The journal of pain : official journal of the American Pain Society
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Multicenter Study
Parent and Child Catastrophizing in Pediatric Sickle Cell Disease.
Pain catastrophizing is poorly understood in children and adolescents with sickle cell disease (SCD) and their parents. The objectives of this study were twofold: 1) to evaluate the interplay between parent and child pain catastrophizing and its effect on disability among youth with SCD, and 2) to evaluate whether child pain catastrophizing served as a mechanism that explained the relation between pain and functional disability within the context of varying levels of parent pain catastrophizing. One hundred youth (8-18 years old) with SCD and parents completed measures of pain characteristics (pain frequency and intensity), catastrophizing (Pain Catastrophizing Scale), and the outcome of functional disability (Functional Disability Inventory) in a cross-sectional study. Youth with low levels of catastrophizing showed high levels of disability in the presence of high levels of parent catastrophizing. Additionally, child pain catastrophizing was a significant mechanism that partially explained the effect of higher pain frequency and pain intensity on greater levels of disability, but only at low levels of parent pain catastrophizing. High levels of parent catastrophizing and incongruence between child and parent catastrophizing contributes to poorer functional outcomes in youth with SCD. ⋯ Youth with SCD and parents with high levels of catastrophic thinking about child pain or incongruent levels of catastrophizing are at increased risk for greater child disability. Clinicians treating youth with SCD should focus on targeting worried thinking about pain in patients and parents to facilitate improved function.
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Multicenter Study
Disrupted self-perception in people with chronic low back pain. Further evaluation of The Fremantle Back Awareness Questionnaire.
Several lines of evidence suggest that body perception is altered in people with chronic back pain. Maladaptive perceptual awareness of the back might contribute to the pain experience as well as serve as a target for treatment. The Fremantle Back Awareness Questionnaire (FreBAQ) is a simple questionnaire recently developed to assess back-specific altered self-perception. The aims of this study were to present the outcomes of a comprehensive evaluation of the questionnaire's psychometric properties and explore the potential relationships between body perception, nociceptive sensitivity, distress, and beliefs about back pain and the contribution these factors might play in explaining pain and disability. Two hundred fifty-one people with chronic back pain completed the questionnaire as well as a battery of clinical tests. The Rasch model was used to explore the questionnaires' psychometric properties and correlation and multiple linear regression analyses were used to explore the relationship between altered body perception and clinical status. The FreBAQ appears unidimensional with no redundant items, has minimal ceiling and floor effects, acceptable internal consistency, was functional on the category rating scale, and was not biased by demographic or clinical variables. FreBAQ scores were correlated with sensitivity, distress, and beliefs and were uniquely associated with pain and disability. ⋯ Several lines of evidence suggest that body perception might be disturbed in people with chronic low back pain, possibly contributing to the condition and offering a potential target for treatment. The FreBAQ was developed as a quick and simple way of measuring back-specific body perception in people with chronic low back pain. The questionnaire appears to be a psychometrically sound way of assessing altered self-perception. The level of altered self-perception is positively correlated with pain intensity and disability as well as showing associations with psychological distress, pain catastrophization, fear avoidance beliefs, and lumbar pressure pain threshold. In this sample, it appears that altered self-perception might be a more important determinant of clinical severity than psychological distress, pain catastrophization, fear avoidance beliefs, or lumbar pressure pain threshold.
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Randomized Controlled Trial
The effects of Tai Chi and neck exercises in the treatment of chronic non-specific neck pain: A randomized controlled trial.
This study aimed to test the efficacy of Tai Chi for treating chronic neck pain. Subjects with chronic nonspecific neck pain were randomly assigned to 12 weeks of group Tai Chi or conventional neck exercises with weekly sessions of 75 to 90 minutes, or a wait-list control. The primary outcome measure was pain intensity (visual analogue scale). Secondary outcomes included pain on movement, functional disability, quality of life, well-being and perceived stress, postural and interoceptive awareness, satisfaction, and safety. Altogether, 114 participants were included (91 women, 49.4 ± 11.7 years of age). After 12 weeks Tai Chi participants reported significantly less pain compared with the wait list group (average difference in mm on the visual analogue scale: -10.5; 95% confidence interval, -20.3 to -.9; P = .033). Group differences were also found for pain on movement, functional disability, and quality of life compared with the wait list group. No differences were found for Tai Chi compared with neck exercises. Patients' satisfaction with both exercise interventions was high, and only minor side effects were observed. Tai Chi was more effective than no treatment in improving pain in subjects with chronic nonspecific neck pain. Because Tai Chi is probably as effective as neck exercises it may be considered a suitable alternative to conventional exercises for those with a preference toward Tai Chi. ⋯ This article presents results of a randomized controlled trial comparing Tai Chi, conventional neck exercises, and no treatment for chronic nonspecific neck pain. Results indicate that Tai Chi exercises and conventional neck exercises are equally effective in improving pain and quality of life therefore representing beneficial interventions for neck pain.