The Clinical journal of pain
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Randomized Controlled Trial
Effects of Cognitive-behavioral Therapy (CBT) on Brain Connectivity Supporting Catastrophizing in Fibromyalgia.
Fibromyalgia (FM) is a chronic, common pain disorder characterized by hyperalgesia. A key mechanism by which cognitive-behavioral therapy (CBT) fosters improvement in pain outcomes is via reductions in hyperalgesia and pain-related catastrophizing, a dysfunctional set of cognitive-emotional processes. However, the neural underpinnings of these CBT effects are unclear. Our aim was to assess CBT's effects on the brain circuitry underlying hyperalgesia in FM patients, and to explore the role of treatment-associated reduction in catastrophizing as a contributor to normalization of pain-relevant brain circuitry and clinical improvement. ⋯ The results add to the growing support for the clinically important associations between S1-insula connectivity, clinical pain, and catastrophizing, and suggest that CBT may, in part via reductions in catastrophizing, help to normalize pain-related brain responses in FM.
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Randomized Controlled Trial
Effectiveness of Periosteal Stimulation Therapy and Home Exercise Program in the Rehabilitation of Patients with Advanced Knee Osteoarthritis.
Osteoarthritis (OA) of the knee is the most common form of joint disease. It is one of the major causes of impaired function that reduces quality of life in older people worldwide. Periosteal Stimulation Therapy (PST) with boosters in combination with home exercises may be a suitable treatment option for such patients. ⋯ PST with boosters combined with a home exercise program was shown to be beneficial for improving subjective knee pain and functional performance of older patients with advanced knee OA.