The Clinical journal of pain
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Randomized Controlled Trial Clinical Trial
Global and specific behavioral measures of pain in children with cerebral palsy.
The aim of this research was to validate global and behavioral observation methods for measuring pain in children with cerebral palsy (CP). ⋯ These findings support the hypothesis that children with CP express discernible pain behaviors regardless of cognitive or language ability. These results contribute to multidimensional assessment of pain in children with neurologic impairment.
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Randomized Controlled Trial Clinical Trial
Patterns of pain variation related to myogenous temporomandibular disorders.
Myogenous temporomandibular disorders are characterized by jaw muscle pain. The aims were: 1) to characterize this pain generally in terms of intensity, frequency, duration, and behavior across a period of 2 weeks; 2) to identify main intraday pain patterns and to examine whether subgroups of patients in this respect differed in clinical, demographic, pain and sleep variables, psychosocial factors, and use of medication; and 3) to investigate some possible interday trends of pain intensity at a group level. ⋯ Two main daily pain patterns occur in patients with myogenous temporomandibular disorders (79%: maximal pain late in the day; 21%: early in the day), which might be related to differences in processes that influence pain sensitivity and patterns of jaw muscle activation. The interday similarities in pain level suggest that a sustained influence of counseling after the intake or an influence of a common behavioral pattern with a cycle duration of a week are not involved.
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Randomized Controlled Trial Clinical Trial
The effects of cognitive-behavioral and physical therapy preventive interventions on pain-related sick leave: a randomized controlled trial.
Recent recommendations suggest that reassuring patients with an acute bout of low back pain and encouraging a return to normal activities may be helpful in preventing the development of chronic disability. There is also a question as to whether psychologic or physical therapy interventions actually add anything to such reassurance and advice in terms of preventing chronicity. This study aimed to ascertain the preventive effects on future sick leave and health-care utilization of adding on a cognitive-behavioral group intervention or a cognitive-behavioral group intervention and preventive physical therapy (focused on activity and exercise) relative to a minimal treatment group (examination, reassurance, and activity advice). ⋯ Taken as a whole, this study shows that adding cognitive-behavioral intervention and cognitive-behavioral intervention and preventive physical therapy can enhance the prevention of long-term disability. There was no substantial difference in the results between the cognitive-behavioral intervention group and cognitive-behavioral intervention and preventive physical therapy group.
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Randomized Controlled Trial Clinical Trial
The effectiveness of multidisciplinary rehabilitation in the treatment of fibromyalgia: a randomized controlled trial.
To assess the effectiveness of multidisciplinary rehabilitation in the treatment of fibromyalgia in comparison to standard medical care. ⋯ Positive health-related outcomes in this mostly unresponsive condition can be obtained with a low-cost, group multidisciplinary intervention in a community-based, nonclinical setting.
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Randomized Controlled Trial Clinical Trial
Treatment expectancy affects the outcome of cognitive-behavioral interventions in chronic pain.
Patients' initial beliefs about the success of a given pain treatment are shown to have an important influence on the final treatment outcome. The aims of the paper are to assess determinants of patients' treatment expectancy and to examine the extent to which treatment expectancy predicts the short-term and long-term outcome of cognitive-behavioral treatment of chronic pain. This study employs the data of 2 pooled randomized clinical trials evaluating the effectiveness of cognitive-behavioral interventions for 171 patients with fibromyalgia and chronic low back pain. ⋯ A regression model of 3 factors (better pain coping and control, active and positive interpretation of pain, and less disability compensation) significantly explained 10% of the variance in pretreatment expectancy. Pretreatment expectancy significantly predicted each of the 4 outcome measures immediately after treatment and at 12 months follow-up. This study corroborates the importance of treatment expectation before entering a cognitive-behavioral intervention in patients with chronic musculoskeletal pain.