The Clinical journal of pain
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Randomized Controlled Trial Multicenter Study
Patient characteristics and variation in treatment outcomes: which patients benefit most from acupuncture for chronic pain?
The aim of this study was to identify patients' characteristics that increase or decrease their benefit from acupuncture treatment of chronic pain. ⋯ Future research to clarify the modifying effects with special focus on patients' expectations and other psychological variables is needed.
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To examine the development of fear avoidance behaviours following whiplash injury using two different measures of fear avoidance, the Pictorial Fear of Activities Scale-Cervical (PFActS-C), and the Tampa Scale of Kinesiophobia (TSK-17). Secondarily we assessed the capacity of these measures to predict recovery status at long term follow up and initial cervical range of movement (ROM). ⋯ Fear avoidance beliefs and behaviours develop quickly following whiplash injury and influence both the initial physical presentation and long term outcome of patients with WAD. The PFActS-C may provide a measure of fear of movement which is more specific to the cervical spine in patients with WAD in comparison to the TSK-17.
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To explore the role of neuropathy in persistent pain after thoracotomy, combining a clinical follow-up and a psychophysical examination of the operated area. ⋯ Peripheral neuropathy is common after thoracotomy, with variant characteristics, ranging from subclinical disturbances to severe pain. The process seems to develop between the discharge from hospital and the sixth week after thoracotomy.
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General practitioners (GPs) manage the majority of patients with chronic low back pain (LBP) in the Republic of Ireland's health system; however, little is known about their attitudes and beliefs, and how these influence their practice behavior. This study aimed to determine the attitudes and beliefs of GPs regarding chronic LBP, the factors that influence these, and their impact on the management of patients with chronic LBP. ⋯ The current results show partial adherence to current LBP guidelines: GPs manage patients within a biomedical framework, and postgraduate education is not significantly impacting on chronic LBP management. GPs' beliefs do not correlate with their management, which only reflects partial adherence to LBP guideline recommendations. Further research is needed to explore the role of patient factors in the consultation outcomes.
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This study was designed to investigate whether the PainDETECT Questionnaire (PDQ) classification was predictive of outcomes at 3 and 12 months follow-up in low back pain (LBP) patients with associated leg pain. Identification of clinically important subgroups and targeted treatment is believed to be important in LBP care. The PD-Q is designed to classify whether a person has neuropathic pain, based on their self-reported pain characteristics. However, it is unknown whether this classification is a prognostic factor or predicts treatment response. ⋯ The PDQ classification was a prognostic factor but was not predictive of response to treatment that was not targeted to neuropathic pain. Further studies should investigate whether PD-Q groups are predictive of treatment response when targeted to neuropathic pain.