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3. What Are the Mechanisms of Action of Cognitive-Behavioral, Mind-Body, and Exercise-based Interventions for Pain and Disability in People With Chronic Primary Musculoskeletal Pain?: A Systematic Review of Mediation Studies From Randomized Controlled Trials

Author

Alaiti, Rafael K, Castro, Julia, Lee, Hopin, Caneiro, J P, Vlaeyen, Johan W.S., Kamper, Steven J, da Costa, Marcelo F, Alaiti, Rafael K, Castro, Julia, Lee, Hopin, Caneiro, J P, Vlaeyen, Johan W.S., Kamper, Steven J, and da Costa, Marcelo F

Abstract

OBJECTIVES: This systematic review examined studies that used mediation analysis to investigate the mechanisms of action of cognitive-behavioral, mind-body, and exercise-based interventions for pain and disability in people with chronic primary musculoskeletal pain.MATERIALS AND METHODS: We searched 5 electronic databases for articles that conducted mediation analyses of randomized controlled trials to either test or estimate indirect effects.RESULTS: We found 17 studies (n=4423), including 90 mediation models examining the role of 22 putative mediators on pain or disability, of which 4 had partially mediated treatment effect; 8 had mixed results, and 10 did not mediate treatment effect. The conditions studied were chronic whiplash-associated pain, chronic low back pain, chronic knee pain, and mixed group of chronic primary musculoskeletal pain.DISCUSSION: We observed that several of the studies included in our systematic review identified similar mechanisms of action, even between different interventions and conditions. However, methodological limitations were common. In conclusion, there are still substantial gaps with respect to understanding how cognitive-behavioral, mind-body, and exercise-based interventions work to reduce pain and disability in people with chronic primary musculoskeletal pain.

Published
2022

5. Distorted distance perception to reachable points in people with chronic shoulder pain

Author

José Eduardo Pompeu, Victoria J. Madden, Marcello F. de Sousa, Juliana T. Gasparin, Rafael Krasic Alaiti, Daniel S. Harvie, Maria Helena Leite Hunziker, Marcelo Fernandes da Costa, Alaiti, Rafael K, Harvie, Daniel S, Gasparin, Juliana T, de Sousa, Marcello F, Pompeu, José E, Madden, Victoria J, Hunziker, Maria Helena Leite, and da Costa, Marcelo F

Subjects
Male, medicine.medical_specialty, body image, shoulder pain, media_common.quotation_subject, Physical Therapy, Sports Therapy and Rehabilitation, Perceptual inference, Correlation, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, perceptual distortion, Shoulder Pain, Perception, medicine, Body Image, Humans, pain, 030212 general & internal medicine, Perceptual Distortion, media_common, Aged, Pain Measurement, Persistent pain, Distance Perception, Chronic pain, Middle Aged, medicine.disease, perceptual inference, MOVIMENTO (FISIOLOGIA), Case-Control Studies, Chronic shoulder pain, Female, Chronic Pain, Psychology, chronic pain, 030217 neurology & neurosurgery
Abstract

usc Perception is not simply a carbon copy of the real world, but is subject to distortions that may reflect protective drive. This study aimed to investigate whether people with chronic shoulder pain show perceptual distortions of space and body that may promote protective behavior. Eighty-four people with shoulder pain and 51 healthy controls participated. Participants estimated (1) distances to points on a cork-board within and outside reaching distance, and (2) the perceived length of their own arms. A novel measure of movement-related pain was also used to determine whether movement-related pain relates to perceptual distortion. Overall, distance and arm length estimates did not differ between groups, nor did participants perceive their arms to be of different length. However, a moderate correlation between movement-related pain and the index of distance perception was found within the pain group, specifically for distance estimates to points within reach. Our results suggest that distorted perception is not a typical consequence of chronic shoulder pain; however, that it may occur in cases where pain is strongly linked to movement. Our findings have implications for understanding avoidance of movement in people with persistent pain. Refereed/Peer-reviewed

Published
2019

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