RESUMEN
This prospective study aims to evaluate dental pain, anxiety, and catastrophizing levels in pregnant women undergoing root canal treatment. Sixty pregnant and non-pregnant women presenting dental pain and an indication for root canal treatment were included in the study. Dental anxiety and catastrophizing were investigated using validated questionnaires. The endodontic intervention was performed, and a numerical scale measured preoperative and postoperative dental pain. The results were analyzed using STATA software 12.0. Unadjusted analyses assessed the association between pregnancy and pain, anxiety, and catastrophizing levels. Multiple linear regression models using 'forward stepwise' entry procedures were used to assess the independent effects of variables on pain scores. The significance level was set at 0.05. Initially, most patients experienced intense dental pain. The levels of dental pain, dental anxiety, and catastrophizing did not differ between pregnant and non-pregnant women. Logistic regression showed that postoperative pain was associated with irreversible pulpitis diagnosis (OR = 4.78; 95%CI 1.55-13.55) and high catastrophizing levels (OR = 1.96; 95%CI 1.01-3.84). Preoperative and postoperative pain rates and anxiety and catastrophizing were similar between pregnant and non-pregnant patients. Postoperative pain was associated with irreversible pulpitis diagnosis and high catastrophizing levels. The similarity between pregnant and non-pregnant women regarding preoperative and postoperative dental pain and catastrophizing and anxiety levels supports the indication of root canal treatment during the gestational period whenever necessary.
Asunto(s)
Catastrofización , Ansiedad al Tratamiento Odontológico , Dimensión del Dolor , Dolor Postoperatorio , Tratamiento del Conducto Radicular , Odontalgia , Humanos , Femenino , Tratamiento del Conducto Radicular/psicología , Embarazo , Adulto , Estudios Prospectivos , Ansiedad al Tratamiento Odontológico/psicología , Dolor Postoperatorio/psicología , Catastrofización/psicología , Adulto Joven , Odontalgia/psicología , Encuestas y Cuestionarios , Complicaciones del Embarazo/psicología , Modelos Logísticos , Pulpitis/psicología , Pulpitis/cirugía , Pulpitis/terapia , Estadísticas no ParamétricasRESUMEN
Objective: (1) This trial will compare the clinical and psychosocial effectiveness of in-group and individually pain neuroscience education (PNE) in patients with chronic low back pain (CLBP). In addition, (2) the influence of social determinants of health on post-treatment results will be analyzed. Methods: A three-arm randomized controlled trial will be conducted. Sixty-nine participants with CLBP will be recruited in a 1:1:1 ratio. Participants, assessor, and statistician will be blinded to group assignment. The PNE intervention will be adapted to the context of the participants. An experimental group (n = 33) will receive PNE in an in-group modality, the other experimental group (n = 33) will receive PNE in an individually modality and the control group (n = 33) will continue with usual care. Additionally, participants will be encouraged to stay active by walking for 20-30 min 3-5 times per week and will be taught an exercise to improve transversus abdominis activation (bracing or abdominal following). The outcome measures will be fear avoidance and beliefs, pressure pain threshold, pain self-efficacy, catastrophizing, pain intensity, and treatment expectation. Outcome measures will be collected at one-week before intervention, immediately post-intervention, and four-weeks post-intervention. Conclusion: The innovative approach of PNE oriented to fear beliefs proposed in this study could broaden the application strategies of this educational therapeutic modality. Impact. Contextualized PNE delivered by physical therapist could be essential to achieve a good cost-effectiveness ratio of this intervention to improve the clinical condition of people with CLBP.
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Dolor Crónico , Dolor de la Región Lumbar , Neurociencias , Educación del Paciente como Asunto , Humanos , Dolor de la Región Lumbar/psicología , Dolor de la Región Lumbar/terapia , Neurociencias/educación , Educación del Paciente como Asunto/métodos , Dolor Crónico/terapia , Dolor Crónico/psicología , Masculino , Femenino , Adulto , Catastrofización/psicología , Dimensión del Dolor , Persona de Mediana Edad , Resultado del Tratamiento , Autoeficacia , Terapia por Ejercicio/métodosRESUMEN
BACKGROUND: The Brief Measure of Preoperative Emotional Stress (B-MEPS) is a suitable screening tool for Preoperative Emotional Stress (PES). However, personalized decision-making demands practical interpretation of the refined version of B-MEPS. Thus, we propose and validate cut-off points on the B-MEPS to classify PES. Also, we assessed if the cut-off points screened preoperative maladaptive psychological features and predicted postoperative opioid use. METHODS: This observational study comprises samples of two other primary studies, with 1009 and 233 individuals, respectively. The latent class analysis derived emotional stress subgroups using B-MEPS items. We compared membership with the B-MEPS score through the Youden index. Concurrent criterion validity of the cut-off points was performed with the severity of preoperative depressive symptoms, pain catastrophizing, central sensitization, and sleep quality. Predictive criterion validity was performed with opioid use after surgery. RESULTS: We chose a model with three classes labeled mild, moderate, and severe. The Youden index points -0.1663 and 0.7614 of the B-MEPS score classify individuals, in the severe class, with a sensitivity of 85.7% (80.1%-90.3%) and specificity of 93.5% (91.5-95.1%). The cut-off points of the B-MEPS score have satisfactory concurrent and predictive criterion validity. CONCLUSIONS: These findings showed that the preoperative emotional stress index on the B-MEPS offers suitable sensitivity and specificity for discriminating the severity of preoperative psychological stress. They provide a simple tool to identify patients prone to severe PES related to maladaptive psychological features, which might influence the perception of pain and analgesic opioid use in the postoperative period.
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Analgésicos Opioides , Dolor Postoperatorio , Humanos , Dolor Postoperatorio/diagnóstico , Dolor Postoperatorio/psicología , Catastrofización/diagnóstico , Catastrofización/psicología , Estrés Psicológico/diagnósticoRESUMEN
This study aimed to evaluate the association of pain-related disability with biopsychosocial factors in temporomandibular disorders (TMD) patients. The study was carried out at the Orofacial Pain Outpatient Clinic of the State University of Feira de Santana, Bahia, from September 2018 to March 2020. The sociodemographic aspects, TMD subtypes, presence of pain-induced disability, pressure pain threshold, perceived stress, anxiety, depression, and catastrophizing were evaluated in 61 patients. The studied variables were compared between patients with and without pain-induced disability. Crude and adjusted logistic regression were performed to obtain estimates of odds ratios (OR) and 95% confidence intervals. With the exception of catastrophizing, there was no association between the biopsychosocial factors and pain-induced disability. The presence of catastrophizing increased the chance of having chronic pain-induced disability by 4.02 times. The results of this study indicate a strong association between pain catastrophizing and disability in individuals with chronic painful TMD.
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Dolor Crónico , Trastornos de la Articulación Temporomandibular , Humanos , Catastrofización/psicología , Dolor Crónico/psicología , Ansiedad , Dimensión del Dolor/métodos , Trastornos de la Articulación Temporomandibular/psicologíaRESUMEN
OBJECTIVE: Interventions based on pain education and self-management are dependent on factors such as attention, memory, concentration, and executive function. To explore the relationship between cognitive performance and the variables pain intensity, central sensitization, catastrophizing, and hypervigilance in women diagnosed with chronic pain-related TMD. METHODOLOGY: This is a cross-sectional study. A total of 33 women (mean age: 38±4.6 years; range: 18 to 66 years) with chronic pain-related TMD (myalgia and/or arthralgia) diagnosed according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Specific questionnaires were used to evaluate cognitive performance, overall pain intensity, central sensitization, hypervigilance, and pain catastrophizing. The data were analyzed using Pearson's correlation coefficient and backward stepwise multiple linear regression (statistical significance at 5% alpha). RESULTS: Approximately 53% of the study sample showed decreased cognitive performance. High central sensitization, hypervigilance, and pain catastrophizing were observed. A significant negative correlation was observed between cognitive performance and hypervigilance (p=.003, r=-.49), cognitive performance and catastrophizing (p<.001, r=-.58), and cognitive performance and pain intensity (p<.001, r=-.58). Regarding the partial regression coefficients, only catastrophizing and pain intensity showed statistical significance (t=-2.12, p=.043; t=-2.64, p=.014, respectively), indicating a significant role in explaining cognitive performance at the sample. CONCLUSION: High pain intensity and the presence of catastrophic thoughts regarding pain can predict impaired cognitive performance in women with chronic pain-related TMD. Management strategies addressing psychosocial dimensions such as reducing catastrophizing and ensuring complete understanding of the condition are important.
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Dolor Crónico , Humanos , Femenino , Adulto , Estudios Transversales , Dimensión del Dolor , Catastrofización/psicología , CogniciónRESUMEN
Chronic pelvic pain (CPP) in women is a highly prevalent condition worldwide and requires multimodal treatment. Adverse childhood experiences have been associated with CPP in women, while allodynia and poor outcomes have been linked to pain catastrophizing in these patients. Pain perception has been associated with parenting style during childhood. The objective of this study was to investigate the association between parenting style, pain catastrophizing, anxiety, depression and CPP in women. A case-control study was conducted between May 2018 and August 2021 with 123 women with CPP and 123 pain-free controls. Questionnaires were used to collect participants' data. The association between parenting style and CPP was assessed using multiple logistic regression, with odds ratios (OR) and 95% confidence intervals (CI) being calculated. The correlation between catastrophizing, pain intensity, pain duration, anxiety, depression, and parenting style in women with CPP was assessed using Spearman's rank correlation coefficient (r). A higher frequency of low maternal care (60.7% versus 45.2%; p = 0.026), anxiety (79.7% versus 56.9%; p < 0.001), depression (73.2% versus 56.1%; p = 0.008) and physical violence (31.7% versus 14.6%; p = 0.003) was found in the CPP group compared to the controls. There was no association between parenting style and CPP in the adjusted analysis. A positive correlation was found between catastrophizing and pain intensity (r = 0.342; p < 0.001), anxiety (r = 0.271; p = 0.002), depression (r = 0.272; p = 0.002), and maternal overprotection (r = 0.185; p = 0.046). A negative correlation was found between anxiety and maternal (r = -0.184; p = 0.047) and paternal (r = -0.286; p = 0.006) care and between depression and maternal (r = -0.219; p = 0.018) and paternal (r = -0.234; p = 0.026) care. The present results suggest a significant but weak association of parenting style with pain catastrophizing, the mental health of women with CPP, and the way in which they experience pain.
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Catastrofización , Dolor Crónico , Humanos , Femenino , Catastrofización/psicología , Responsabilidad Parental/psicología , Salud Mental , Estudios de Casos y Controles , Dolor Pélvico , Dolor Crónico/psicología , Depresión/psicologíaRESUMEN
Abstract Background Patients' postoperative treatment might be affected by their psychological state. The study aimed to evaluate the effects of anxiety, coping ability (stress tolerance), depression, and pain catastrophizing on analgesic consumption in patients scheduled for sleeve gastrectomy. Methods This prospective observational study consisted of 72 patients. The Distress Tolerance Scale (DTS), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Pain Catastrophizing Scale (PCS) were completed in the preoperative period. In the postoperative period, pain intensity, as measured with the Visual Analogue Scale (VAS), and morphine consumption (mg) were evaluated after 2, 6, 8, and 24 hours. Total morphine consumption was recorded. Results The results revealed a strong negative correlation between distress tolerance and postoperative total morphine consumption (r = -0.702, p< 0.001). There was a strong positive correlation between total morphine consumption and pain catastrophizing (r = 0.801, p< 0.001). A moderate positive correlation was observed between total morphine consumption and anxiety and between total morphine consumption and depression (r = 0.511, p< 0.001; r = 0.556, p< 0.001, respectively). Linear regression revealed that distress tolerance, anxiety, depression, and pain catastrophizing are predictors of postoperative morphine consumption (β = 0.597, p< 0.001; β = 0.207, p= 0.036; β = 0.140, p= 0.208; β = 0.624, p< 0.001, respectively). Conclusions Distress tolerance, anxiety, depression, and pain catastrophizing can be predictive of postoperative analgesic consumption. In the estimation of postoperative analgesic consumption, distress tolerance, as well as anxiety, depression, and pain catastrophizing, were found to be important predictors.
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Humanos , Depresión/psicología , Catastrofización/psicología , Ansiedad/psicología , Dolor Postoperatorio/psicología , Dolor Postoperatorio/tratamiento farmacológico , Periodo Posoperatorio , Analgésicos , MorfinaRESUMEN
Osteoarthritis (OA) is the most common joint condition. It affects more than 300 million people worldwide, who suffer from pain and physical disability. OBJECTIVE: To determine the results of cognitive educational interventions for pain management and psychosocial variables in adults with OA. METHOD: A systematic review was conducted based on searches in MEDLINE, OVID, LILACS, Scopus, PEDro, OTseeker, The Cochrane Library, EBSCO, and Google Scholar. The search strategy included the main terms neuroscience education and osteoarthritis, without any re-strictions with regard to dates or study type (PROSPERO register CRD42021222763). RESULTS: We included four articles that implemented the intervention in 1-6 sessions, addressing concepts related to goal orientation and providing strategies for understanding pain. The results suggest that there is an improvement between the groups (PNE) when compared, but this cannot necessarily be attributed to pain neuroscience education (PNE), as small effect sizes for variables such as pain catastrophizing and kinesiophobia were observed. The response in the modulation of acute pain following the surgical procedure may produce a variation in the responses and this may be mediated by medications. CONCLUSION: The study revealed an improvement in favor of the groups managed with PNE, although more studies documenting the topic are warranted.
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Dolor Crónico , Osteoartritis , Adulto , Catastrofización/psicología , Dolor Crónico/psicología , Humanos , Osteoartritis/terapia , Manejo del Dolor , Dimensión del DolorRESUMEN
BACKGROUND: Patients' postoperative treatment might be affected by their psychological state. The study aimed to evaluate the effects of anxiety, coping ability (stress tolerance), depression, and pain catastrophizing on analgesic consumption in patients scheduled for sleeve gastrectomy. METHODS: This prospective observational study consisted of 72 patients. The Distress Tolerance Scale (DTS), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Pain Catastrophizing Scale (PCS) were completed in the preoperative period. In the postoperative period, pain intensity, as measured with the Visual Analogue Scale (VAS), and morphine consumption (mg) were evaluated after 2, 6, 8, and 24 hours. Total morphine consumption was recorded. RESULTS: The results revealed a strong negative correlation between distress tolerance and postoperative total morphine consumption (r = -0.702, p < 0.001). There was a strong positive correlation between total morphine consumption and pain catastrophizing (r = 0.801, p < 0.001). A moderate positive correlation was observed between total morphine consumption and anxiety and between total morphine consumption and depression (r = 0.511, p < 0.001; r = 0.556, p < 0.001, respectively). Linear regression revealed that distress tolerance, anxiety, depression, and pain catastrophizing are predictors of postoperative morphine consumption (ß = 0.597, p < 0.001; ß = 0.207, p = 0.036; ß = 0.140, p = 0.208; ß = 0.624, p < 0.001, respectively). CONCLUSIONS: Distress tolerance, anxiety, depression, and pain catastrophizing can be predictive of postoperative analgesic consumption. In the estimation of postoperative analgesic consumption, distress tolerance, as well as anxiety, depression, and pain catastrophizing, were found to be important predictors.
Asunto(s)
Catastrofización , Depresión , Analgésicos/uso terapéutico , Ansiedad/psicología , Catastrofización/psicología , Depresión/psicología , Humanos , Morfina , Dolor Postoperatorio/tratamiento farmacológico , Dolor Postoperatorio/psicología , Periodo PosoperatorioRESUMEN
OBJECTIVE: To analyze the measurement properties of the Brazilian-Portuguese version of the Tampa Scale for Kinesiophobia-11 in patients with fibromyalgia. METHODS: Assessment was made at three time points: baseline (n=130) and 15 days (n=54) and eight weeks after baseline (n=51). Data collected at baseline were used to assess internal consistency, criterion and construct validity, and ceiling and floor effects. Data collected at baseline and 15 days after baseline were used to assess reliability and measurement error, and data collected before and after an eight-week exercise-based physical therapy intervention were used to assess interpretability of change scores. RESULTS: The Tampa Scale for Kinesiophobia-11 showed adequate internal consistency (Cronbach's alpha=0.77; alpha if item deleted: 0.74-0.77), substantial reliability (intraclass correlation coefficient2,1=0.85; 95% confidence interval: 0.75, 0.90), good measurement error (standard error of measurement: 2.65 points), and a minimal detectable change (90% confidence) of 6.16 points. For validity, the Tampa Scale for Kinesiophobia-11 showed a positive and good correlation with the original Tampa Scale for Kinesiophobia (r=0.84, p<0.01), positive and moderate correlation with the Pain Catastrophizing Scale (r=0.55, p<0.01), positive and weak correlation with the Numerical Pain Rating Scale (r=0.25, p<0.01), positive and moderate correlation with the Beck Depression Inventory (r=0.39, p<0.01), and no correlation with the Patient-Specific Functional Scale (r=0.11, p=0.23). Kinesiophobia, pain, function, catastrophizing, and depression statistically improved after the eight-week intervention (p<0.01). CONCLUSION: The Tampa Scale for Kinesiophobia-11 is consistent, reliable, and appropriate to assess fear of movement in patients with fibromyalgia in the clinical context. Responsiveness of the Tampa Scale for Kinesiophobia-11 should be tested in future studies.
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Fibromialgia/fisiopatología , Movimiento/fisiología , Trastornos Fóbicos/psicología , Brasil , Catastrofización/psicología , Comparación Transcultural , Miedo/psicología , Humanos , Dolor , Trastornos Fóbicos/diagnóstico , Trastornos Fóbicos/epidemiología , Portugal , Psicometría/métodos , Reproducibilidad de los Resultados , Encuestas y CuestionariosRESUMEN
BACKGROUND: Fibromyalgia (FM) is a musculoskeletal chronic pain syndrome that impacts negatively patient's daily lives. Its pathogenesis is characterized by a complex relationship between biological and psychosocial factors not fully understood yet. Pain catastrophizing is associated with FM and is an important predictor of outcomes. This study aimed to answer two questions: (i) whether the allele and genotype frequencies of BDNF Val66Met (rs6265) polymorphism differs between FM patients and healthy controls (HC); and (ii) if the BDNF Val66Met polymorphism is a factor that predicts pain catastrophizing in FM. METHODS: In a cross-sectional design, 108 FM patients and 108 HC were included. FM patients responded to the Brazilian Portuguese version of the Pain Catastrophizing Scale (BP-PCS) to assess pain catastrophizing, as well as other validated tools for anxiety (The State-Trait Anxiety Inventory - STAI), depression (Beck Depression Inventory II - BDI-II) and functional aspects (Fibromyalgia Impact Questionnaire - FIQ; Central Sensitization Inventory validated and adapted for Brazilian population - CSI-BP; Pittsburgh Sleep Quality Index - PSQI; and Resilience Scale). All subjects were genotyped for the BDNF Val66Met polymorphism. RESULTS: Val allele was significantly more frequent in FM patients compared to the control group (p < 0.05). Also, FM patients with Val/Val genotype showed more pain catastrophizing thoughts, and this genotype was significantly associated with magnification and rumination dimensions of BP-PCS (p < 0.05). Furthermore, there were significant differences in levels of anxiety and symptoms of depression, years of education, and the functional situation between the FM and control groups. CONCLUSIONS: The findings show an association of BDNF Val66Met polymorphism with pain catastrophizing in FM, which opens new avenues to comprehend the interplay between molecular genetic characteristics and neuroplasticity mechanisms underpinning FM.
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Alelos , Factor Neurotrófico Derivado del Encéfalo/genética , Catastrofización/genética , Fibromialgia/genética , Adulto , Ansiedad/diagnóstico , Estudios de Casos y Controles , Catastrofización/psicología , Depresión/diagnóstico , Femenino , Fibromialgia/psicología , Genotipo , Humanos , Persona de Mediana Edad , Polimorfismo Genético , Escalas de Valoración Psiquiátrica , Rumiación CognitivaRESUMEN
BACKGROUND: The mat Pilates method is the therapeutic modalities which can be used in fibromyalgia treatment. Although there are no well-designed studies that prove the effectiveness of the mat Pilates method in this population. The objective was to evaluate the effectiveness of the mat Pilates method for improving symptoms in women with fibromyalgia. METHODS: A single blind randomized controlled trial in which 42 women with fibromyalgia were randomized into two groups: mat Pilates and aquatic aerobic exercise. The exercises were performed twice a week for 12 weeks. Two evaluations were performed: one at baseline (T0), and another at 12 weeks after randomization (T12). The primary outcome was pain measured by the Visual Analogue Scale (VAS). Secondary outcomes were function (Fibromyalgia Impact Questionnaire), sleep (Pittsburgh Sleep Quality Index [PSQI]), quality of life (Short Form 36 [SF-36]), fear avoidance (Fear Avoidance Beliefs Questionnaire [FABQ-BR]) and pain catastrophizing (Pain-Related Catastrophizing Thoughts Scale [PRCTS]). RESULTS: There was improvement in both groups in relation to pain and function (p < 0.05). The aspects related to quality of life and the FABQ questionnaire only showed improvement in the mat Pilates group (p < 0.05). There was improvement in the PSQI and PRCTS variables only in the aquatic aerobic exercise group (p < 0.05), but no differences were observed between the groups for any of the evaluated variables. CONCLUSION: Significant improvements were observed in the two groups in relation to the disease symptoms, and no differences were observed between mat Pilates and aquatic aerobic exercise in any of the measured variables. TRIAL REGISTRATION: ClinicalTrials.gov Identifier (NCT03149198), May 11, 2017. Approved by the Ethics Committee of FACISA/UFRN (Number: 2.116.314).
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Técnicas de Ejercicio con Movimientos/métodos , Ejercicio Físico , Fibromialgia/terapia , Adulto , Catastrofización/psicología , Miedo , Femenino , Humanos , Persona de Mediana Edad , Dimensión del Dolor/métodos , Calidad de Vida , Método Simple Ciego , Sueño , Piscinas , Factores de Tiempo , Adulto JovenRESUMEN
The objective of this study was to compare the scores of the Helplessness, Magnification, Rumination, and Catastrophizing factors of the Pain Catastrophizing Scale (PCS) between samples with different pain characteristics. The psychometric properties of the PCS were evaluated in 1,151 Brazilian adults (78.9% female; 38.6 (SD = 10.8) years): 335 had no pain, 390 had been in pain for less than 3 months, 250 had been in recurring pain for more than 3 months, and 176 had been in continuous pain for more than 3 months. Confirmatory factor analysis (CFA) was conducted to verify the fit of the PCS models. Convergent validity and reliability were evaluated. Multi-group analysis was used to estimate the invariance of the factorial model. The global score for the PCS factors was obtained using the regression weight matrix for estimating factor scores from CFA. Analysis of variance was used to compare scores between samples. After excluding three items, the tri-factorial model showed adequate fit. The model parameters were invariant (Δχ2(λ,i,ß,Res); p≥0.05). Individuals experiencing pain showed higher scores for catastrophic thoughts. Individuals with pain for less than 3 months had the highest scores for Rumination (p < 0.001). The PCS showed valid, reliable, and invariant results for the sample of Brazilian adults in no pain or with different pain conditions. The PCS adequately discriminated individuals in pain from those without pain. Among those in pain, Rumination was the only discriminating factor.
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Catastrofización/psicología , Desamparo Adquirido , Dimensión del Dolor/psicología , Dolor/psicología , Rumiación Cognitiva , Brote de los Síntomas , Adulto , Análisis de Varianza , Brasil , Estudios Transversales , Análisis Factorial , Femenino , Humanos , Masculino , Dimensión del Dolor/métodos , Escalas de Valoración Psiquiátrica , Psicometría , Valores de Referencia , Reproducibilidad de los Resultados , Encuestas y CuestionariosRESUMEN
BACKGROUND: The objective of this study is to analyze the influence of a 14-week periodized circuit training protocol on patients with knee osteoarthritis (OA), in randomized intervention groups, on thigh intermuscular adipose tissue (interMAT), body composition, systemic inflammation, cartilage degradation, and its repercussion on pain, functional performance and quality of life. METHODS: This study presents a protocol for a randomized controlled trial. Sixty selected participants diagnosed with knee OA grades II and III, 40-65 years old and BMI < 30 kg/m2, will be randomly divided into three groups:periodized circuit training, strength training, and educational protocol. The circuit training and strength training protocols consist of 14-week training protocols conducted 3 times a week. The circuit training group will perform selected exercises previously stratified as light, moderate, and intense, arranged progressively in a circuit model, the strength group will perform regular strength exercises, and the educational protocol group will participate in a 14-week protocol with lectures twice a month about healthy lifestyles. Baseline and follow-up evaluations will be conducted for thigh interMAT (computed tomography), body composition (DXA), inflammation (IL-1ß, IL-6, IL-10, TNF-α, leptin, and adiponectin), and joint degradation biomarkers (uCTX-II and sCOMP), performance-based tests (30s Chair Stand Test, 40 m Fast-paced Walk Test and Stair Climb Test), quadriceps and hamstring maximal isometric voluntary contraction (MIVC), and questionnaires (WOMAC and pain catastrophizing scale). Repeated measures ANOVA will be used to compare differences between groups (circuit training X strength training X educational protocol) at the different times of assessment (baseline x follow-up or baseline x during protocol x follow-up) for each of the dependent variables. When significant main effects were found, the pots hoc Bonferroni test will be used to identify statistical differences. A significance level of 5% (p < 0.05) will be adopted. DISCUSSION: This will be the first randomized controlled trial to assess the effects of a circuit training protocol on patients with knee OA on thigh intermuscular adipose tissue (interMAT). Given the prevalence and impact of OA and the widespread availability of this intervention, assessing the efficacy of a low-cost, non-pharmacological, and non-invasive treatment for knee OA patients has the potential for immediate and high clinical impact. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02761590 , registered in May 4, 2016.
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Tejido Adiposo/metabolismo , Ejercicio en Circuitos/métodos , Terapia por Ejercicio/métodos , Osteoartritis de la Rodilla/rehabilitación , Dolor/rehabilitación , Adulto , Biomarcadores/análisis , Biomarcadores/metabolismo , Composición Corporal/fisiología , Cartílago Articular/metabolismo , Cartílago Articular/patología , Cartílago Articular/fisiopatología , Catastrofización/diagnóstico , Catastrofización/psicología , Ejercicio en Circuitos/economía , Terapia por Ejercicio/economía , Femenino , Humanos , Articulación de la Rodilla/fisiopatología , Masculino , Persona de Mediana Edad , Osteoartritis de la Rodilla/complicaciones , Osteoartritis de la Rodilla/fisiopatología , Osteoartritis de la Rodilla/psicología , Dolor/etiología , Dolor/fisiopatología , Dolor/psicología , Dimensión del Dolor , Músculo Cuádriceps/metabolismo , Músculo Cuádriceps/fisiopatología , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Encuestas y Cuestionarios , Resultado del TratamientoRESUMEN
AIMS: To culturally adapt the Craniofacial Pain and Disability Inventory (CF-PDI) for a Brazilian population and to assess its psychometric properties, including internal consistency, reliability, and construct and structural validity. METHODS: A total of 100 female and male TMD patients with temporomandibular disorders (TMD), with or without headaches, were included. Participants were assessed based on the Research Diagnostic Criteria for TMD and the International Headache Society criteria. For statistical analyses, intraclass correlation coefficient (ICC) was used for assessing reliability (test-retest), Cronbach's alpha for internal consistency, Pearson rank correlation for construct validity, and confirmatory factor analysis (CFA) for structural validity. RESULTS: The CFA provided the following three factors/domains for the Brazilian CF-PDI (CF-PDI/Br): (1) functional and psychosocial limitation; (2) pain; and (3) frequency of comorbidities. Scores for test-retest reliability and internal consistency in each domain were acceptable (ICC > 0.9; Cronbach's α > 0.77). Correlations between CF-PDI scores and jaw functional limitation, pain-related disability, pain catastrophizing, depression, neck pain-related disability, and kinesiophobia scores were confirmed in 89% (50/56) of the comparisons. CONCLUSION: The CF-PDI/Br with three factors had sound psychometric properties. Therefore, the Brazilian Portuguese version can be used in clinical settings and for research purposes.
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Dolor Facial/fisiopatología , Trastornos de la Articulación Temporomandibular/fisiopatología , Adulto , Brasil , Catastrofización/psicología , Cultura , Depresión/psicología , Dolor Facial/psicología , Análisis Factorial , Femenino , Humanos , Lenguaje , Masculino , Persona de Mediana Edad , Trastornos Fóbicos/psicología , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Trastornos de la Articulación Temporomandibular/psicología , Traducciones , Adulto JovenRESUMEN
OBJECTIVE: The aim of this study was to investigate whether catastrophizing is associated with static balance, mobility, and functional capacity in patients with knee osteoarthritis. METHODS: A blind, cross-sectional study was conducted involving 60 volunteers (males and females), ages 40 to 80 years, with a diagnosis of knee osteoarthritis. Patients were recruited from a physical therapy clinic in the city of São Paulo, Brazil. The following measures were used for the evaluations: Pain-Related Self-Statement Scale, Functional Reach Test, Timed Up and Go Test, Lower Extremity Functional Scale, and Western Ontario and McMaster University Osteoarthritis Index. In statistical analysis, histograms were created to determine distribution of data. Spearman's correlation coefficients (rs) were then calculated to determine the strength of the associations among the variables. RESULTS: No significant correlation was found between the Pain-Related Self-Statement Scale score and the other clinical measures employed in the present study: Functional Reach Test (rs = 0.151; P = .249), Timed Up and Go Test (rs = -0.147; P =.264), Lower Extremity Functional Scale (rs = 0.023; P = .860), and Western Ontario and McMaster University Osteoarthritis (rs = -0.222; P = .088). CONCLUSIONS: In this study, catastrophizing was not associated with static balance, mobility, or functional capacity in patients with knee osteoarthritis.
Asunto(s)
Catastrofización/psicología , Osteoartritis de la Rodilla/fisiopatología , Osteoartritis de la Rodilla/psicología , Rango del Movimiento Articular/fisiología , Adulto , Anciano , Anciano de 80 o más Años , Brasil , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Equilibrio Postural/fisiología , Estudios de Tiempo y MovimientoRESUMEN
Fear of movement (kinesiophobia) seems to play an important role in the development of chronic pain. However, for temporomandibular disorders (TMD), there is a scarcity of studies about this topic. The Tampa Scale for Kinesiophobia for TMD (TSK/TMD) is the most widely used instrument to measure fear of movement and it is not available in Brazilian Portuguese. The purpose of this study was to culturally adapt the TSK/TMD to Brazilian Portuguese and to assess its psychometric properties regarding internal consistency, reliability, and construct and structural validity. A total of 100 female patients with chronic TMD participated in the validation process of the TSK/TMD-Br. The intraclass correlation coefficient (ICC) was used for statistical analysis of reliability (test-retest), Cronbach's alpha for internal consistency, Spearman's rank correlation for construct validity and confirmatory factor analysis (CFA) for structural validity. CFA endorsed the pre-specified model with two domains and 12-items (Activity Avoidance - AA/Somatic Focus - SF) and all items obtained a loading factor greater than 0·4. Acceptable levels of reliability were found (ICC > 0·75) for all questions and domains of the TSK/TMD-Br. For internal consistency, Cronbach's α of 0·78 for both domains were found. Moderate correlations (0·40 < r < 0.60) were observed for 84% of the analyses conducted between TSK/TMD-Br scores versus catastrophising, depression and jaw functional limitation. TSK/TMD-Br 12 items and two-factor demonstrated sound psychometric properties (transcultural validity, reliability, internal consistency and structural validity). In such a way, the instrument can be used in clinical settings and for research purposes.
Asunto(s)
Dolor Crónico/diagnóstico , Lenguaje , Dimensión del Dolor/normas , Trastornos Fóbicos/diagnóstico , Trastornos de la Articulación Temporomandibular/diagnóstico , Traducciones , Adulto , Brasil , Catastrofización/diagnóstico , Catastrofización/psicología , Dolor Crónico/etiología , Dolor Crónico/psicología , Comparación Transcultural , Femenino , Humanos , Persona de Mediana Edad , Movimiento , Trastornos Fóbicos/psicología , Portugal/etnología , Psicometría , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Trastornos de la Articulación Temporomandibular/complicaciones , Trastornos de la Articulación Temporomandibular/psicología , Adulto JovenRESUMEN
OBJECTIVES: To investigate the immediate and 1-month effects of functional taping to lumbar spine for pain intensity and postural control in patients with chronic non-specific low back pain. DESIGN: Randomised clinical trial. PARTICIPANTS: One hundred and twenty participants aged 18 to 50 years. INTERVENTIONS: Participants will be allocated at random to receive one of three interventions: functional star-shape taping for 7 days, sham functional taping for 7 days or minimal intervention, one session. MAIN OUTCOME MEASURES: The primary outcomes will be pain intensity and postural control. Four measurements of static posturography will be conducted: pre-intervention, immediately after application of the tape, 7 days post-intervention (after removal of the tape) and 1-month follow-up. The secondary outcomes will be low-back-pain-related disability, global perceived effect of treatment and fear avoidance beliefs. Primary and secondary outcomes will be assessed on three occasions: pre-intervention, 7 days post-intervention and at 1-month follow-up. All statistical analyses will be conducted following intention-to-treat principles, and the treatment effects will be calculated using linear mixed models. DISCUSSION: The results of this study will determine the effects of functional taping on pain intensity and postural control compared with sham taping and minimal intervention. CLINICAL TRIAL REGISTRATION NUMBER: NCT02546466.
Asunto(s)
Cinta Atlética , Dolor de la Región Lumbar/rehabilitación , Región Lumbosacra , Modalidades de Fisioterapia , Adolescente , Adulto , Ansiedad/psicología , Catastrofización/psicología , Depresión/psicología , Femenino , Humanos , Dolor de la Región Lumbar/complicaciones , Dolor de la Región Lumbar/psicología , Masculino , Persona de Mediana Edad , Equilibrio Postural , Postura , Proyectos de Investigación , Autoeficacia , Método Simple Ciego , Adulto JovenRESUMEN
Measurement instruments of pain catastrophizing for middle-aged and elderly individuals are needed to understand its impact on low back pain. The goals were to cross-culturally adapt the Pain Catastrophizing Scale, assess the construct validity through Rasch analysis, and verify reliability and convergent validity of pain catastrophizing with psychosocial factors. 131 individuals aged 55 years and older with acute low back pain were interviewed . The intra-rater reliability was Kp = 0.80 and interrater Kp = 0.75. The Rasch analysis found adequate reliability coefficients (0.95 for items and 0.90 for individuals ). The separation index for the elderly was 2.95 and 4.59 items. Of the 13 items, one did not fit the model, which was justified in the sample evaluated. The pain catastrophizing correlated with most psychosocial factors. The instrument proved to be clinically useful. Subsequent studies should carry out the same analysis in different populations.
Asunto(s)
Catastrofización/psicología , Dolor de la Región Lumbar/psicología , Dimensión del Dolor/psicología , Anciano , Anciano de 80 o más Años , Brasil , Comparación Transcultural , Femenino , Humanos , Lenguaje , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Dimensión del Dolor/métodos , Dimensión del Dolor/normas , Psicometría , Reproducibilidad de los Resultados , Estadísticas no Paramétricas , Encuestas y Cuestionarios/normas , TraduccionesRESUMEN
Measurement instruments of pain catastrophizing for middle-aged and elderly individuals are needed to understand its impact on low back pain. The goals were to cross-culturally adapt the Pain Catastrophizing Scale, assess the construct validity through Rasch analysis, and verify reliability and convergent validity of pain catastrophizing with psychosocial factors. 131 individuals aged 55 years and older with acute low back pain were interviewed . The intra-rater reliability was Kp = 0.80 and interrater Kp = 0.75. The Rasch analysis found adequate reliability coefficients (0.95 for items and 0.90 for individuals ). The separation index for the elderly was 2.95 and 4.59 items. Of the 13 items, one did not fit the model, which was justified in the sample evaluated. The pain catastrophizing correlated with most psychosocial factors. The instrument proved to be clinically useful. Subsequent studies should carry out the same analysis in different populations.
Instrumentos de medida da catastrofização da dor para indivíduos de meia-idade e idosos são necessários para compreensão do impacto na dor lombar nessa população. Os objetivos foram adaptar transculturalmente a Escala de Catastrofização da Dor, avaliar a validade de construto pela análise Rasch, verificar a confiabilidade e a validade convergente da catastrofização da dor com fatores psicossociais. Participaram 131 indivíduos comunitários com 55 anos e mais com dor lombar aguda. A confiabilidade intra-examinadores foi de Kp = 0,80 e inter-examinadores Kp = 0,75. A análise Rasch, detectou adequados coeficientes de confiabilidade (0,95 para itens e 0,90 para indivíduos). O índice de separação dos idosos foi de 2,95 e dos itens 4,59. Dos 13 itens, um não se enquadrou no modelo, o que se justificou na amostra avaliada. A catastrofização da dor se correlacionou com a maioria dos fatores psicossociais. O instrumento mostrou-se clinicamente útil. Estudos subsequentes devem proceder às mesmas análises em diferentes populações.