The Clinical journal of pain
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Randomized Controlled Trial Clinical Trial
Research to encourage exercise for fibromyalgia (REEF): use of motivational interviewing, outcomes from a randomized-controlled trial.
Regular exercise is associated with important benefits in patients with fibromyalgia (FM). Unfortunately, long-term maintenance of exercise after a structured program is rare. The present study tested the efficacy of Motivational Interviewing (MI) to promote exercise and improve symptoms in patients with FM. ⋯ Despite a lack of benefits on long-term outcome, MI seems to have short-term benefits with respect to self-report physical activity and clinical outcomes. This is the first study in FM that explicitly addresses exercise maintenance as a primary aim.
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To determine the cost-effectiveness of self-management techniques for older populations (65 and over) with chronic pain and in the absence of such evidence to investigate this question in an aging adult population (average age 60 and over). ⋯ Self-management is effective among an aging adult population (mean age over 60) with chronic pain and may be cost-effective when outcomes are measured using the Western Ontario and McMaster Universities Osteoarthritis Index pain score. Cost-effectiveness is less certain when measured using the QALY metric. Uncertainty over conclusions regarding cost-effectiveness exists partly due to lack of information regarding societal willingness to pay for pain improvement. There is a need for large multicentred high-quality RCTs to confirm the findings of this review exclusively among older aged populations, such as those who have already reached the statutory retirement age.
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Lumbar flexion-relaxation (FR) is a well-known phenomenon that can reliably be seen in normal subjects but not in most chronic low back pain (CLBP) patients. The purpose of this study was to determine which surface electromyographic (SEMG) measures of FR best distinguish CLBP patients from pain-free control subjects. Standing SEMG and lumbar flexion range of motion (ROM) were also evaluated. ⋯ Because all SEMG measures of FR performed acceptably, the determination of which SEMG measure of FR is "best" is largely dependent on one's specific purpose. In addition, ROM measures were found to be important components of the FR assessment.
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To identify demographic, medical, and psychosocial characteristics that distinguished sickle cell disease (SCD) patients who were frequent utilizers of urgent or emergent care resources from low-utilizing patients. ⋯ The study strengthens emerging evidence that disease severity, familial factors related to greater parental education, and psychiatric illness are important factors in high care utilization in patients with SCD.
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To evaluate the effects of vitamin D supplementation in outpatient veterans with multiple areas of chronic pain. ⋯ Standardized vitamin D supplementation in veterans with multiple areas of chronic pain can be effective in improving their pain levels, sleep, and various aspects of QoL.