Their Ratio As Potential Predictors Of Pain And Disability At Six- And 12-Months After Distal Radius Fracture, Maryam Farzad, Joy C. Mcdermid, Saurabh Mehta, Ruby Grewal, Erfan Shafiee

Physical Therapy Faculty Research

Background: Removal of immobilization is a critical phase of distal radius fracture (DRF) rehabilitation, typically occurring by 2 months post injury. This study examined the extent to which pain at rest (PAR), movement evoked pain (MEP), or the ratio between those (MEPR) assessed at 2-months after DRF predicts the occurrence of chronic pain or disability at 6- and 12-months after the injury.

Methods: This secondary analysis of a prospective cohort study was done at the Hand and Upper Limb Centre (HULC), London, Ontario, Canada. A total of 229 patients with DRF (159 (69.4%) women) were included. Scores for the pain …

Physical Therapy With Adjunct Therapies In Patients With Chronic Pain And Disability Post-Motor Vehicle Accidents, Lakshmi Subramanian

Dissertations and Theses

This project is a thorough literature review of studies concerning physical therapy interventions in conjunction with adjunct treatments for patients post-motor vehicle accidents focused on the therapy’s efficacy as related to functional outcome measures. Physical therapy is frequently treatment of choice for patients after minor motor vehicle accidents. However, most patients seek concomitant therapies like acupuncture, chiropractic, epidural steroid injection, and psychological counselling. This paper seeks to gather data on the efficacy of different treatment modalities when used in conjunction with each other. Often patients are traumatised or develop anxiety about driving requiring counselling and therapy. The vast majority of …

The Resolve Trial For People With Chronic Low Back Pain: Statistical Analysis Plan, Matthew K. Bagg, Serigne Lo, Aidan G. Cashin, Robert D. Herbert, Neil E. O'Connell, Hopin Lee, Markus Hubscher, Benedict M. Wand, Edel O'Hagan, Rodrigo R.N Rizzoli, G Lorimer Moseley, Tasha R. Stanton, Christopher G. Maher, Stephen Goodall, Sopany Saing, James H. Mcauley

Physiotherapy Papers and Journal Articles

Background: Statistical analysis plans describe the planned data management and analysis for clinical trials. This supports transparent reporting and interpretation of clinical trial results. This paper reports the statistical analysis plan for the RESOLVE clinical trial. The RESOLVE trial assigned participants with chronic low back pain to graded sensory-motor precision training or sham-control.

Results: We report the planned data management and analysis for the primary and secondary outcomes. The primary outcome is pain intensity at 18-weeks post randomization. We will use mixed-effects models to analyze the primary and secondary outcomes by intention-to-treat. We will report adverse effects in full. We …

Transcutaneous Electrical Nerve Stimulation (Tens) For Chronic Pain - An Overview Of Cochrane Reviews (Review), William Gibson, Benedict M. Wand, Catherine Meads, Mark J. Catley, Neil E. O'Connell

Physiotherapy Papers and Journal Articles

Background: Chronic pain, considered to be pain lasting more than three months, is a common and often difficult to treat condition that can significantly impact upon function and quality of life. Treatment typically includes pharmacological and non-pharmacological approaches. Transcutaneous electrical nerve stimulation (TENS) is an adjunct non-pharmacological treatment commonly recommended by clinicians and often used by people with pain.

Objectives: To provide an overview of evidence from Cochrane Reviews of the effectiveness of TENS to reduce pain in adults with chronic pain (excluding headache or migraine). To provide an overview of evidence from Cochrane Reviews of the safety of …

Non-Invasive Brain Stimulation Techniques For Chronic Pain, Neil E. O'Connell, Louise Marston, Sally Spencer, Lorraine H. Desouza, Benedict M. Wand

Physiotherapy Papers and Journal Articles

Stimulating the brain without surgery in the management of chronic pain in adults

Bottom line: There is a lack of high-quality evidence to support or refute the effectiveness of non-invasive brain stimulation techniques for chronic pain.

Background: Electrical stimulation of the brain has been used to address a variety of painful conditions. Various devices are available that can electrically stimulate the brain without the need for surgery or any invasive treatment. There are five main treatment types: repetitive transcranial magnetic stimulation (rTMS) in which the brain is stimulated by a coil applied to the scalp, cranial electrotherapy stimulation (CES) in …

Predicting Response To Medial Branch Blocks: A Clinical Decision Making Tool, Swati Mehta

Electronic Thesis and Dissertation Repository

Chronic neck pain can lead to long-term disability and socio-economic burden. Several demographic, clinical, and psychosocial factors have been implicated in the development of neck pain disability. These factors may also influence management of neck pain. Optimal treatment often requires targeting interventions based on specific diagnosis. One of the most common cause of neck pain is cervical facet joint injury. Currently, the gold standard for diagnosing facetogenic injury is through the medial branch block (MBB) procedure. Though the procedure is relatively safe, it is still invasive and may result in adverse effects. In Canada, access to this procedure is limited …

Chronic Mid Portion Achilles Tendinopathy Is Not Associated With Central Sensitisation, Ian W. Skinner, James R. Debenham, Sarah Krumenachera, Max K. Bulsara, Benedict M. Wand

James Debenham

Achilles tendinopathy (AT) is a common painful and disabling condition and current understanding of its pathophysiology is incomplete. Widespread hyperalgesia as a clinical manifestation of central sensitisation has emerged as a possible contributor to the pain state in chronic musculoskeletal injuries. Eight AT participants and eight healthy, gender, age and activity matched participants were recruited to participate in a case-controlled repeated measures study. Pressure pain threshold (PPT) was measured with a manual electronic algometer at four sites bilaterally; tibialis anterior (TA), patella tendon (PT), common wrist extensor tendon (CWET), and first dorsal interosseous (1DI). We hypothesised a reduction in PPT …

Transcutaneous Electrical Nerve Stimulation (Tens) For Chronic Pain - An Overview Of Cochrane Reviews (Protocol), M J. Catley, W Gibson, B M. Wand, C Meads, N. E. O'Connell

Physiotherapy Papers and Journal Articles

This is the protocol for a review and there is no abstract. The objectives are as follows:

1. To provide an overview of evidence from Cochrane systematic reviews of the effectiveness of TENS to reduce pain in adults with chronic pain (excluding headache or migraine).
2. To provide an overview of evidence from Cochrane systematic reviews of the safety of TENS to reduce pain in adults with chronic pain (excluding headache or migraine).
3. To identify possible sources of inconsistency in the approaches taken to evaluating the evidence related to TENS for chronic pain (excluding headache or migraine) in the Cochrane Library with …

The Implications Of Chronic Pain Models For Rehabilitation Of Distal Radius Fracture, Saurabh Mehta, Joy Macdermid, Mary Tremblay

Saurabh Mehta

Distal radius fracture (DRF) is the most common fracture and usually occurs as a result of a fall. Most patients recover following DRF with minimal residual pain or disability; however, a small subset of patients continue to experience pain and disability even one year after the injury. Currently, there are no practice guidelines for early identification and treatment of patients who are potentially at greater risk of developing these adverse outcomes. As a result, hand therapy management of patients following DRF does not incorporate screening of these at-risk patients. The objective of this paper is to apply constructs from learned …

Therapeutic Neuroscience Education For Patients With Chronic Low Back Pain And Its Effect On Activity Level, Pain Perception, And Function, Stephen Burton, Amber Domingo, Ryan Spencer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Chronic low back pain (CLBP) is a significant cause of disability and inactivity in the United States. Patients with chronic pain are often symptomatic even in the absence of tissue damage. This is a major reason patients need to be educated about their pain. Cognitions such as fear, anxiety and faulty beliefs may impact the pain experiences and changing cognitions are important in changing pain behavior. If patients understand that the pain they are experiencing may not be a true indication of the health of their tissues, they may experience less fear of their pain, and may be able …

Fibromyalgie, Douleur Et Fasciathérapie, Cyril Dupuis, Danis Bois

Danis Bois

Ce travail porte sur la fasciathérapie appliquée aux douleurs de la fibromyalgie, et tente de répondre à la question « quels sont les effets de la fasciathérapie sur la douleur et ses consé- quences, ainsi que sur le vécu des patients qui souffrent de fibromyalgie ? » Pour cela, j’ai présenté le champ théorique des douleurs chroniques et du syndrome fibromyalgique, ainsi que celui des thérapies s’adressant aux fascias et notamment la fasciathérapie méthode Danis Bois. J’ai abordé cette recherche avec une posture double pour tenter d’appréhender la complexité de la douleur. La première, qualitative, est basée sur des entretiens …

The Implications Of Chronic Pain Models For Rehabilitation Of Distal Radius Fracture, Saurabh Mehta, Joy Macdermid, Mary Tremblay

Physical Therapy Faculty Research

Distal radius fracture (DRF) is the most common fracture and usually occurs as a result of a fall. Most patients recover following DRF with minimal residual pain or disability; however, a small subset of patients continue to experience pain and disability even one year after the injury. Currently, there are no practice guidelines for early identification and treatment of patients who are potentially at greater risk of developing these adverse outcomes. As a result, hand therapy management of patients following DRF does not incorporate screening of these at-risk patients. The objective of this paper is to apply constructs from learned …