The Clinical journal of pain
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A limited number of quantitative sensory pain tests (QST) were selected on the basis of ease of application and interpretation in a clinical setting. QST results were summarized as a composite score on a scale of 0 to 4 that was deemed to facilitate clinical interpretation. The QST set was used to investigate differences in pain sensitivity between low-back pain (LBP) subgroups and was correlated with important clinical parameters. ⋯ Pain sensitivity may be important for the prognosis of LBP, but QST is not currently part of routine clinical examination of LBP patients. The selected set of pain tests and the composite score of pain sensitivity could serve as a clinically applicable QST procedure in the examination of LBP.
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Randomized Controlled Trial Observational Study
Pain and Recovery After Total Knee Arthroplasty: A Twelve Months Follow-up After a Prospective Randomized Study Evaluating Nefopam and Ketamine for Early Rehabilitation.
Ketamine and nefopam has been documented to decrease pain intensity and improve rehabilitation after total knee arthroplasty (TKA). We conducted a follow-up study of a previously randomized clinical trial to determine the prevalence and risk factors of chronic pain 1 year after TKA and to assess the role of perioperative administration of ketamine and nefopam. ⋯ After TKA, the intensity of postoperative pain is a risk factor of chronic pain on movement. Intraoperative ketamine seems to improve long-term results of rehabilitation in this setting.
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Randomized Controlled Trial
Evidence-Based Development and Initial Validation of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate-II (Pacslac-II).
Our goal was to develop and validate, based on theoretical and empirical knowledge, the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC-II), a shorter tool that would improve on the PACSLAC, while addressing limitations of the original version. ⋯ Findings indicate that the empirical and theoretically driven revisions to the PACSLAC led to improved ability to differentiate between pain and nonpain states, while retaining its clinical utility.
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Pain diaries are important tools for clinical trials and optimal assay sensitivity of outcomes derived from these diaries is a worthwhile goal. Jensen and colleagues recently reported results suggesting that single-day diary-based outcomes could possibly be as psychometrically sound as outcomes based on taking the average of many diaries. ⋯ We come to a different conclusion than that advanced by Jensen and colleagues and conclude that their results were unusual in that very high test-retest reliability among days was found. With our 4 diary data sets we find that aggregating multiple diaries yields more reliable outcomes and improved sensitivity. We suggest that using single-day diaries will often lead to underpowered studies and that pretesting is advised before adopting single-day diaries. We also suggest that other researchers replicate these findings within their diary-based clinical trials.