European journal of pain : EJP
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An issue that arises when selecting therapy is whether patient or clinician preferences for treatment moderate the effect of treatment. To evaluate this question we conducted a secondary analysis of the results of a randomized controlled trial of exercise treatment of chronic whiplash. Immediately prior to randomization, treatment preference ratings were collected from each patient and from the physiotherapist who assessed each patient. ⋯ The interaction effect of treatment group by patient preference was 0.1 (-0.3 to 0.5, p=0.68) on the 0-10 pain intensity scale and -0.1 (-0.5 to 0.3, p=0.64) on the 0-10 function scale. The interaction effect of treatment group by therapist preference was 0.0 (-0.3 to 0.4, p=0.786) on the 0-10 pain intensity scale and -0.2 (-0.4 to 0.1, p=0.296) on the 0-10 function scale. Our findings do not provide evidence that patient or therapist treatment preferences moderate the effect of exercise treatment for chronic whiplash.
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Comparative Study
Interactions between spatial summation, 2-point discrimination and habituation of heat pain.
Recently, spatial summation (SS) of two discrete noxious stimuli was found to occur at separation distances less than 10cm in the forearm. Interestingly though, with larger separation distances there is 2-point discrimination (2PD) but not SS. However, previous studies have not examined the interactions between these spatial phenomena and temporal aspects of pain. ⋯ However, when the initial pain score was fixed (but the stimulus temperature varied) habituation occurred with all stimulation configurations but significantly less for two probes separated by 0.4cm. Sex was not a factor in SS and 2PD of pain, however there was greater habituation in females than males. In conclusion, SS of pain counteracts 2PD of pain and to a lesser extent, pain habituation.
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Multicenter Study Comparative Study
Stop the pain! A nation-wide quality improvement programme in paediatric oncology pain control.
Little is known about the impact of translation of pain management clinical practice guidelines on pain control in paediatrics. In an effort to overcome this, a longitudinal, nation-wide, multi-centre paediatric quality improvement (QI) study was initiated by the German Society of Pediatric Haematology and Oncology (GPOH) entitled Schmerz-Therapie in der Onkologischen Paediatrie (STOP). ⋯ STOP predominantly aimed at and succeeded in the improvement of structure, process and outcome quality. With regard to patients' and parents' opinions, the interview tools might have been unsuited to measure the quality of pain control, or STOP was insufficient to improve pain control to a magnitude significant to the patient.
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Comparative Study
Neck muscles' cross-sectional area in adolescents with and without headache - MRI study.
Cervical musculature may play an important role in the genesis of tension-type headache. However, there are no reports on a possible association between the morphometrical features of the neck flexion and extension muscles and adolescence headache. ⋯ This preliminary work demonstrates that both girls and boys with tension-type headache and migraine have differences in the size of neck flexion muscles, especially unilaterally. In boys, unilaterally increased size of neck flexion and extension muscles is associated with migraine. These findings, if confirmed in further studies, may have important diagnostic and therapeutic implications for rehabilitation of adolescents with headache.
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Multicenter Study Clinical Trial
Efficacy and safety of pregabalin in patients with diabetic peripheral neuropathy or postherpetic neuralgia: Open-label, non-comparative, flexible-dose study.
We assessed the efficacy and safety of a flexible-dose pregabalin regimen in patients with diabetic peripheral neuropathy (DPN) or postherpetic neuralgia (PHN) under clinical practice conditions. Further, the trial investigated the correlation of unspecific measures of change (patient and physician global impression of change, PGIC and CGIC) and specific measures of morbidity. The primary outcomes of this prospective, open-label, non-controlled study were the correlation between global status (PGIC and CGIC) and changes in pain, sleep, and anxiety scores as assessed on numerical or visual rating scales. ⋯ In conclusion, pregabalin in a flexible-dose regimen improved pain, sleep, anxiety and general state, and was well tolerated. The efficacy and safety profile of pregabalin was consistent with the data from the controlled clinical trials. The PGIC and CGIC and the specific pain and sleep scores, but not the anxiety score were generally well correlated but not synonymous.