The journal of pain : official journal of the American Pain Society
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Pain neuroscience education (PNE) is an approach used in the management of chronic musculoskeletal pain. Previous reviews on PNE and other pain interventions, have focused on mean treatment effects, but in the context of "precision medicine," any inter-individual differences in treatment response are also important to quantify. If inter-individual differences are present, and predictors identified, PNE could be tailored to certain people for optimizing effectiveness. ⋯ PERSPECTIVE: We bring a novel method to pain science for calculating inter-individual differences in response to a treatment. This is conductedwithin the context of a systematic review and meta-analysis on PNE. We highlight how using erroneous methods for calculating inter-individual differences can drastically change conclusions when compared to appropriate methods.
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During pain, motor performance tends to decline. However, athletes who engage in contact sports are able to maintain performance despite the inherent pain that accompanies participation. This may be the result of being challenged rather than threatened by pain; adaptive coping strategies; habituation to pain; or finding pain less bothersome. ⋯ Moreover, pain tolerance, intensity, and bothersomeness may differentiate novice and experienced athletes. PERSPECTIVE: Exposure to voluntary pain and challenge states are associated with adaptive responses to pain. Motor task performance may be maintained in individuals with more experience of sports-related pain.
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Treatment of neuropathic pain (NP) in patients with spinal cord injury (SCI) remains a major challenge. The aim of the present study is to investigate if the effect of transcranial direct current stimulation combined with visual illusion, following a previously published protocol, has differential effects on pain-related sensory symptoms according to sensory phenotypes profiles. One hundred and thirty SCI patients with NP participated in this open-label trial. ⋯ Despite a reduction of NP with the combined treatment, the analysis of sensory phenotype pain profiles does not provide a predictive value regarding the analgesic results of this combined neuromodulatory treatment. PERSPECTIVE: In this article we confirm the analgesic effect of a combined neuromodulatory therapy, transcranial direct current stimulation associated with visual illusion in patients with NP after an SCI. We have identified 5 clusters of NP with distinct sensory phenotypes, but there was not any specific sensory phenotype cluster that significantly responded to the combined therapy better than the other.
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Review Meta Analysis
Exercise-induced hypoalgesia in healthy individuals and people with chronic musculoskeletal pain: a systematic review and meta-analysis.
Exercise-induced hypoalgesia (EIH) is a reduction in pain that occurs during or following exercise. Randomized controlled studies published from 1980 to January 2020 that examined experimentally induced pain before and during/following a single bout of exercise in healthy individuals or people with chronic musculoskeletal pain were systematically reviewed. Data were analyzed using random-effects meta-analyses and studies were appraised using the Cochrane Risk of Bias tool and GRADE. ⋯ Registration: PROSPERO ID: CRD42018085886. PERSPECTIVE: Based on low-quality data from small samples, a single bout of aerobic exercise reduces experimental pain in healthy individuals. The evidence is unclear in people with chronic musculoskeletal pain but warrants further investigation due to the limited number of studies in these populations.
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Randomized Controlled Trial
An Initial Psychometric Evaluation of the Pain Concepts Questionnaire in a Low-SES Setting.
The examination of pain beliefs for chronic pain assessment and treatment has been a growing area of interest. A variety of questionnaires have been developed to assess pain beliefs, however, these questionnaires often require high levels of literacy and education. The pain concepts questionnaire (PCQ) was developed with literacy-adaptations to better evaluate pain beliefs in a low socioeconomic (SES) population. ⋯ PERSPECTIVE: This study is an initial evaluation of the psychometric properties of a new measure of chronic pain beliefs, the pain concepts questionnaire (PCQ). The PCQ is literacy-adapted and was assessed within a low-SES population. Psychometric proprieties of this measure were promising and could be useful in pain assessment and interventions.