Clinical Journal of Pain最新文献

{"title":"Engagement in Digital Self-management Interventions for Chronic Pain: A Systematic Review.","authors":"R Ross MacLean, Rachel Shor, Erin D Reilly, Lillian Reuman, Chelsey Solar, Allison M Halat, Diana M Higgins","doi":"10.1097/AJP.0000000000001289","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001289","url":null,"abstract":"<p><strong>Objectives: </strong>Digital interventions promise to increase access to non-pharmacological chronic pain treatment and reduce burden for both individuals seeking care and pain providers/clinics. Unfortunately, despite early evidence of efficacy, engagement in self-management digital interventions for chronic conditions is typically low. A comprehensive analysis into how engagement in these programs is measured and reported is warranted. The current systematic review evaluated engagement in digital self-management interventions for chronic pain and identified gaps to improve reporting of engagement data.</p><p><strong>Methods: </strong>We conducted a pre-registered systematic review using Boolean search terms to identify digital chronic pain self-management interventions that did not include clinician support. After removal of duplicates and screening, 148 full-text manuscripts were assessed, and 44 studies met inclusion criteria. Data was extracted and examined from included manuscripts.</p><p><strong>Results: </strong>Of the 44 included articles, five articles were based on two separate datasets, resulting in a final sample of 40 unique datasets representing 4,178 participants that were mostly non-Hispanic White, female, and with at least some college education. Approximately 10% of studies did not report any data related to system use or self-reported engagement. Most engagement data consisted of mean system use variables, with a handful of studies describing self-reported use of skills and very few studies examining demographic variables associated with engagement.</p><p><strong>Discussion: </strong>To address identified gaps in the reviewed literature, we suggest guidelines for collecting and reporting engagement in digital chronic pain interventions. Consistent reporting of engagement data will improve evaluation, efficacy, and improvement of interventions designed to assist individuals who may otherwise not receive non-pharmacological pain treatment.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Convergent Validity of Pain Drawings and Anatomical Checklists in Individuals with Chronic Pain.","authors":"Jeremy Fung, David W Evans, Deborah Falla, Marco Barbero","doi":"10.1097/AJP.0000000000001290","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001290","url":null,"abstract":"<p><strong>Objectives: </strong>The assessment of the spatial characteristics of pain, such as location and extent, is essential in the clinical evaluation of pain syndromes, especially when managing patient's with chronic musculoskeletal pain. This study evaluated the convergent validity of pain drawings (PDs) and anatomical checklists (ACLs) in measuring pain location (PL) and pain extent (PE) in individuals with chronic musculoskeletal pain.</p><p><strong>Methods: </strong>Twenty volunteers participated, each completing a PD and an ACL in a randomized order following standardized training. PDs were digitized and analyzed using a custom algorithm on a web platform. PL was categorized across 45 anatomical areas. PE was assessed using a region-weighted approach by means of the Margolis rating scale and a pixel-based method. Statistical analyses included Spearman's rho and the Jaccard Index to compare the obtained PD metrics.</p><p><strong>Results: </strong>A strong correlation was found between a PDs and ACLs for PE (Spearman's rho=0.823), suggesting similar capabilities in quantifying the spatial distribution of pain. However, a significant discrepancy in PL measurements, with a mean Jaccard Index of 0.54, indicated poor agreement between methods.</p><p><strong>Discussion: </strong>These results highlight the non-interchangeability of these instruments for PL identification and underscore the importance of each tool's unique advantages and limitations. The study also highlighted the potential benefits of incorporating innovative pain metrics into current health questionnaires to enhance their clinimetric properties. These findings advocate for continued research with larger and more diverse patient cohorts to further validate PDs and ACLs and to explore additional psychometric properties for pain assessment.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Pain Treatment on Fatigue and Sleep Quality in Children and Adolescents - A Longitudinal Study.","authors":"Ariane Sommer, Susanne Grothus, Benedikt B Claus, Lea Höfel, Julia Wager","doi":"10.1097/AJP.0000000000001288","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001288","url":null,"abstract":"<p><strong>Objectives: </strong>Fatigue and poor sleep quality are common comorbidities in pediatric chronic pain patients and closely related to pain characteristics. Little is known about whether fatigue and sleep quality change after pain therapy or whether there are differences between various treatment intensities.</p><p><strong>Methods: </strong>In a longitudinal study with three measurement points (T1 - before therapy, T2 - 3 mo after therapy, T3 - 6 mo after therapy), n=248 outpatient and n=338 inpatient youth (11-17 y; 73.4% female) receiving pain therapy (single outpatient consultation for outpatient youth vs. intensive interdisciplinary pain treatment for inpatient youth) at two different pain centers were studied. We examined the prevalence of fatigue and poor sleep quality in out- versus inpatient youth, as well as the longitudinal relationships between fatigue, sleep quality, and pain variables. Changes in fatigue and sleep quality over the course of pain therapy in out- and inpatient youth were also explored.</p><p><strong>Results: </strong>Fatigue was highly prevalent, particularly among inpatient youth, with 44% experiencing moderate or severe fatigue symptoms. There were significant correlations between fatigue, sleep quality, and pain-related factors such as pain intensity, functional impairment, and pain-related missed school days. Fatigue symptoms and sleep quality worsened in inpatient youth but partially improved in outpatient youth from pre- to post-therapy.</p><p><strong>Discussion: </strong>Fatigue and sleep are relevant comorbidities in youth living with chronic pain. Addressing these issues should become an established goal of pediatric pain management, as it might further improve pain outcomes. This may require complementary interventions to explicitly target these comorbidities.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Pain Self-Efficacy Moderate the Association of Psychosocial Factors with the Health-Related Quality of Life of Patients Scheduled for Lumbar Spine Surgery?","authors":"Yu Kondo, Yuta Watanabe, Takahiro Miki, Keita Tsushima, Ryo Otsuki, Tsuneo Takebayashi","doi":"10.1097/AJP.0000000000001285","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001285","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the moderating role of pain self-efficacy in the association of multiple psychosocial factors with the health-related quality of life (HRQOL) of patients scheduled for lumbar spine surgery.</p><p><strong>Methods: </strong>This cross-sectional study analyzed 258 patients scheduled for lumbar spine surgery. Data were collected preoperatively using validated tools to measure HRQOL, pain self-efficacy, pain intensity, anxiety and depression, fear of movement, pain catastrophizing, and central sensitization symptoms. Hierarchical multiple regression analysis and simple slope tests were performed to assess the associations of psychosocial factors with HRQOL and the moderating effects of pain self-efficacy on these relationships.</p><p><strong>Results: </strong>The final model explained 43.8% of the HRQOL variance. Significant interactions were noted between pain self-efficacy and pain intensity (P<0.01), anxiety (P<0.01), fear of movement (P<0.05), and pain catastrophizing (P<0.01). The negative associations of these psychological factors with HRQOL were significant only in the low pain self-efficacy group, whereas these associations were attenuated to nonsignificant levels in the high pain self-efficacy group.</p><p><strong>Discussion: </strong>In this cross-sectional study, different associations between psychosocial factors and HRQOL were observed based on pain self-efficacy levels in patients awaiting lumbar spine surgery. This finding suggests that pain self-efficacy assessment may help identify high-risk patients who need additional preoperative psychological support.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Analgesic Efficacy of Different Regional Blocks After Single-incision Video-assisted Thoracoscopic Surgery.","authors":"Gu-Yue Liu, Fu-Shan Xue, Mu Jin","doi":"10.1097/AJP.0000000000001287","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001287","url":null,"abstract":"","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional Anesthesia Techniques as Perioperative Analgesia Method for Posterior Cervical Spine Surgery.","authors":"Jie Hu, Jing Yang","doi":"10.1097/AJP.0000000000001286","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001286","url":null,"abstract":"","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Professionals' Perspectives of Working with Children and Adolescents Experiencing Chronic Pain: Barriers and Facilitators.","authors":"Jennifer G Norton, Toby Newton-John, Mark Alcock, Janine Moore, Nicole Southon, Joshua W Pate","doi":"10.1097/AJP.0000000000001284","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001284","url":null,"abstract":"<p><strong>Objectives: </strong>To identify health professional's perception of barriers, facilitators and training needs when working with children experiencing chronic pain.</p><p><strong>Methods: </strong>Cross-sectional online survey of health professionals working with children experiencing chronic pain. Survey questions were a range of exploratory open and closed-ended questions, which included yes/no responses, choosing from a list, ranking options and open responses. Quantitative data were analysed using descriptive statistics and percentages; qualitative data were analysed using content analysis.</p><p><strong>Results: </strong>180 health professionals took part, of which 44% were physiotherapists. Tertiary hospitals and private practices were most common workplaces. The most frequently reported categories of both barriers and facilitators were workforce and system factors, child factors and parent factors. The most frequently reported confidence areas and development areas were health professional factors, approaches to care and team structure. 75% of participants reported they were moderately to extremely interested in further training in paediatric chronic pain management and indicated a preference for interactive training rather than \"passive\" learning formats.</p><p><strong>Discussion: </strong>Health professionals report a diverse range of perspectives when working with children experiencing chronic pain, including perceived barriers and facilitators to care. Most health professionals were interested in future training in paediatric chronic pain management. Future research exploring the parent and child perspective and how these factors present clinically is needed to inform future training opportunities for health professionals working with children experiencing chronic pain.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Effectiveness of Non-invasive Brain Stimulation for the Treatment of Pain, Fatigue, and Sleep Quality in Fibromyalgia. A Systematic Review with Network Meta-Analysis.","authors":"Ishtiaq Ahmed, Rustem Mustafaoglu, Aamir Raoof Memon, Rubab Zafeer, Huanyu Xiong, Sofia Straudi, Nils Runge","doi":"10.1097/AJP.0000000000001282","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001282","url":null,"abstract":"<p><strong>Objectives: </strong>There is tentative evidence to support the analgesic effects of non-invasive brain stimulation (NiBS) in fibromyalgia (FM), but a comprehensive synthesis is lacking. This systematic review with network meta-analysis (NMA) aims to determine the relative effectiveness of different NiBS techniques, such as transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) in FM, and to identify the optimal stimulation location and intensity/frequency.</p><p><strong>Methods: </strong>Four databases were searched until 9 July 2023 for randomized trials (RCTs) comparing NiBS in FM. Pain was the primary outcome, while fatigue and sleep were secondary outcomes. A frequentist NMA calculated standardized-mean-differences (SMDs) for pain, with pairwise meta-analysis for fatigue and sleep. Bias was assessed with the Cochrane-risk-of-bias-tool (RoB-2.0), and evidence certainty via Confidence-in-NMA.</p><p><strong>Results: </strong>43 RCTs with 2120 participants were included. NMA showed that low frequency (LF)-rTMS (SMD -1.20,(95%CI -1.82,-0.58)), dual tDCS (-0.91,(-1.82,-0.58)) and high frequency (HF)-rTMS (-0.58,(-1.00,-0.17)) likely results in reduction in pain intensity at the end of intervention compared with sham stimulation. For stimulation location, right dorsolateral prefrontal cortex (DLPFC)(-1.42,(-2.69,-0.15)), bilateral DLPFC (-0.94,(-1.82,-0.05), and left primary motor cortex (M1)(-0.49,(-0.85,-0.14)) likely results in reduction in pain intensity at the end of intervention, with DLPFC maintaining effects in short term. LF-rTMS over DLPFC (-1.42,(-2.69,-0.15)) and HF-rTMS over M1 (-0.78,(-1.39,-0.18)) likely results in reduction in pain intensity at the end of intervention, with LF-rTMS over right DLPFC maintaining effects in short term. NiBS appears to be safe and may reduce fatigue and improve sleep quality.</p><p><strong>Discussion: </strong>Excitatory stimulation like HF-rTMS over M1 and inhibitory like LF-rTMS over DLPFC may yield better results.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impacts of Poor Sleep Quality on Knee Pain and Quality of Life in Young Adults: Insights from a Population-Based Cohort.","authors":"Emma Hertel, Michael Skovdal Rathleff, Christian Lund Straszek, Sinead Holden, Kristian Kjær-Staal Petersen","doi":"10.1097/AJP.0000000000001283","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001283","url":null,"abstract":"<p><strong>Objectives: </strong>Poor sleep is common among young adults and is often associated with pain. This study investigates the relationship between pain-related outcomes, sleep quality, and quality of life in young adults with and without knee pain.</p><p><strong>Methods: </strong>This study is a secondary analysis of the 5-year follow-up of a prospective cohort study. 523 young adults were surveyed for knee pain in 2011 and followed up five years later. Respondents reporting knee pain at both points were categorized as having knee pain (n=177), while controls did not report knee pain (n=85). Five-year follow-up data assessed clinical pain intensity, pain-related outcomes, quality of life, and physical activity. Additionally, respondents were scored as having good, moderate, or poor sleep quality.</p><p><strong>Results: </strong>In the knee pain group, respondents with poor sleep had worse Knee injury and Osteoarthritis Outcome Score (KOOS) scores across all domains (P<0.05), decreased quality of life (P<0.001), impacted mood (P<0.05), and impacted everyday life (P<0.001) compared to those with good sleep. Respondents with poor sleep in both the knee pain and control group reported more pain sites per month (P<0.01) compared to those with good sleep. Finally, respondents in the knee pain group with poor sleep had increased pain medication usage compared to those with good sleep (P<0.05).</p><p><strong>Discussion: </strong>This study emphasizes the negative association between poor sleep quality and knee pain in young adults. The results indicate a need for strategies to address sleep disturbances in young adults to alleviate pain-related suffering and to increase quality of life.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Psychological Factors Explain the Persistence of Symptoms in Individuals with Rotator Cuff-related Shoulder Pain? A Prospective Cohort Study.","authors":"Dayana Patricia Rosa, Marc-Olivier Dubé, Simon Beaulieu-Bonneau, Alex Scott, Hugo Masse-Alarie, Jean-Sébastien Roy","doi":"10.1097/AJP.0000000000001280","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001280","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether psychosocial factors such as resilience, perceived stress, catastrophizing, anxiety, depression, pain self-efficacy, and social support, explain the persistence of pain and disability in individuals with RCRSP following an education program.</p><p><strong>Methods: </strong>One hundred forty-three individuals with persistent RCRSP were included in this prospective cohort study. At baseline, participants completed self-reported questionnaires related to pain, disability, and psychosocial constructs, including resilience, stress, catastrophizing, anxiety and depressive symptoms, pain self-efficacy, and social support. Thereafter, participants took part in an educational program aimed at promoting self-management of RCRSP that included two meetings with a physiotherapist. After 12 and 24-weeks, participants filled only pain and disability questionnaires and based on their scores, were classified as having persistent shoulder pain or as recovered.</p><p><strong>Results: </strong>A univariable modified Poisson regression showed that higher perceived stress (RRadjusted: 1.02; 95%CI: 1.01-1.04), catastrophizing (RRadjusted: 1.01; 95%CI: 1.01-1.02), symptoms of depression (RRadjusted: 1.03; 95%CI: 1.01-1.06) and anxiety (RRadjusted: 1.03; 95%CI: 1.01-1.06), along with lower resilience (RRadjusted: 0.90; 95%CI: 0.81-1.00), were associated with ongoing RCRSP at 12 weeks. Additionally, reduced pain self-efficacy was associated with persistent pain at both 12 weeks (RRadjusted: 0.98; 95%CI: 0.97-0.99) and 24 weeks (RRadjusted: 0.99; 95%CI: 0.98-1.00). Multivariable regression indicated that only pain self-efficacy served as a protective factor against persistent RCRSP (RRadjusted: 0.98; 95%CI: 0.97-0.99).</p><p><strong>Discussion: </strong>This study sheds light on the impact of psychosocial factors on persistent RCRSP, underscoring the importance of positive beliefs in pain management. Importantly, pain self-efficacy emerges as a key factor in recovery.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}