J Rheumatol
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Comparative Study
Teaching clinical skills in musculoskeletal medicine: the use of structured clinical instruction modules.
To assess student evaluation, satisfaction, and examination outcomes for a new method of teaching musculoskeletal (MSK) medicine clinical skills, structured clinical instruction modules (SCIM), and to compare with the outcomes of a traditional method of teaching clinical skills (small group bedside tutorials). ⋯ The SCIM is an effective method of teaching clinical skills in MSK medicine, comparable with patient partners and traditional registrar based bedside teaching methods, but it is less resource intensive.
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To describe the change of pain reports over time in 3 cohorts derived from the general population: (1) no chronic pain (NCP; n = 1156); (2) chronic regional pain (CRP; n = 502); and (3) chronic widespread pain (CWP; n = 242). To identify risk factors that predict the development or persistence of chronic widespread pain. ⋯ Although the overall prevalence of CWP was stable over a 3-year period there was a considerable variation on an individual basis. This variability in expressing CWP was moderately predicted by a combination of risk factors, the most important being the number of painful regions at baseline. Future research will need to show how useful the identified factors are in clinical practice and whether intervention aimed at changing these factors will improve pain outcome.
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomized clinical trial comparing fitness and biofeedback training versus basic treatment in patients with fibromyalgia.
To compare the therapeutic effects of physical fitness training or biofeedback training with the results of usual care in patients with fibromyalgia (FM). ⋯ In terms of training intensity and maximal heart rates, the high impact fitness intervention had a low impact benefit. Therefore effectiveness of high impact physical fitness training cannot be demonstrated. Thus compared to usual care, the fitness training (i.e., low impact) and biofeedback training had no clear beneficial effects on objective or subjective patient outcomes in patients with FM.
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To estimate the severity of depression, anxiety, and other symptoms of psychological distress in a representative general population sample of fibromyalgia (FM) cases (FC) compared to pain controls (PC), and to identify strong correlates of depression and anxiety. ⋯ Depression and anxiety are common and frequently severe even among community cases of FM.
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The WHO-ILAR Community Oriented Program for Control of Rheumatic Diseases (COPCORD) primarily aims to estimate the burden of rheumatic-musculoskeletal symptoms/disorders (RMS). We investigated data on pain and disability, perceptions and beliefs in the first rural community based COPCORD study in India. ⋯ The findings of this study (1) demonstrate that RMS, although a predominant ailment, has a modest effect on daily living in most subjects with RMS; (2) indicate there is inconsistency between the measures of pain and disability (using HAQ) and their effects; (3) describe the beliefs and expectations of the community. Based on the data and community support, the COPCORD has been continued for Stages II and III, especially with a view to health education.