Search

Background Evidence for effectiveness of transcutaneous electrical nerve stimulation ( TENS) is still inconclusive. As heterogeneity of chronic pain patients might be an important factor for this lack of efficacy, identifying factors for a successful long-term outcome is of great importance. Methods A prospective study was performed to identify variables with potential predictive value for 2 outcome measures on long term (6 months); (1) continuation of TENS, and (2) a minimally clinical important pain reduction of ≥ 33%. At baseline, a set of risk factors including pain-related variables, psychological factors, and disability was measured. Results In a multiple logistic regression analysis, higher patient's expectations, neuropathic pain, no severe pain (< 80 mm visual analogue scale [ VAS]) were independently related to long-term continuation of TENS. For the outcome 'minimally clinical important pain reduction,' the multiple logistic regression analysis indicated that no multisited pain (> 2 pain locations) and intermittent pain were positively and independently associated with a minimally clinical important pain reduction of ≥ 33%. Conclusion The results showed that factors associated with a successful outcome in the long term are dependent on definition of successful outcome. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Although the importance of psychosocial factors has been highlighted in many studies in patients with chronic low back pain (CLBP), there is a lack of research examining the role of illness perceptions in explaining functional disability and physical activity in patients with CLBP. Aim: The aim of the study was to explore the value of illness perceptions in explaining functional disability and physical activity in patients with CLBP. Methods: Eighty‐four participants with CLBP (of > 3 months' duration) completed a battery of questionnaires investigating psychosocial factors (Pain Catastrophizing Scale [PCS], Illness Perceptions Questionnaire Revised [IPQ‐R], and 36‐Item Short Form mental health scale [SF‐36_MH]) and perceived pain intensity (visual analog scale [VAS]), as well as the Oswestry Disability Index (ODI) and Baecke questionnaire. The latter 2 were entered separately as dependent variables in a regression analysis. Results: The combined variables (VAS, PCS, SF‐36_MH, IPQ‐R) accounted for 62% of the variance in functional disability (ODI). Adding the results of the IPQ‐R to the scores of the other 3 variables (VAS, PCS, SF‐36_MH) significantly increased the explained variance of ODI scores in CLBP patients, yielding 18% additional information (P < 0.01). Only 5% of the variance in the Baecke questionnaire was explained by combining the 4 variables. None of the single variables alone made a significant contribution to R². Conclusions: Illness perceptions are an important factor for explaining functional disability, but not for explaining habitual physical activity in CLBP patients. [ABSTRACT FROM AUTHOR]

Background Content validity, the proper reflection of the concept to be measured, is yet unknown for the Credibility and Expectancy Questionnaire ( CEQ). It is frequently used in pain rehabilitation because treatment expectancy is influential on the outcome. Objective To test and improve the content validity of the CEQ in a sample of patients with chronic pain in different phases of their treatment. Methods A qualitative observational study design using the Three-Step Test-Interview method was used. Therein, data collection, analyses, and adaptations occur iteratively. Results Seventeen patients with chronic pain in different stages of treatment participated through convenience sampling from the mother sample of a randomized controlled trial. The main study parameter is content validity, which is defined as (1) interpretations and responses of the participants and (2) the identification of response problems operationalized, and resulting in changes in the CEQ. For patients waiting for treatment, the written instruction of the CEQ allowed different interpretations. After changing the instructions, the CEQ became an easy-to-understand and content-valid questionnaire. For patients who had already undergone treatment, changes regarding time frame and recall period were necessary to overcome interpretation and response problems to the CEQ. Discussion After small changes, the CEQ appeared to be a content-valid measurement instrument for patients waiting for treatment. However, for patients who had already undergone treatment, the content validity of the CEQ was less, and considerable changes were necessary. [ABSTRACT FROM AUTHOR]

Objective The objective of this study was to evaluate whether patients with fibromyalgia FM need more oxygen and more time to complete a walking and stair-climbing task than healthy volunteers and perceive the performance of these tasks as more strenuous. Furthermore, it was evaluated whether a less efficient performance is more pronounced in patients reporting a higher level of fear of movement. Methods Thirty patients with FM and 30 matched healthy volunteers completed a 500-meter walking and a stair-climbing task (60 steps) while wearing a mobile gas analyzing unit. Mean and total oxygen consumption and time needed to complete each task were recorded. After both tasks, a Borg score was used to measure perceived exertion. Fear of movement was measured with the Tampa Scale for Kinesiophobia. Results Patients with FM needed more time to complete the walking and stair-climbing task and reported higher levels of exertion compared to healthy volunteers. However, the total oxygen consumption for performing both tasks was not different. In patients with FM, a higher level of fear of movement was associated with a higher perceived exertion after the walking task. Interestingly, a higher somatic focus is related to a lower mean oxygen consumption needed to perform the stair-climbing task. Conclusion In conclusion, patients with FM perceive a walking and stair-climbing task as more strenuous than healthy controls, even though they walked slower and no differences in total O2 consumption during completion of both tasks were found. [ABSTRACT FROM AUTHOR]