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 Gut Feeling Is…": An Ethnographic Study Exploring Interprofessional Communication About Children And Adolescents With Chronic Musculoskeletal Pain In Paediatric Rheumatology., Rebecca R. Lee, Janet E. Mcdonagh, Tim Rapley, Albert Farre, Mark Connelly, Tonya M. Palermo, Karine Toupin-April, Emily Wakefield, Sarah Peters, Lis Cordingley

Manuscripts, Articles, Book Chapters and Other Papers

Interprofessional communication about inflammatory and non-inflammatory musculoskeletal conditions is an important component of assessment and management in paediatric rheumatology. Chronic pain is a feature of some of these conditions which likely influences the extent and type of communication about pain. Research investigating interprofessional communication about paediatric pain is limited but has found that communication is inclusive of the biopsychosocial context of children/adolescents as well as their families. The aim of this ethnographic study was to explore interprofessional communication about children and adolescents with chronic musculoskeletal pain in paediatric rheumatology. We observed forty-five healthcare professionals recruited from 3 UK paediatric rheumatology …

The Role Of Adaptive Goal Processes In Mental Wellbeing In Chronic Pain, Tara Swindells, Joanne Iddon, Joanne M. Dickson

Research outputs 2022 to 2026

Chronic pain, experienced as pain persisting for three months or longer, is associated with risk of poor mental health and disability. Research has implicated adaptive goal processes as important to mental wellbeing in a range of populations. However, research has rarely assessed these mechanisms in relation to pain characteristics and mental wellbeing in chronic pain populations. This study aimed to examine the potentially mediating roles of goal flexibility and goal tenacity in the relationships between pain intensity and pain interference and mental wellbeing among individuals with chronic pain. Community members who self-identified as experiencing non-cancer chronic pain (N = 315) …

"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 …

Theta Burst Brain Stimulation In Painful Diabetic Neuropathy Patients: Investigating Neural Mechanisms, Bhushan Thakkar

Theses and Dissertations

Chronic pain (CP) is a significant contributor to disability and disease burden globally. In 2019, approximately 50.2 million adults (20.4% of the US population) experienced chronic pain, contributing to $560-635 billion in direct medical costs. In addition, the worldwide prevalence of diabetes mellitus has reached epidemic proportions and is set to increase to 629 million by 2045. Almost 50% of patients with diabetes present with diabetic neuropathy (DN), and one in five patients with diabetes presents with painful DN (pDN) which is the most common cause of neuropathic pain (NP) in the US. Symptomatic treatment is the mainstay of management …

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 …

Chronic Pain Treatment Strategies In Parkinson’S Disease, Amber N. Edinoff, Niro Sathivadivel, Timothy Mcbride, Allyson Parker, Chikezie Okeagu, Alan David Kaye, Adam M. Kaye, Jessica S. Kaye, Rachel J. Kaye, Meeta M. Sheth, Omar Viswanath, Ivan Urits

School of Pharmacy Faculty Articles

Neurological disorders, including Parkinson’s disease (PD), have increased in prevalence and are expected to further increase in the coming decades. In this regard, PD affects around 3% of the population by age 65 and up to 5% of people over the age of 85. PD is a widely described, physically and mentally disabling neurodegenerative disorder. One symptom often poorly recognized and under-treated by health care providers despite being reported as the most common non-motor symptom is the finding of chronic pain. Compared to the general population of similar age, PD patients suffer from a significantly higher level and prevalence of …

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 …

Body Awareness And Chronic Low Back Pain: Validity And Reliability Study Of Turkish Version Of Body Awareness Rating Scale, Aynur Demi̇rel, Di̇lara Onan, Yasemi̇n Özel Asliyüce, Müzeyyen Öz, Utku Berberoğlu, Özlem Ülger

Turkish Journal of Medical Sciences

Background/aim: Previous studies reported that patients with chronic low back pain (CLBP) had trouble describing senses or body functions. A questionnaire, the body awareness rating questionnaire (BARQ), was recently developed for assessing body awareness. The aim of the study was to develop a Turkish version of the BARQ and investigate the validity and reliability in patients with CLBP. Materials and methods: BARQ translated to Turkish with forward-backward method. Ninety-nine patients with CLBP and 101 healthy controls (HC) completed the BARQ-T. Fifty-one of patients with CLBP and HC repeated BARQ-T 3 days later. In addition to BARQ-T, Oswestry disability index (ODI), …

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 …

The Use Of Hydrotherapy For Chronic Pain, Emily S. Medal

Honors Undergraduate Theses

The purpose of this thesis is to provide a critical analysis of research findings about hydrotherapy as a means of reducing chronic pain used independently of opioids. Chronic pain is often treated with analgesics of varying potency, some with serious adverse side effects if used over a long period of time. Exploring the effectiveness of therapies other than medication to treat chronic pain is important to decrease or eliminate the amount to pain medication taken for chronic pain. Hydrotherapy is one therapy that may improve the pain experience for those with chronic pain. A literature search was conducted using the …

Patient-Defined Meaningfulness Within Chronic Pain Rehabilitation: A Concept Analysis, Katrina Liddiard, Annette J. Raynor, Annette M. Rivard, Cary A. Brown

Research outputs 2014 to 2021

Background: As the problem of chronic pain grows worldwide, rehabilitation is critical to improved patient well-being. There is thus a need for rehabilitation-focused research. It appears that outcomes are improved when patients perceive the rehabilitation process to be meaningful. However, there is no empirical evidence determining how this would be achieved. An important first step is to identify and describe the concept of meaningfulness as it is used in the chronic pain rehabilitation literature. Objective: This paper reports the findings of a structured concept analysis to define meaningfulness from the patient perspective in chronic pain rehabilitation. Methodology: In consultation with …

Private Pain – Identifying Gaps In The Management Of Chronic Pain Patients In Private Hospitals: A Case Study, Johanna Gale

Journal of Perioperative Nursing

This is a case study of a patient who experiences chronic pain and was admitted for an acute surgical procedure in a private hospital. It illustrates how communication and teamwork can be overlooked within the multidisciplinary focus when jointly caring for this group of patients within the public and private sectors. This case study offers a nurse-led approach to improving individualised health care for chronic pain patients while preventing gaps in health care.

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 …

Differences In Swedish And Australian Medical Student Attitudes And Beliefs About Chronic Pain, Its Management, And The Way It Is Taught, Linda Rankin, Britt-Marie Stalnacke, Christopher J. Fowler, Gisselle Gallego

Medical Papers and Journal Articles

Background and aims: Medical students receive training in the management of chronic pain, but the training is often suboptimal. Considering that the basis for physician’s knowledge is their medical education, it is important to explore the attitudes and beliefs of medical students with respect both to chronic pain management and to their views on current pain education. Therefore, the aim of this study was to compare Swedish and Australian medical student’s attitudes and beliefs about patients with chronic pain, and their perceptions regarding their chronic pain management education.

Methods: An online survey was conducted with final year Australian and Swedish …

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 …

The Genicular Nerve: Radiofrequency Lesion Application For Chronic Knee Pain, Paki̇ze Kirdemi̇r, Serdar Çatav, Fi̇li̇z Alkaya Solmaz

Turkish Journal of Medical Sciences

Background/aim: We investigated the short- and medium-term effectiveness of genicular nerve radiofrequency (RF) applied in patients with chronic knee pain due to osteoarthritis. Materials and methods: Radiofrequency was performed in 49 patients with a diagnosis of knee osteoarthritis. VAS and WOMAC were measured at baseline and at 1, 4, and 12 weeks postprocedure. Under fluoroscopic guidance, the cannula was advanced percutaneously towards the area connecting the shaft to the epicondyle. The RF electrode was inserted through the cannula and the electrode tip temperature was raised to 80 °C for 90 s. One RF lesion was made for each genicular nerve. …

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 …

The Prevalence And Impact Of Chronic Pain In Baccalaureate Nursing Students, Kathleen M. Davis, Julia E. Schwarz

Williams Honors College, Honors Research Projects

Chronic pain is a problem because it can have a large impact on activities of daily life of people, regardless of age. Few researchers have described the prevalence and impact of chronic pain in young adults, while even fewer have done so in the United States. The purpose of this study is to determine the prevalence of chronic pain and the impact it has on daily life for undergraduate nursing students. The theoretical framework is guided on the biopsychosocial model of chronic pain. This cross-sectional, descriptive study uses convenience sampling and data collected through an online Qualtrics survey, which was …

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 …

Effect Of Head And Limb Orientation On Trunk Muscle Activation During Abdominal Hollowing In Chronic Low Back Pain, Kevin Parfrey, Sean G. Gibbons, Eric J. Drinkwater, David G. Behm

Research outputs 2014 to 2021

Background: Individuals with chronic low back pain (CLBP) have altered activations patterns of the anterior trunk musculature when performing the abdominal hollowing manœuvre (attempt to pull umbilicus inward and upward towards the spine). There is a subgroup of individuals with CLBP who have high neurocognitive and sensory motor deficits with associated primitive reflexes (PR). The objective of the study was to determine if orienting the head and extremities to positions, which mimic PR patterns would alter anterior trunk musculature activation during the hollowing manoeuvre. Methods. This study compared surface electromyography (EMG) of bilateral rectus abdominis (RA), external oblique (EO), and …

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 …