The Clinical journal of pain
-
Randomized Controlled Trial
A randomized controlled trial of cognitive-behavioral therapy for the treatment of PTSD in the context of chronic whiplash.
Whiplash-associated disorders (WAD) are common and involve both physical and psychological impairments. Research has shown that persistent posttraumatic stress symptoms are associated with poorer functional recovery and physical therapy outcomes. Trauma-focused cognitive-behavioral therapy (TF-CBT) has shown moderate effectiveness in chronic pain samples. However, to date, there have been no clinical trials within WAD. Thus, this study will report on the effectiveness of TF-CBT in individuals meeting the criteria for current chronic WAD and posttraumatic stress disorder (PTSD). ⋯ This study provides support for the effectiveness of TF-CBT to target PTSD symptoms within chronic WAD. The finding that treatment of PTSD resulted in improvements in neck disability and quality of life and changes in cold pain thresholds highlights the complex and interrelating mechanisms that underlie both WAD and PTSD. Clinical implications of the findings and future research directions are discussed.
-
Randomized Controlled Trial Multicenter Study
Efficacy and safety of duloxetine 30 mg/d in patients with fibromyalgia: a randomized, double-blind, placebo-controlled study.
To evaluate the efficacy and safety of duloxetine 30 mg/d in adults with fibromyalgia. ⋯ Duloxetine 30 mg/d did not significantly reduce pain severity in patients with fibromyalgia. However, duloxetine-treated patients reported global improvement in symptoms and function. Safety findings were consistent with the known duloxetine safety profile.
-
Randomized Controlled Trial
Follow-up of yoga of awareness for fibromyalgia: results at 3 months and replication in the wait-list group.
Published preliminary findings from a randomized-controlled trial suggest that an 8-week Yoga of Awareness intervention may be effective for improving symptoms, functional deficits, and coping abilities in fibromyalgia. The primary aims of this study were to evaluate the same intervention's posttreatment effects in a wait-list group and to test the intervention's effects at 3-month follow-up in the immediate treatment group. ⋯ These findings indicate that the benefits of Yoga of Awareness in fibromyalgia are replicable and can be maintained.
-
To examine clinical outcomes of an interdisciplinary day-hospital treatment program (comprised of physical, occupational, and cognitive-behavioral therapies with medical and nursing services) for pediatric complex regional pain syndrome (CRPS). ⋯ A day-hospital interdisciplinary rehabilitation approach seems effective in reducing disability and improving physical and emotional functioning and occupational performance among children and adolescents with CRPSs that have failed to improve with outpatient treatment.
-
Disability in patients with chronic neck pain: heart rate variability analysis and cluster analysis.
Adequately addressing the scope of disability in patients with chronic neck pain is crucial in a clinical setting. The aim of this study was to determine the disease profile of patients with chronic neck pain and to analyze the factors related to the level of disability. ⋯ We suggest that 3 distinct subgroups of patients with chronic neck pain exhibit particular features. Furthermore, reduced heart rate variability was associated with subjective disability in these patients. Further study is advised to establish the pathologic mechanism and clinical applications of our findings.