The Clinical journal of pain
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Randomized Controlled Trial
An online self-help CBT intervention for chronic lower back pain.
Research has shown that cognitive and behavioral therapies can effectively improve quality of life in chronic pain patients. Unfortunately, many patients lack access to cognitive and behavioral therapy treatments. We developed a pilot version of an interactive online intervention to teach self-management skills for chronic lower back pain, a leading cause of disability and work absenteeism. The objective of this randomized, controlled trial was to evaluate its efficacy. ⋯ Use of this pilot intervention seems to have had positive effects on a number of pain-related outcomes, including disability. Future research will evaluate the effectiveness of the completed intervention, with particular attention to quality of life and disability.
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To determine whether patients with myogenous and mixed temporomandibular disorders (TMD) have greater fatigability of the cervical extensor muscles while performing a neck extensor muscle endurance test (NEMET) when compared with healthy controls. ⋯ These results highlight the fact that alterations of endurance capacity of the extensor cervical muscles could be implicated in the neck-shoulder disturbances presented in patients with TMD.
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To estimate the prevalence of widespread pain (WP) according to the American College of Rheumatology, 1990, in women with chronic low back pain (CLBP) consulting primary health care and to evaluate the differences in body function, activity, participation, environmental factors, health-related quality of life, and other health-related aspects between patients having CLBP with or without WP. ⋯ Twenty-eight percent fulfilled the American College of Rheumatology 1990 criteria for WP. When WP was present, patients reported significantly more impaired body functions, more severe activity limitations, and participation restrictions. Environmental factors, health-related quality of life, and other health-related aspects were also negatively impacted. It is suggested that the presence of WP should be evaluated in female patients with CLBP.
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Recent work suggests that psychological influence on pain intensity and knee function should be considered for patients after anterior cruciate ligament reconstruction (ACLR). The Tampa Scale for Kinesiophobia (TSK) and Pain Catastrophizing Scale (PCS) have been used to determine psychological influence in these patients. However, TSK and PCS factor structures have not been described for patients with ACLR. This study investigated 2 groups of patients post-ACLR to determine if the use of shortened questionnaires is warranted. ⋯ Shortened versions of the TSK-11 and PCS may be appropriate for ACLR populations, depending on the postoperative phase. These data may guide future research of psychological factors in ACLR populations so that levels predictive of risk for developing chronic pain and/or inability to return to pre-injury activity levels can be determined.
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To identify signs and symptoms that should alert clinicians to the need for additional psychological assessment in patients with chronic low back pain (CLBP). ⋯ This study established a clinically useful screening instrument for the identification of patients with CLBP who might benefit from additional psychological assessment in an outpatient rehabilitation setting. Further research is needed to confirm our preliminary results.