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International Journal of Molecular... Apr 2023Over 80% of patients affected by cancer develops cancer-related pain, one of the most feared consequences because of its intractable nature, particularly in the terminal... (Meta-Analysis)
Meta-Analysis Review
Over 80% of patients affected by cancer develops cancer-related pain, one of the most feared consequences because of its intractable nature, particularly in the terminal stage of the disease. Recent evidence-based recommendations on integrative medicine for the management of cancer pain underline the role of natural products. The present systematic review and meta-analysis aims at appraising for the first time the efficacy of aromatherapy in cancer pain in clinical studies with different design according to the most updated Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 recommendations. The search retrieves 1002 total records. Twelve studies are included and six are eligible for meta-analysis. The present study demonstrates significant efficacy of the use of essential oils in the reduction of the intensity of pain associated with cancer ( < 0.00001), highlighting the need for earlier, more homogeneous, and appropriately designed clinical trials. Good certainty body of evidence is needed for effective and safe management of cancer-related pain using essential oils by establishment of a step-by-step preclinical-to-clinical pathway to provide a rational basis for clinical use in integrative oncology. PROSPERO registration: CRD42023393182.
Topics: Humans; Cancer Pain; Oils, Volatile; Pain; Aromatherapy; Neoplasms
PubMed: 37108246
DOI: 10.3390/ijms24087085 -
PM & R : the Journal of Injury,... Feb 2019The purpose of this systematic review was to investigate the effect of adding the cognitive behavioral treatment (CBT) component to routine physical therapy (PT) on pain...
The Influence of Cognitive Behavioral Therapy on Pain, Quality of Life, and Depression in Patients Receiving Physical Therapy for Chronic Low Back Pain: A Systematic Review.
OBJECTIVE
The purpose of this systematic review was to investigate the effect of adding the cognitive behavioral treatment (CBT) component to routine physical therapy (PT) on pain and depression reduction, improvement in quality of life, and enhanced function in patients with chronic low back pain (CLBP). TYPE: Systematic review.
LITERATURE SURVEY
Google Scholar, PubMed, Ovid, ScienceDirect, ProQuest, Scopus, Cochrane Library, and Embase electronic databases were explored for the key terms of "behavioral (or behavioural) treatment" OR "behavior (behaviour) treatment" OR "behavior (behaviour) therapy" OR "cognitive behavior (or behaviour) treatment" OR "cognitive treatment" OR "cognitive therapy" OR "operant behavior (or behaviour) treatment" OR "respondent behavior (or behaviour) treatment" AND "physical therapy" OR "physiotherapy" OR "exercise therapy" OR "electrotherapy" OR "electrical therapy" OR "manual therapy" OR "myofascial therapy" OR "rehabilitation" AND "low back pain" OR "lower back pain" OR "back pain" OR "chronic back pain" OR "chronic lower back pain", with no limitation on language, through January 2018.
METHODOLOGY
All randomized controlled trials that statistically compared the effectiveness of CBT + PT and PT were included for quality analysis. Studies were rated by high to poor quality, using Hailey's classification, based on their design and performance.
SYNTHESIS
Of the 10 included studies, 7 were rated as high quality and 3 as good quality. Although CBT + PT was found to be superior to PT for pain, disability, quality of life, and functional capacity variables in some of the included studies, no extra benefit from CBT was documented in other investigations. The included studies also failed to show any advantage of CBT + PT over PT in reducing depression, and PT was even found to be superior to CBT + PT in one high-quality study.
CONCLUSIONS
Although appearing to be advantageous by reducing pain and disability and enhancing functional capacity and quality of life, CBT effects on depression cannot be teased out from the effects of PT.
LEVEL OF EVIDENCE
I.
Topics: Chronic Pain; Cognitive Behavioral Therapy; Depression; Humans; Low Back Pain; Physical Therapy Modalities; Quality of Life
PubMed: 30266349
DOI: 10.1016/j.pmrj.2018.09.029 -
The British Journal of Surgery Sep 2017Pain present for at least 3 months after a surgical procedure is considered chronic postsurgical pain (CPSP) and affects 10-50 per cent of patients. Interventions for... (Review)
Review
BACKGROUND
Pain present for at least 3 months after a surgical procedure is considered chronic postsurgical pain (CPSP) and affects 10-50 per cent of patients. Interventions for CPSP may focus on the underlying condition that indicated surgery, the aetiology of new-onset pain or be multifactorial in recognition of the diverse causes of this pain. The aim of this systematic review was to identify RCTs of interventions for the management of CPSP, and synthesize data across treatment type to estimate their effectiveness and safety.
METHODS
MEDLINE, Embase, PsycINFO, CINAHL and the Cochrane Library were searched from inception to March 2016. Trials of pain interventions received by patients at 3 months or more after surgery were included. Risk of bias was assessed using the Cochrane risk-of-bias tool.
RESULTS
Some 66 trials with data from 3149 participants were included. Most trials included patients with chronic pain after spinal surgery (25 trials) or phantom limb pain (21 trials). Interventions were predominantly pharmacological, including antiepileptics, capsaicin, epidural steroid injections, local anaesthetic, neurotoxins, N-methyl-d-aspartate receptor antagonists and opioids. Other interventions included acupuncture, exercise, postamputation limb liner, spinal cord stimulation, further surgery, laser therapy, magnetic stimulation, mindfulness-based stress reduction, mirror therapy and sensory discrimination training. Opportunities for meta-analysis were limited by heterogeneity. For all interventions, there was insufficient evidence to draw conclusions on effectiveness.
CONCLUSION
There is a need for more evidence about interventions for CPSP. High-quality trials of multimodal interventions matched to pain characteristics are needed to provide robust evidence to guide management of CPSP.
Topics: Acupuncture Therapy; Behavior Therapy; Chronic Pain; Combined Modality Therapy; Exercise Therapy; Humans; Laser Therapy; Pain, Postoperative; Spinal Cord Stimulation
PubMed: 28681962
DOI: 10.1002/bjs.10601 -
Neuroscience and Biobehavioral Reviews Jan 2021BELAVY, D. L., J. Van Oosterwijck, M. Clarkson, E. Dhondt, N. L. Mundell, C. Miller and P. J. Owen. NEUROSCI BIOBEHAV REV 21(1) XXX-XXX, 2020. Exercise training is... (Meta-Analysis)
Meta-Analysis Review
BELAVY, D. L., J. Van Oosterwijck, M. Clarkson, E. Dhondt, N. L. Mundell, C. Miller and P. J. Owen. NEUROSCI BIOBEHAV REV 21(1) XXX-XXX, 2020. Exercise training is capable of reducing pain in chronic pain syndromes, yet its mechanisms are less well established. One mechanism may be via the impact of exercise on increasing a person's pain threshold. Here we show, via meta-analysis of fifteen exercise training studies in pain syndromes that exercise training leads to increased pressure pain thresholds (low to moderate quality evidence). We also find low to moderate quality evidence exists that exercise training was more effective than non-exercise interventions, such as pain education, massage and stress management for improving pain sensitivity. Further, the effect of exercise was greater locally at the site of pain and less so at remote regions. These finding suggest that adaptations in central inhibition occur over time with exercise training and, more widely, add to the mechanistic understanding of how effective interventions can improve pain in chronic pain syndromes.
Topics: Chronic Pain; Exercise; Exercise Therapy; Humans; Pain Threshold
PubMed: 33253748
DOI: 10.1016/j.neubiorev.2020.11.012 -
BMC Geriatrics Dec 2014There is evidence of under-detection and poor management of pain in patients with dementia, in both long-term and acute care. Accurate assessment of pain in people with... (Review)
Review
BACKGROUND
There is evidence of under-detection and poor management of pain in patients with dementia, in both long-term and acute care. Accurate assessment of pain in people with dementia is challenging and pain assessment tools have received considerable attention over the years, with an increasing number of tools made available. Systematic reviews on the evidence of their validity and utility mostly compare different sets of tools. This review of systematic reviews analyses and summarises evidence concerning the psychometric properties and clinical utility of pain assessment tools in adults with dementia or cognitive impairment.
METHODS
We searched for systematic reviews of pain assessment tools providing evidence of reliability, validity and clinical utility. Two reviewers independently assessed each review and extracted data from them, with a third reviewer mediating when consensus was not reached. Analysis of the data was carried out collaboratively. The reviews were synthesised using a narrative synthesis approach.
RESULTS
We retrieved 441 potentially eligible reviews, 23 met the criteria for inclusion and 8 provided data for extraction. Each review evaluated between 8 and 13 tools, in aggregate providing evidence on a total of 28 tools. The quality of the reviews varied and the reporting often lacked sufficient methodological detail for quality assessment. The 28 tools appear to have been studied in a variety of settings and with varied types of patients. The reviews identified several methodological limitations across the original studies. The lack of a 'gold standard' significantly hinders the evaluation of tools' validity. Most importantly, the samples were small providing limited evidence for use of any of the tools across settings or populations.
CONCLUSIONS
There are a considerable number of pain assessment tools available for use with the elderly cognitive impaired population. However there is limited evidence about their reliability, validity and clinical utility. On the basis of this review no one tool can be recommended given the existing evidence.
Topics: Adult; Aged; Aged, 80 and over; Dementia; Female; Humans; Male; Middle Aged; Pain; Pain Measurement; Reproducibility of Results; Review Literature as Topic
PubMed: 25519741
DOI: 10.1186/1471-2318-14-138 -
Archives of Physical Medicine and... Sep 2014To investigate the effectiveness of aquatic exercise in the management of musculoskeletal conditions. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To investigate the effectiveness of aquatic exercise in the management of musculoskeletal conditions.
DATA SOURCES
A systematic review was conducted using Ovid MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Embase, and The Cochrane Central Register of Controlled Trials from earliest record to May 2013.
STUDY SELECTION
We searched for randomized controlled trials (RCTs) and quasi-RCTs evaluating aquatic exercise for adults with musculoskeletal conditions compared with no exercise or land-based exercise. Outcomes of interest were pain, physical function, and quality of life. The electronic search identified 1199 potential studies. Of these, 1136 studies were excluded based on title and abstract. A further 36 studies were excluded after full text review, and the remaining 26 studies were included in this review.
DATA EXTRACTION
Two reviewers independently extracted demographic data and intervention characteristics from included trials. Outcome data, including mean scores and SDs, were also extracted.
DATA SYNTHESIS
The Physiotherapy Evidence Database (PEDro) Scale identified 20 studies with high methodologic quality (PEDro score ≥6). Compared with no exercise, aquatic exercise achieved moderate improvements in pain (standardized mean difference [SMD]=-.37; 95% confidence interval [CI], -.56 to -.18), physical function (SMD=.32; 95% CI, .13-.51), and quality of life (SMD=.39; 95% CI, .06-.73). No significant differences were observed between the effects of aquatic and land-based exercise on pain (SMD=-.11; 95% CI, -.27 to .04), physical function (SMD=-.03; 95% CI, -.19 to .12), or quality of life (SMD=-.10; 95% CI, -.29 to .09).
CONCLUSIONS
The evidence suggests that aquatic exercise has moderate beneficial effects on pain, physical function, and quality of life in adults with musculoskeletal conditions. These benefits appear comparable across conditions and with those achieved with land-based exercise. Further research is needed to understand the characteristics of aquatic exercise programs that provide the most benefit.
Topics: Exercise Therapy; Humans; Musculoskeletal Diseases; Osteoarthritis; Pain; Pain Measurement; Physical Therapy Modalities; Quality of Life; Swimming
PubMed: 24769068
DOI: 10.1016/j.apmr.2014.04.005 -
The Journal of Orthopaedic and Sports... Feb 2022To investigate the effectiveness of walking/running, cycling, or swimming for treating or preventing nonspecific low back pain (LBP). (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To investigate the effectiveness of walking/running, cycling, or swimming for treating or preventing nonspecific low back pain (LBP).
DESIGN
Intervention systematic review.
LITERATURE SEARCH
Five databases were searched to April 2021.
STUDY SELECTION CRITERIA
Randomized controlled trials evaluating walking/running, cycling, or swimming to treat or prevent LBP were included.
DATA SYNTHESIS
We calculated standardized mean differences (SMDs) and 95% confidence intervals (CIs). Certainty of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
RESULTS
No trials assessed LBP prevention or addressed acute LBP. Nineteen trials (2362 participants) assessed treatment of chronic/recurrent LBP. Low-certainty evidence suggests that walking/running was less effective than alternate interventions in reducing pain in the short term (8 trials; SMD, 0.81; 95% CI: 0.28, 1.34) and medium term (5 trials; SMD, 0.80; 95% CI: 0.10, 1.49). High-certainty evidence suggests that walking/running was less effective than alternate interventions at reducing disability in the short term (8 trials; SMD, 0.22; 95% CI: 0.06, 0.38) and medium term (4 trials; SMD, 0.28; 95% CI: 0.05, 0.51). There was high-certainty evidence of a small effect in favor of walking/running compared to minimal/no intervention for reducing pain in the short term (10 trials; SMD, -0.23; 95% CI: -0.35, -0.10) and medium term (6 trials; SMD, -0.26; 95% CI: -0.40, -0.13) and disability in the short term (7 trials; SMD, -0.19; 95% CI: -0.33, -0.06). Scarcity of trials meant few conclusions could be drawn regarding cycling and swimming.
CONCLUSION
Although less effective than alternate interventions, walking/running was slightly more effective than minimal/no intervention for treating chronic/recurrent LBP. .
Topics: Back Pain; Chronic Pain; Humans; Low Back Pain; Swimming; Walking
PubMed: 34783263
DOI: 10.2519/jospt.2022.10612 -
Pain Feb 2021The burden of pain in newborn infants has been investigated in numerous studies, but little is known about the appropriateness of the use of pain scales according to the...
The burden of pain in newborn infants has been investigated in numerous studies, but little is known about the appropriateness of the use of pain scales according to the specific type of pain or infant condition. This systematic review aimed to evaluate the reporting of neonatal pain scales in randomized trials. A systematic search up to March 2019 was performed in Embase, PubMed, PsycINFO, CINAHL, Cochrane Library, Scopus, and Luxid. Randomized and quasirandomized trials reporting neonatal pain scales were included. Screening of the studies for inclusion, data extraction, and quality assessment was performed independently by 2 researchers. Of 3718 trials found, 352 with 29,137 infants and 22 published pain scales were included. Most studies (92%) concerned procedural pain, where the most frequently used pain scales were the Premature Infant Pain Profile or Premature Infant Pain Profile-Revised (48%), followed by the Neonatal Infant Pain Scale (23%). Although the Neonatal Infant Pain Scale is validated only for acute pain, it was also the second most used scale for ongoing and postoperative pain (21%). Only in a third of the trials, blinding for those performing the pain assessment was described. In 55 studies (16%), pain scales that were used lacked validation for the specific neonatal population or type of pain. Six validated pain scales were used in 90% of all trials, although not always in the correct population or type of pain. Depending on the type of pain and population of infants included in a study, appropriate scales should be selected. The inappropriate use raises serious concerns about research ethics and use of resources.
Topics: Acute Pain; Humans; Infant; Infant, Newborn; Pain Measurement; Pain, Postoperative; Pain, Procedural; Randomized Controlled Trials as Topic
PubMed: 32826760
DOI: 10.1097/j.pain.0000000000002046 -
Journal of Bodywork and Movement... Jul 2016Chronic low back pain (CLBP) is a prevalent issue that engenders enormous social and economic burdens. Recently, kinesio taping (KT) has become of interest in the... (Review)
Review
BACKGROUND
Chronic low back pain (CLBP) is a prevalent issue that engenders enormous social and economic burdens. Recently, kinesio taping (KT) has become of interest in the management of chronic pain. Accordingly, this is the first systematic review to explicitly report the effects of KT on CLBP.
OBJECTIVE
The aim of this review was to summarize the results of randomized controlled trials (RCTs) investigating the effects of KT on CLBP.
METHODS
A search was performed on the electronic databases PubMed, MEDLINE, SPORT Discus and Science Direct, up to June 17, 2015, using the following keywords: Kinesiology taping, kinesio taping, chronic low back pain.
RESULTS
In total, five studies involving 306 subjects met the inclusion criteria and corresponded to the aim of this review. The methodological quality of the included RCTs was good, with a mean score of 6.6 on the 10-point PEDro Scale. Moderate evidence suggests KT, as a sole treatment or in conjunction with another treatment, is no more effective than conventional physical therapy and exercise with respect to improving pain and disability outcomes. There is insufficient evidence suggesting that KT is superior to sham taping in improving pain and disability. Limited evidence suggests that KT is more effective than sham taping in improving range of motion (ROM) and global perceived effect (GPE) in the short term. Very limited evidence indicates that KT is more effective than conventional physical therapy in improving anticipatory postural control of the transversus abdominus muscles and improved cerebral cortex potential.
CONCLUSION
Kinesio taping is not a substitute for traditional physical therapy or exercise. Rather, KT may be most effective when used as an adjunctive therapy, perhaps by improving ROM, muscular endurance and motor control. More high quality studies that consider the multiple factors that mediate CLBP, in the short, intermediate and long term, are needed to strengthen the evidence of the effectiveness of KT on CLBP.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42015023837.
Topics: Athletic Tape; Disability Evaluation; Fear; Humans; Low Back Pain; Pain Measurement; Physical Therapy Modalities; Randomized Controlled Trials as Topic; Range of Motion, Articular
PubMed: 27634093
DOI: 10.1016/j.jbmt.2016.04.018 -
International Urogynecology Journal Nov 2022Chronic pelvic pain syndrome (CPPS) is defined as the occurrence of chronic pelvic pain (CPP) in the absence of a specific cause. People typically refer to pain... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION AND HYPOTHESIS
Chronic pelvic pain syndrome (CPPS) is defined as the occurrence of chronic pelvic pain (CPP) in the absence of a specific cause. People typically refer to pain associated with urological, gynaecological, and sexual dysfunction, affecting the quality of life. Therefore, we assessed the effectiveness of myofascial manual therapies (MMT) for pain and symptom impact.
METHODS
A systematic review and meta-analysis were conducted. Findings were reported following the 2020 PRISMA statement. Five databases were searched for RCTs. Studies were independently assessed through a standardized form, and their internal validity was evaluated using the Cochrane risk of bias (RoB) tool. Effect sizes (ES) were calculated post-treatment, and the quality of evidence was assessed through GRADE criteria.
RESULTS
Seven articles were included in the review, five of these in the meta-analysis. None of these studies were completely judged at low RoB. MMT was revealed to be not significantly superior for pain reduction [ES: -0.54 (-1.16; 0.08); p = 0.09], for symptom impact [ES: -0.37 (-0.87; 0.13); p = 0.15], and for quality of life [ES: -0.44 (-1.22, 0.33), p = 0.26] compared to standard care. The quality of evidence was "very low". Other results were presented in a qualitative synthesis.
CONCLUSIONS
In patients with CPP/CPPS, MMT is not considered superior to other interventions for pain reduction and symptom impact improvements. However, a positive trend was detected, and we should find confirmation in the future. Further high-quality, double-blinded, sham-controlled RCTs are first necessary to confirm these positive effects and to improve the quality of evidence.
Topics: Female; Humans; Chronic Pain; Genital Diseases, Female; Musculoskeletal Manipulations; Pelvic Pain; Quality of Life; Syndrome
PubMed: 35389057
DOI: 10.1007/s00192-022-05173-x