Articles: pain-measurement.
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Meta Analysis Comparative Study
Comparative efficacy of oral pharmaceuticals for the treatment of chronic peripheral neuropathic pain: meta-analysis and indirect treatment comparisons.
Neuropathic pain is generally chronic and challenging to treat. Studies often ignore chronicity by reporting short-duration outcomes and fail to account for medication tolerability. We assessed efficacy of oral medications on chronic peripheral neuropathic pain. ⋯ Pregabalin and duloxetine had the largest beneficial effects for chronic peripheral neuropathic pain. In the absence of head-to-head trials, meta-analysis and indirect treatment comparisons inform best practice clinical decision-making.
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Review Meta Analysis Comparative Study
[Subgroup-specific therapy of low back pain: description and validity of two classification systems].
In spite of profound advances in the diagnosis and therapy, low back pain (LBP) remains one of the main challenges for health systems in western industrialized countries. Clinical trials and meta-analyses typically show heterogeneous evidence and small effect sizes. One explanation for this phenomenon is the heterogeneous nature of the population of patients with LBP, not adequately considered in clinical practice and research. Recent studies and one meta-analysis show that therapy which is specifically directed at well defined subgroups leads to improved effectiveness of interventions, especially for non-surgical interventions such as manual therapy or physiotherapy. ⋯ The reliability of the described classification systems is moderate to good, aspects of validity have been shown. Their implementation in clinical practice seems recommendable.
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Many studies have reported putative factors for the development of chronic pain after surgery. However, advances in knowledge about the etiology and prognosis of chronic postsurgical pain (CPSP) could be gained by improving methodology within studies of surgical pain. The purpose of this study was to review predictive factors and to propose core risk factor and outcome domains for inclusion in future epidemiological studies investigating CPSP. ⋯ There is potential to advance the field of CPSP research by striving for consensus among pain experts; this would advance current evidence by improving our ability to compare findings from different studies and would facilitate the aggregation of surgical cohort datasets to allow international comparisons. We propose these findings as a starting point to build a comprehensive framework for epidemiological studies investigating chronic pain after surgery.
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Review Meta Analysis
A meta-analytic review of the hypoalgesic effects of exercise.
The purpose of this article was to examine the effects of acute exercise on pain perception in healthy adults and adults with chronic pain using meta-analytic techniques. Specifically, studies using a repeated measures design to examine the effect of acute isometric, aerobic, or dynamic resistance exercise on pain threshold and pain intensity measures were included in this meta-analysis. The results suggest that all 3 types of exercise reduce perception of experimentally induced pain in healthy participants, with effects ranging from small to large depending on pain induction method and exercise protocol. In healthy participants, the mean effect size for aerobic exercise was moderate (d(thr) = .41, d(int) = .59), while the mean effect sizes for isometric exercise (d(thr) = 1.02, d(int) = .72) and dynamic resistance exercise (d(thr) = .83, d(int) = .75) were large. In chronic pain populations, the magnitude and direction of the effect sizes were highly variable for aerobic and isometric exercise and appeared to depend on the chronic pain condition being studied as well as the intensity of the exercise. While trends could be identified, the optimal dose of exercise that is needed to produce hypoalgesia could not be systematically determined with the amount of data available. ⋯ This article presents a quantitative review of the exercise-induced hypoalgesia literature. This review raises several important questions that need to be addressed while also demonstrating that acute exercise has a hypoalgesic effect on experimentally induced pain in healthy adults, and both a hypoalgesic and hyperalgesic effect in adults with chronic pain.
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Osteoarthr. Cartil. · Oct 2012
Review Meta AnalysisQuantitative sensory testing in painful osteoarthritis: a systematic review and meta-analysis.
To systematically review the use of quantitative sensory testing (QST) in pain characterisation (phenotyping) in osteoarthritis (OA). ⋯ QST of PPTs demonstrated good ability to differentiate between people with OA and healthy controls. Lower PPTs in people with OA in affected sites may suggest peripheral, and in remote sites central, sensitisation. PPT measurement merits further evaluation as a tool for phenotyping OA pain.