Obesity Hurts: The Why and How of Integrating Weight Reduction With Chronic Pain Management

Physical Therapy, Journal Year: 2021, Volume and Issue: 101(11)

Published: Aug. 11, 2021

Abstract Amongst adults with chronic pain, overweight and obesity are highly prevalent. The association between pain is driven by several explanations, including increased biomechanical load, changes in the gut microbiome, low-grade (neuro)inflammation. Moreover, link overweight, can best be considered from a lifestyle perspective. Since conservative treatment for often limited to short-term small effects, addressing important comorbidities within approach could next step towards precision medicine these patients. Indeed, evidence shows that combining weight reduction management more effective reduce disability, compared either intervention alone. This perspective article aims update reader current understanding of possible explanatory mechanisms behind interaction overweight/obesity an adult population. Second, this paper applies knowledge clinical practice, assessment pain. Henceforth, recommendations guidelines provided based on available scientific authors’ expertise. Impact will guide clinicians implementation programs management.

Language: Английский

---

Associates of Insomnia in People with Chronic Spinal Pain: A Systematic Review and Meta-Analysis

Journal of Clinical Medicine, Journal Year: 2021, Volume and Issue: 10(14), P. 3175 - 3175

Published: July 19, 2021

Insomnia is a major problem in the chronic spinal pain (CSP) population and has negative impact on health well-being. While insomnia commonly reported, underlying mechanisms explaining relation between sleep are still not fully understood. Additionally, no reviews regarding prevention of and/or associated factors people with CSP currently available. To gain better understanding occurrence this population, we conducted systematic review literature exploring associates for PubMed, Web Science Embase. Three independent reviewers extracted data performed quality assessment. A meta-analysis was every potential associate presented at least two studies. total 13 studies were found eligible, which together identified 25 different 24,817 CSP. Twelve had cross-sectional design. Moderate-quality evidence showed significantly higher rate when one following present: high intensity, anxiety depression. Low-quality increased odds female sex, performing professional activities physical/musculoskeletal comorbidities. Higher healthcare use also related to presence insomnia. One study strong association levels catastrophizing neck pain. Last, reduced physically active low back compared inactive This provides an overview available Several significant identified. These findings can be helpful characteristics origin witch CSP, identify who (less) likely have determine directions future research area.

Language: Английский

---

An Educational and Exercise Mobile Phone–Based Intervention to Elicit Electrophysiological Changes and to Improve Psychological Functioning in Adults With Nonspecific Chronic Low Back Pain (BackFit App): Nonrandomized Clinical Trial

JMIR mhealth and uhealth, Journal Year: 2022, Volume and Issue: 10(3), P. e29171 - e29171

Published: Jan. 7, 2022

Concomitant psychological and cognitive impairments modulate nociceptive processing contribute to chronic low back pain (CLBP) maintenance, poorly correlated with radiological findings. Clinical practice guidelines recommend self-management multidisciplinary educational exercise-based interventions. However, these recommendations are based on self-reported measurements, which lack evidence of related electrophysiological changes. Furthermore, current mobile health (mHealth) tools for quality scarce evidence. Thus, it is necessary increase knowledge mHealth changes elicited by evidence-based interventions.The aim this study investigate a self-managed 4-week intervention (BackFit app) in electroencephalographic electrocardiographic activity, pressure thresholds (PPTs), pain, disability, functioning CLBP versus the same face-to-face modality.A 2-arm parallel nonrandomized clinical trial was conducted at University Balearic Islands (Palma, Spain). A total 50 patients nonspecific were assigned group (23/50, 46%; mean age 45.00, SD 9.13 years; 10/23, 43% men) or (27/50, 54%; 48.63, 7.54 7/27, 26% men). The primary outcomes activity (at rest during modified version Eriksen flanker task) heart rate variability rest), PPTs, intensity ratings. secondary (mood, anxiety, kinesiophobia, catastrophizing, fear-avoidance beliefs), performance (percentage hits reaction times).After intervention, frequency analysis resting-state data showed increased beta-2 (16-23 Hz; 0.0020 vs 0.0024; P=.02) beta-3 (23-30 0.0013 0.0018; P=.03) activity. In addition, source analyses revealed higher power density beta (16-30 Hz) anterior cingulate cortex alpha (8-12 postcentral gyrus lower delta (2-4 cuneus precuneus. Both groups also improved depression (7.74 5.15; P=.01), kinesiophobia (22.91 20.87; P=.002), avoidance (14.49 12.86; P<.001), helplessness (6.38 4.74; P=.02), beliefs (35 29.11; P=.03), physical (12.07 9.28; P=.01) scores, but there an disability score (6.08 7.5; P=.01). No significant differences between sessions found data, from task, subjective ratings, performance.Both modalities mainly functioning. Given limitations our study, conclusions must be drawn carefully further research will needed. Nevertheless, best knowledge, first reporting after intervention.ClinicalTrials.gov NCT04576611; https://clinicaltrials.gov/ct2/show/NCT04576611.

Language: Английский

---

Patient-related barriers and enablers to the implementation of high-value physiotherapy for chronic pain: a systematic review

Pain Medicine, Journal Year: 2023, Volume and Issue: 25(2), P. 104 - 115

Published: Sept. 27, 2023

To identify and synthesize patient-related barriers to enablers of the implementation high-value physiotherapy (HVP) for chronic pain. Furthermore, review what interventions have been used facilitate HVP pain, as well their efficacy.

Language: Английский

---

Níveis de Atividade Física e Lombalgia Crônica Inespecífica

Saúde Coletiva (Barueri), Journal Year: 2025, Volume and Issue: 15(93), P. 14638 - 14655

Published: Feb. 21, 2025

A Lombalgia Crônica Inespecífica (LCI) é uma das principais causas de incapacidade em todo o mundo, impactando negativamente a qualidade vida pessoas afetadas, gerando custos significativos para os sistemas saúde. As evidências nas últimas duas décadas revolucionaram condução da abordagem e tratamento dos casos, sendo que algumas arestas como níveis atividade física quanto às características práticas, frequência, intensidade se apresentam vagas pouco detalhadas forma geral publicações temática. O objetivo investigar as relações entre lombalgia crônica inespecífica. Desse modo, este estudo envolve revisão literatura, estudos publicados no período 2012 2024 inglês português, com convergência temática propostos. plataformas Pubmed, SciELO, Biblioteca Cochrane, Scopus, Web of Science Physioterapia Evidence Database (PEDro). Foram selecionados, partir critérios inclusão seleção, 35 estudos. Ficou evidente relação aos há necessidade maior aprofundamento na pelos diferentes estudos, mas predomínio indicações práticas moderada. exposição gradual exercícios aeróbicos, fortalecimento/resistência, coordenação/estabilização controle motor, preferencialmente estratégias multimodais combinadas cognição, bem como, ioga, tanto realizados individualmente grupo, indicam benefícios sintomáticos funcionais LCI.

---

Motivation to exercise in patients with chronic low back pain

BMC Musculoskeletal Disorders, Journal Year: 2025, Volume and Issue: 26(1)

Published: March 6, 2025

Chronic low back pain (CLBP) is one of the most common musculoskeletal problems worldwide. Even though regular exercise recommended as primary conservative approach in treating this condition, significant part patients lead sedentary lifestyle. Motivation to variables that effects adherence exercise-based treatments. This study aimed characterize motives for exercise, posited by self-determination theory, persons with CLBP, and identify subgroups (clusters) motivational profiles combination socioeconomic clinical characteristics using k-means cluster analysis. Data were collected between September 2022 2023. A total 103 adults CLBP completed paper-pencil Exercise Self-Regulation Questionnaire (SRQ-E) provided self-reported measures on anthropometric socio-economic characteristics. Inclusion criteria age (≥ 18 years) non-specific (lasting longer than 12 weeks). Exclusion included specific lumbar spine pathology (e.g., fracture, cancer), worsening neurological symptoms, recent injection therapy (within 3 months), current alcohol or drug misuse. Three distinct clusters identified among participants: two characterized predominantly autonomous motivation (moderately motivated cluster: 31.1%; highly 54.4%), while (controlled convinced 14.6%) showed a higher level controlled motivation. Associations observed factors such disability scores, duration pain, greater number physiotherapy sessions, elevated BMI. Notably, was linked poorer outcomes. provides insights into revealing primarily autonomously motivated, notable subgroup exhibited lower, The presence associated worse functioning, duration, increased utilization services. Although these findings suggest link outcomes, cross-sectional design limits causal inferences. Further research needed explore relationships longitudinally. ClinicalTrials.Gov Identifier: NCT05512338 (22.8.2022, NCT05512338).

Language: Английский

---

Application of Virtual Reality to Home-Visit Rehabilitation for Patients With Chronic Musculoskeletal Pain: A Single-Group Pre-post Comparison Study

Cureus, Journal Year: 2025, Volume and Issue: unknown

Published: March 11, 2025

Objective Virtual reality (VR) is increasingly used to alleviate pain during the rehabilitation of patients with chronic musculoskeletal pain. Previous studies on application VR have reported improvements in pain, functional impairment, and psychological status patients. However, focus many previous was short-term effects hospitals. Studies that report home-based for mid- long-term periods are lacking. Hence, aim study investigate feasibility safety applying home-visit these Methods A single-group pre-post comparative conducted at two home healthcare agencies Japan. Six female participants (mean age: 76.5 years) underwent 10 sessions VR-applied over weeks. In intervention, a standalone headset (MetaQuest 2TM; Meta Platforms Inc., Menlo Park, CA, USA) view natural landscape content rehabilitation. Pain levels, heart rate variability (HRV), motivation rehabilitation, mood states, Catastrophizing Scale (PCS) scores, quality life (QoL) were measured various time points before, during, after interventions. All variables summarized as means standard deviations, medians interquartile ranges, or frequencies percentages, appropriate. Results completed without dropping out experiencing adverse effects, thereby supporting intervention. levels significantly decreased compared baseline showing reductions more than 4.5 Numerical Rating (NRS; 0-10). The HRV values showed inconsistent trends: an increase decrease parasympathetic sympathetic nerve indices, respectively, between first intervention point, revealing shift towards dominance, whereas no clear trend observed from 2nd 10th all remained strong, intrinsic regulation dominant factor. states stable within healthy range throughout period. PCS scores initially increased; however, they time. Regarding QoL, mental health high, physical social functioning declined improved, respectively. Conclusions feasible safe approach may reduce rehabilitation; its did not persist long enough improve constant other factors. Further larger sample sizes appropriate control groups required confirm effectiveness benefits this approach.

Language: Английский

---

Can Acupuncture Improve Chronic Spinal Pain? A Systematic Review and Meta-Analysis

Global Spine Journal, Journal Year: 2020, Volume and Issue: 11(8), P. 1248 - 1265

Published: Oct. 9, 2020

Systematic review and meta-analysis.To investigate the effect safety of acupuncture for treatment chronic spinal pain.MEDLINE, EMBASE, Cochrane Central Register Controlled Trials (CENTRAL), Web Science, WHO Clinical Trial Registry, US National Library Medicine clinical trial registry were searched from January 1, 2000, to November 2019. Randomized controlled trials (RCTs) involving patients with pain treated by versus sham acupuncture, no treatment, or another included.Data was extracted 22 RCTs including 2588 patients. Pooled analysis revealed that can reduce compared (weighted mean difference [WMD] -12.05, 95% confidence interval [CI] -15.86 -8.24), mediation control (WMD -18.27, CI -28.18 -8.37), usual care -9.57, -13.48 -9.44), -17.10, -24.83 -9.37). In terms functional disability, improve physical function at immediate-term follow-up (standardized [SMD] -1.74, -2.04 -1.44), short-term (SMD -0.89, -1.15 -0.62), long-term -1.25, -1.48 -1.03).In summary, conventional therapy such as medication, massage, exercise, has a significantly superior on reduction in improvement. Acupuncture might be an effective it is safe therapy.

Language: Английский

---

High Intensity Training Is an Effective Modality to Improve Long-Term Disability and Exercise Capacity in Chronic Nonspecific Low Back Pain: A Randomized Controlled Trial

International Journal of Environmental Research and Public Health, Journal Year: 2021, Volume and Issue: 18(20), P. 10779 - 10779

Published: Oct. 14, 2021

Previous research indicates that high intensity training (HIT) is a more effective exercise modality, as opposed to moderate (MIT), improve disability and physical performance in persons with chronic nonspecific low back pain (CNSLBP). However, it unclear how well benefits are maintained after intervention cessation. This study aimed evaluate the long-term effectiveness of HIT on disability, intensity, patient-specific functioning, capacity, trunk muscle strength, compare MIT CNSLBP. Persons CNSLBP (n = 35) who participated randomized controlled trial comparing effects an versus (24 sessions/12 weeks) were included for evaluation at baseline (PRE), directly (POST), six months program finalization (FU) strength. A general linear model was used PRE-FU POST-FU deltas these outcome measures each group (time effects) differences between (interaction effects). Ultimately, twenty-nine participants (mean age 44.1 year) analysed (HIT:16; MIT:13). Six lost follow-up. At FU, functioning level POST (which significant from PRE, p < 0.05) both groups. led greater conservation lowered improved capacity when compared (p 0.05). leads maintenance cessation 12-week supervised therapy intervention,

Language: Английский

---

It Hurts to Move! Intervention Effects and Assessment Methods for Movement-Evoked Pain in Patients With Musculoskeletal Pain: A Systematic Review with Meta-analysis

Journal of Orthopaedic and Sports Physical Therapy, Journal Year: 2022, Volume and Issue: 52(6), P. 345 - 374

Published: Feb. 6, 2022

Objectives To estimate the effects of musculoskeletal rehabilitation interventions on movementevoked pain and to explore assessment methods/protocols used evaluate movement-evoked in adults with pain. Design Systematic review meta-analysis. Literature Search Three electronic databases (PubMed, Web Science, Scopus) were searched. Study Selection Criteria Randomized controlled trials investigating for included. Data Synthesis Meta-analysis was conducted outcomes homogeneous data from at least 2 trials. The mean change primary outcome measure. Certainty evidence assessed using Grading Recommendations Assessment, Development Evaluation framework. Results Thirty-eight included, 60 different assessed. There moderate-certainty a beneficial effect exercise therapy compared no treatment (standardized difference [SMD], −0.65; 95% confidence interval [CI]: −0.83, −0.47; P<.001) low-certainty transcutaneous electrical nerve stimulation (SMD, −0.46; CI: −0.71, −0.21; P = .0004). benefit when sham −0.28; −0.60, 0.05; .09; evidence). Conclusion that is effective reducing patients treatment. Consider as first-choice clinical practice. J Orthop Sports Phys Ther 2022;52(6):345–374. Epub: 05 Feb 2022. doi:10.2519/jospt.2022.10527

Language: Английский

---