Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Physical activity within a CBT intervention improves coping with pain in traumatized refugees: results of a randomized controlled design.
Many traumatized refugees experience both posttraumatic stress disorder and chronic pain. Based on Mutual Maintenance Theory and the Perpetual Avoidance Model, this study examined the additional effect of physical activity within a biofeedback-based cognitive behavioral therapy (CBT-BF) for traumatized refugees. ⋯ Findings of improved coping strategies, larger effect sizes, and higher rates of clinical improvement in the CBT-BF+active group suggest that physical activity adds value to pain management interventions for traumatized refugees. Given the small sample size, however, these preliminary results need replication in a larger trial.
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The objective of this study was to report clinical spectrum of central post stroke pain (CPSP) and correlate these with magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT) findings. ⋯ The QST findings in patients with CPSP were similar in patients with thalami and extrathalamic lesions. SPECT and MRI findings were also not different in CPSP patients with and without allodynia.
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To examine whether the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) screening tool can satisfy Rasch model expectations and therefore be transformed into an interval level measurement scale, suitable for use as an outcome measure in clinical studies. ⋯ Neuropathic screening tools such as the LANSS have been used as outcome measures in clinical studies. Rasch analysis demonstrates that the LANSS can be used as such in specific populations of patients with neuropathic pain, however it's reliability in this context does not support use at the individual level and it cannot be used as a generalised measurement tool across pain diagnostic groups. The LANSS remains primarily a diagnostic tool.
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Socioeconomic status influences the relationship between fear-avoidance beliefs work and disability.
Biopsychosocial models are currently accepted for study of low back pain (LBP), but there is little evidence investigating socioeconomic status (SES) influence on disability, pain intensity, and physical impairment. The present study examined SES (income and education) and fear-avoidance model (fear-avoidance beliefs and pain catastrophizing) for their influence on disability, pain intensity and physical impairment. ⋯ This study adds to the growing literature examining biopsychosocial models by considering SES. Our results suggest SES had a minimal influence on pain intensity and physical impairment, but did interact with fear-avoidance beliefs to influence disability.
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Phantom limb pain is often resistant to treatment. Techniques based on visual-kinesthetic feedback could help reduce it. ⋯ Persons with phantom limb pain may benefit from this novel intervention combining observation and motor imagery. Additional studies are needed to confirm our findings, elucidate mechanisms, and identify patients likely to respond.