Pain
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Randomized Controlled Trial
Behavioral cancer pain intervention dosing: results of a Sequential Multiple Assignment Randomized Trial.
Behavioral pain management interventions are efficacious for reducing pain in patients with cancer. However, optimal dosing of behavioral pain interventions for pain reduction is unknown, and this hinders routine clinical use. A Sequential Multiple Assignment Randomized Trial (SMART) was used to evaluate whether varying doses of Pain Coping Skills Training (PCST) and response-based dose adaptation can improve pain management in women with breast cancer. ⋯ Varying PCST doses led to pain reduction over time. Intervention sequences demonstrating the most durable decreases in pain reduction included PCST-Full. Pain Coping Skills Training with intervention adjustment based on response can produce sustainable pain reduction.
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Randomized Controlled Trial
No effect of social interaction on experimental pain sensitivity: a randomized experimental study.
Quantitative sensory testing (QST) is a commonly applied paradigm to investigate pain, which is a subjective experience influenced by a myriad of social and contextual factors. Therefore, it is important to consider the potential sensitivity of QST to the test setting and the social interaction that naturally is a part of it. This may particularly be the case in clinical settings where patients have something at stake. ⋯ All 3 setups consisted of the same pain tests in the same order, including pressure pain threshold and cold pressor tests. We found no statistically significant differences between setups on the primary outcome of conditioned pain modulation nor any secondary QST outcomes. While this study is not without limitations, the results indicate that QST procedures are robust enough not to be influenced by social interaction to an appreciable degree.
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Randomized Controlled Trial
Relationship, differences, and agreement between objective and subjective sleep measures in chronic spinal pain patients with comorbid insomnia: a cross-sectional study.
Sleep disturbances are one of the most frequent reported problems in people with nonspecific chronic spinal pain (nCSP) and presents an additional treatment challenge. Interventions targeting sleep problems are mainly based on subjective sleep complaints and do not take objective sleep into consideration. The aim of this cross-sectional study was to evaluate the relationship and conformity between self-reported and objectively measured sleep parameters (ie, questionnaire vs polysomnography and actigraphy). ⋯ No or weak associations were found between self-reported sleep and objectively measured sleep. Findings suggest that people with nCSP and comorbid insomnia tend to underestimate TST and overestimate SOL. Future studies are necessary to confirm our results.
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Editorial Comment Randomized Controlled Trial
Commentary on Somers et al. Behavioral cancer pain intervention dosing: results of a sequential multiple assignment randomized trial.
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Randomized Controlled Trial
Adjunctive virtual reality pain relief after traumatic injury: a proof-of-concept within-person randomized trial.
In this study, we hypothesized that immersive virtual reality (VR) environments may reduce pain in patients with acute traumatic injuries, including traumatic brain injuries. We performed a randomized within-subject study in patients hospitalized with acute traumatic injuries, including traumatic brain injury with moderate pain (numeric pain score ≥3 of 10). We compared 3 conditions: (1) an immersive VR environment (VR Blu), (2) a content control with the identical environment delivered through nonimmersive tablet computer (Tablet Blu), and (3) a second control composed of donning VR headgear without content to control for placebo effects and sensory deprivation (VR Blank). ⋯ VR Blu was perceived as most effective by patients for pain reduction (F 2,66.84 = 16.28, P < 0.001), and changes in measures of parasympathetic activity including heart rate variability (F 2,55.511 = 7.87, P < 0.001) and pupillary maximum constriction velocity (F 2,61.41 = 3.50, 1-tailed P = 0.038) echoed these effects. There were no effects on opioid usage. These findings outlined a potential clinical benefit for mollifying pain related to traumatic injuries.