The Clinical journal of pain
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Over the past 20 years, there have been numerous attempts to identify methodologies that are capable of the determination of sincerity of effort during muscle testing. The ensuing paper reviewed this literature and drew several conclusions. Injured patients and healthy volunteers do produce less force and more variable force while performing submaximal contractions than maximal contractions. ⋯ Many studies have questionable or at least unknown generalizability to patient samples and actual functional capacity. It is critical that other explanatory variables such as fear of injury, pain, medications, work satisfaction, and other motivational factors be considered. It is our opinion that there is not sufficient empirical evidence to support the clinical application of muscle testing to determine sincerity of effort.
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Comparative Study Clinical Trial
Factors predicting pain reduction in chronic back and neck pain after multimodal treatment.
To determine whether treatment related pain reduction on the short- and long-term is predicted by different baseline variables, and with different accuracy, in patients with chronic low back pain as compared with those with chronic neck pain. ⋯ Patients who reported unchanged or increased pain after multimodal treatment could be predicted with good accuracy, whereas those who reported decreased pain were more difficult to identify. Treatment-related pain alteration in chronic low back pain seems to be predicted by partly different variables than in chronic neck pain.
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Comparative Study Clinical Trial
Prognosis of multifactorial outcome in lumbar discectomy: a prospective longitudinal study investigating patients with disc prolapse.
Although previous research has shown that certain medical data and psychosocial factors predict postoperative pain, it remains unclear whether they also contribute to a more distinct outcome measure that is based on classification of self-reported outcome criteria. To assess the prognostic power of somatic, psychologic, and social predictors when evident outcome criteria of surgical treatment are investigated, this study used a prospective longitudinal design examining preoperative factors associated with outcome six months after lumbar discectomy. ⋯ Classification of patients regarding their individual outcome profiles showed that patients responded differently to lumbar disc-surgery. High risk factors for poor outcome of surgery are Laseque-sign and depression.