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[PMID]:28464364
[Au] Autor:Calner T; Nordin C; Eriksson MK; Nyberg L; Gard G; Michaelson P
[Ad] Endereço:Division of Health and Rehabilitation, Department of Health Sciences, Luleå University of Technology, Sweden.
[Ti] Título:Effects of a self-guided, web-based activity programme for patients with persistent musculoskeletal pain in primary healthcare: A randomized controlled trial.
[So] Source:Eur J Pain;21(6):1110-1120, 2017 Jul.
[Is] ISSN:1532-2149
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Web-based interventions for pain management are increasingly used with possible benefits, but never used in addition to multimodal rehabilitation (MMR). MMR is recommended treatment for persistent pain in Sweden. The aim was to evaluate the effects of a self-guided, web-based programme added to MMR for work ability, pain, disability and health-related quality of life. METHODS: We included 99 participants with persistent musculoskeletal pain in a randomized study with two intervention arms: (1) MMR and web-based intervention, and (2) MMR. Data was collected at baseline, 4 and 12 months. Outcome measures were work ability, working percentage, average pain intensity, pain-related disability, and health-related quality of life. RESULTS: There were no significant effects of adding the web-based intervention to MMR regarding any of the outcome variables. CONCLUSIONS: This trial provides no support for adding a self-guided, web-based activity programme to MMR for patients with persistent musculoskeletal pain. SIGNIFICANCE: The comprehensive self-guided, web-based programme for activity, Web-BCPA, added to multimodal treatment in primary health care had no effect on work ability, pain, disability or health-related quality of life. Future web-based interventions should be tailored to patients' individual needs and expectations.
[Mh] Termos MeSH primário: Internet
Dor Musculoesquelética/terapia
Manejo da Dor/métodos
Qualidade de Vida
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Meia-Idade
Medição da Dor
Atenção Primária à Saúde
Suécia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1002/ejp.1012


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[PMID]:29201303
[Au] Autor:Rhee SM; Oh JH
[Ad] Endereço:Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
[Ti] Título:Bridging Graft in Irreparable Massive Rotator Cuff Tears: Autogenic Biceps Graft versus Allogenic Dermal Patch Graft.
[So] Source:Clin Orthop Surg;9(4):497-505, 2017 Dec.
[Is] ISSN:2005-4408
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:Background: Few comparative studies have reported on the use of biologic grafts for irreparable massive rotator cuff tears. The purpose of this study was to assess the results of arthroscopic bridging graft in irreparable massive rotator cuff tears using an autogenic long head of biceps tendon (LHBT) or an allogenic dermal patch (ADP). Methods: We retrospectively reviewed 24 patients treated using the LHBT (group I) and eight patients with complete rupture of the LHBT treated using an ADP (group II) since 2011. Preoperative Goutallier's fatty degeneration, range of motion (ROM), visual analogue scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES) score, and Quick Disabilities of the Arm, Shoulder, and Hand (DASH) score were assessed and healing failure was evaluated at 1 year after surgery by ultrasonography or magnetic resonance imaging. Results: The mean fatty degeneration in groups I and II was 3.9 and 3.6 for the supraspinatus ( = 0.288), 2.7 and 2.9 for the infraspinatus ( = 0.685), 0.9 and 1.3 for the subscapularis ( = 0.314), and 1.3 and 3.0 for the teres minor ( = 0.005), respectively. Subscapularis tears were found in 8 patients (33.3%) in group I and in 7 patients (87.5%) in group II ( = 0.023). Mean ROMs and functional scores improved significantly in group I (forward flexion: 121.7° to 153.3°, = 0.010; external rotation: 32.7° to 52.7°, = 0.001; external rotation at 90°: 63.3° to 74.5°, = 0.031; internal rotation: T10.5 to T9.3, = 0.045; VAS: 7.0 to 1.1, p < 0.001; ASES score: 45.4 to 81.6, = 0.028; and Quick DASH score: 50.0 to 14.2, = 0.017), whereas only VAS showed significant improvement in group II (from 5.9 to 2.0, = 0.025) and ROMs and other functional scores increased without statistical significance in the group. Healing failure was found in 13 patients (54.2%) in group I and in 6 patients (75.0%) in group II ( = 0.404). Conclusions: The surgeon should prudently choose surgical options for irreparable massive rotator cuff tears, especially in patients with severe fatty degeneration in the teres minor or combined biceps and subscapularis tears.
[Mh] Termos MeSH primário: Tecido Adiposo/patologia
Lesões do Manguito Rotador/fisiopatologia
Lesões do Manguito Rotador/cirurgia
Articulação do Ombro/fisiopatologia
Transplante de Pele
Tendões/transplante
[Mh] Termos MeSH secundário: Idoso
Artroscopia
Feminino
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Dor Musculoesquelética/etiologia
Amplitude de Movimento Articular
Estudos Retrospectivos
Rotação
Lesões do Manguito Rotador/complicações
Lesões do Manguito Rotador/diagnóstico por imagem
Articulação do Ombro/diagnóstico por imagem
Transplante Autólogo
Transplante Homólogo
Ultrassonografia
Cicatrização
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE
[do] DOI:10.4055/cios.2017.9.4.497


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[PMID]:29201297
[Au] Autor:Lee M; Yoo J; Kim JG; Kyung HS; Bin SI; Kang SB; Choi CH; Moon YW; Kim YM; Han SB; In Y; Choi CH; Kim J; Lee BK; Cho S
[Ad] Endereço:Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea.
[Ti] Título:A Randomized, Multicenter, Phase III Trial to Evaluate the Efficacy and Safety of Polmacoxib Compared with Celecoxib and Placebo for Patients with Osteoarthritis.
[So] Source:Clin Orthop Surg;9(4):439-457, 2017 Dec.
[Is] ISSN:2005-4408
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:Background: The aim of this study was to evaluate the safety and analgesic efficacy of polmacoxib 2 mg versus placebo in a superiority comparison or versus celecoxib 200 mg in a noninferiority comparison in patients with osteoarthritis (OA). Methods: This study was a 6-week, phase III, randomized, double-blind, and parallel-group trial followed by an 18-week, single arm, open-label extension. Of the 441 patients with knee or hip OA screened, 362 were randomized; 324 completed 6 weeks of treatment and 220 completed the extension. Patients were randomized to receive oral polmacoxib 2 mg (n = 146), celecoxib 200 mg (n = 145), or placebo (n = 71) once daily for 6 weeks. During the extension, all participants received open-label polmacoxib 2 mg. The primary endpoint was the change in Western Ontario and McMaster Universities (WOMAC)-pain subscale score from baseline to week 6. Secondary endpoints included WOMAC-OA Index, OA subscales (pain, stiffness, and physical function) and Physician's and Subject's Global Assessments at weeks 3 and 6. Other outcome measures included adverse events (AEs), laboratory tests, vital signs, electrocardiograms, and physical examinations. Results: After 6 weeks, the polmacoxib-placebo treatment difference was -2.5 (95% confidence interval [CI], -4.4 to -0.6; = 0.011) and the polmacoxib-celecoxib treatment difference was 0.6 (CI, -0.9 to 2.2; = 0.425). According to Physician's Global Assessments, more subjects were "much improved" at week 3 with polmacoxib than with celecoxib or placebo. Gastrointestinal and general disorder AEs occurred with a greater frequency with polmacoxib or celecoxib than with placebo. Conclusions: Polmacoxib 2 mg was relatively well tolerated and demonstrated efficacy superior to placebo and noninferior to celecoxib after 6 weeks of treatment in patients with OA. The results obtained during the 18-week trial extension with polmacoxib 2 mg were consistent with those observed during the 6-week treatment period, indicating that polmacoxib can be considered safe for long-term use based on this relatively small scale of study in a Korean population. More importantly, the results of this study showed that polmacoxib has the potential to be used as a pain relief drug with reduced gastrointestinal side effects compared to traditional nonsteroidal anti-inflammatory drugs for OA.
[Mh] Termos MeSH primário: Celecoxib/uso terapêutico
Inibidores de Ciclo-Oxigenase 2/uso terapêutico
Furanos/uso terapêutico
Dor Musculoesquelética/tratamento farmacológico
Osteoartrite do Quadril/tratamento farmacológico
Osteoartrite do Joelho/tratamento farmacológico
Sulfonamidas/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Celecoxib/efeitos adversos
Inibidores de Ciclo-Oxigenase 2/efeitos adversos
Método Duplo-Cego
Feminino
Furanos/efeitos adversos
Gastroenteropatias/induzido quimicamente
Seres Humanos
Masculino
Meia-Idade
Dor Musculoesquelética/etiologia
Osteoartrite do Quadril/complicações
Osteoartrite do Quadril/fisiopatologia
Osteoartrite do Joelho/complicações
Osteoartrite do Joelho/fisiopatologia
Amplitude de Movimento Articular
Sulfonamidas/efeitos adversos
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE III; COMPARATIVE STUDY; EQUIVALENCE TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (CG100649); 0 (Cyclooxygenase 2 Inhibitors); 0 (Furans); 0 (Sulfonamides); JCX84Q7J1L (Celecoxib)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE
[do] DOI:10.4055/cios.2017.9.4.439


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[PMID]:29192423
[Au] Autor:Corral-Gudino L; Tan AJ; Del Pino-Montes J; Ralston SH
[Ad] Endereço:Internal Medicine Department, Hospital el Bierzo, Gerencia de Asistencia Sanitaria del Bierzo, SACYL, IBSAL, RETICEF, c/Medicos Sin fronteras, 7, Ponferrada, Leon, Spain, 24411.
[Ti] Título:Bisphosphonates for Paget's disease of bone in adults.
[So] Source:Cochrane Database Syst Rev;12:CD004956, 2017 12 01.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Bisphosphonates are considered to be the treatment of choice for people with Paget's disease of bone. However, the effects of bisphosphonates on patient-centred outcomes have not been extensively studied. There are insufficient data to determine whether reducing and maintaining biochemical markers of bone turnover to within the normal range improves quality of life and reduces the risk of complications. OBJECTIVES: To assess the benefits and harms of bisphosphonates for adult patients with Paget's disease of bone. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, ISI Web of Knowledge and trials registers up to March 2017. We searched regulatory agency published information for rare adverse events. SELECTION CRITERIA: Randomised controlled trials (RCTs) of bisphosphonates as treatment for Paget's disease in adults. DATA COLLECTION AND ANALYSIS: Two review authors independently screened search results, extracted data and assessed studies for risk of bias. We used standard methodological procedures expected by The Cochrane Collaboration. MAIN RESULTS: We included 20 trials (25 reports, 3168 participants). Of these, 10 trials (801 participants) compared bisphosphonates (etidronate, tiludronate, ibandronate, pamidronate, olpadronate, alendronate, risedronate, zoledronate) versus placebo, seven compared two bisphosphonates (992 participants), one trial compared a bisphosphonates with a bisphosphonate plus calcitonin (44 participants), and two studies, the largest trial (1331 participants) and its interventional extension study (502 participants), compared symptomatic treatment and intensive treatment where the goal was to normalise alkaline phosphatase.Most studies were assessed at low or unclear risk of bias. Six of 10 studies comparing bisphosphonates versus placebo were assessed at high risk of bias, mainly around incomplete outcome data and selective outcome reporting.Participant populations were reasonably homogeneous in terms of age (mean age 66 to 74 years) and sex (51% to 74% male). Most studies included participants who had elevated alkaline phosphatase levels whether or not bone pain was present. Mean follow-up was six months.Bisphosphonates versus placeboBisphosphonates tripled the proportion (31% versus 9%) of participants whose bone pain disappeared (RR 3.42, 95% confidence interval (CI) 1.31 to 8.90; 2 studies, 205 participants; NNT 5, 95% CI 1 to 31; moderate-quality evidence). This result is clinically important. Data were consistent when pain change was measured as any reduction (RR 1.97, 95% CI 1.29 to 3.01; 7 studies, 481 participants).There was uncertainty about differences in incident fractures: 1.4% fractures occurred in the bisphosphonates group and none in the placebo group (RR 0.89, 95% CI 0.18 to 4.31; 4 studies, 356 participants; very low-quality evidence).None of the studies reported data on orthopaedic surgery, quality of life or hearing thresholds.Results regarding adverse effects and treatment discontinuation were uncertain. There was a 64% risk of mild gastrointestinal adverse events in intervention group participants and 48% in the control group (RR 1.32, 95% CI 0.91 to 1.92; 6 studies, 376 participants; low-quality evidence). The likelihood of study participants discontinuing due to adverse effects was slightly higher in intervention group participants (4.4%) than the control group (4.1%) (RR 1.01, 95% CI 0.41 to 2.52; 6 studies, 517 participants; low-quality evidence). Zoledronate was associated with an increased risk of transient fever or fatigue (RR 2.57, 95% CI 1.21 to 5.44; 1 study, 176 participants; moderate-quality evidence).Bisphosphonates versus active comparatorMore participants reported pain relief with zoledronate than pamidronate (RR 1.30, 95% CI 1.10 to 1.53; 1 study, 89 participants; NNT 5, 95% CI 3 to 11) or risedronate (RR 1.36, 95% CI 1.06 to 1.74; 1 study, 347 participants; NNT 7, 95% CI 4 to 24; very low quality evidence). This result is clinically important.There was insufficient evidence to confirm or exclude differences in adverse effects of bisphosphonates (RR 1.05, 95% CI 0.95 to 1.76; 2 studies, 437 participants; low-quality evidence) and treatment discontinuation (2 studies, 437 participants) (RR 2.04, 95% CI 0.43 to 9.59; 2 studies, 437 participants; very low-quality evidence).Intensive versus symptomatic treatmentThere was no consistent evidence of difference to response in bone pain, bodily pain or quality of life in participants who received intensive versus symptomatic treatment.Inconclusive results were observed regarding fractures and orthopaedic procedures for intensive versus symptomatic treatment (intensive treatment for fracture: RR 1.84, 95% CI 0.76 to 4.44; absolute risk 8.1% versus 5.2%; orthopaedic procedures: RR 1.58, 95% CI 0.80 to 3.11; absolute risk 5.6% versus 3.0%; 1 study, 502 participants; low-quality evidence).There was insufficient evidence to confirm or exclude an important difference in adverse effects between intensive and symptomatic treatment (RR 1.05, 95% CI 0.79 to 1.41; low-quality evidence).There was insufficient evidence to confirm or exclude an important difference of risk of rare adverse events (including osteonecrosis of the jaw) from the regulatory agencies databases. AUTHORS' CONCLUSIONS: We found moderate-quality evidence that bisphosphonates improved pain in people with Paget's disease of bone when compared with placebo. We are uncertain about the results of head-to-head studies investigating bisphosphonates. We found insufficient evidence of benefit in terms of pain or quality of life from intensive treatment. Information about adverse effects was limited, but serious side effects were rare, and rate of withdrawals due to side effects was low.
[Mh] Termos MeSH primário: Conservadores da Densidade Óssea/uso terapêutico
Difosfonatos/uso terapêutico
Osteíte Deformante/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso
Fosfatase Alcalina/sangue
Conservadores da Densidade Óssea/efeitos adversos
Calcitonina/uso terapêutico
Difosfonatos/efeitos adversos
Feminino
Seres Humanos
Masculino
Dor Musculoesquelética/tratamento farmacológico
Osteíte Deformante/enzimologia
Pacientes Desistentes do Tratamento/estatística & dados numéricos
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Bone Density Conservation Agents); 0 (Diphosphonates); 9007-12-9 (Calcitonin); EC 3.1.3.1 (Alkaline Phosphatase)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD004956.pub3


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[PMID]:29284243
[Au] Autor:Piotrowska SE; Majchrzycki M; Rogala P; Mazurek-Sitarz M
[Ad] Endereço:Department of Spine Surgery, Oncologic Orthopaedics and Traumatology, University of Medical Sciences, Poznan, Poland. sylwia.piotrowskaa@gmail.com.
[Ti] Título:Lower extremity and spine pain in cyclists.
[So] Source:Ann Agric Environ Med;24(4):654-658, 2017 Dec 23.
[Is] ISSN:1898-2263
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The number of cyclists increases each year. Some people treat cycling as a passion and practice it at every possible occasion, while for others it is a mean of transport or a form of relaxation at the weekend. However, very few people realize that cycling can also have a negative impact on their health. OBJECTIVE: To assess the prevalence of lower extremity and spine pain in cyclists, and evaluate the influence of various factors causing it. MATERIAL AND METHODS: The study was performed on 167 subjects during amateur cycling competitions in the Greater Poland and Kuyavian-Pomeranian Provinces. A specially prepared questionnaire was used in the study. The questions related to the pain caused by cycling, the character and the localization of the pain, and the presence of warm-up and stretching. RESULTS: Knee pain was reported in 40% of the study subjects (mostly anterior pain - 26%). Spine pain was reported in 41% of the studied athletes, where 26% was related with the lumbar spine. Variables, such as age, weight, age, BMI, training experience and number of hours devoted to training per week had no influence on the incidence and the localization of leg pain, but it had influence in the case of spine pain. Stretching after cycling was the factor which significantly distinguished the studied groups with regard to the incidence of knee pain. CONCLUSIONS: The most common type of leg pain was knee pain (anterior knee pain) whereas spine pain was most commonly reported in the lumbar spine. Statistical analysis showed that spine pain is more often reported by people who are older, have higher weight, and people who spend more time training per week. Warm-up and stretching after cycling are recommended to cyclists who experience pain.
[Mh] Termos MeSH primário: Atletas/estatística & dados numéricos
Extremidade Inferior/lesões
Vértebras Lombares/lesões
Dor/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Ciclismo
Feminino
Seres Humanos
Masculino
Dor Musculoesquelética
Polônia/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171230
[St] Status:MEDLINE


  6 / 2034 MEDLINE  
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[PMID]:27776506
[Au] Autor:Christensen JR; Bredahl TV; Hadrévi J; Sjøgaard G; Søgaard K
[Ad] Endereço:Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark. jrchristensen@health.sdu.dk.
[Ti] Título:Background, design and conceptual model of the cluster randomized multiple-component workplace study: FRamed Intervention to Decrease Occupational Muscle pain - "FRIDOM".
[So] Source:BMC Public Health;16(1):1116, 2016 10 24.
[Is] ISSN:1471-2458
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Several RCT studies have aimed to reduce either musculoskeletal disorders, sickness presenteeism, sickness absenteeism or a combination of these among females with high physical work demands. These studies have provided evidence that workplace health promotion (WHP) interventions are effective, but long-term effects are still uncertain. These studies either lack to succeed in maintaining intervention effects or lack to document if effects are maintained past a one-year period. This paper describes the background, design and conceptual model of the FRIDOM (FRamed Intervention to Decrease Occupational Muscle pain) WHP program among health care workers. A job group characterized by having high physical work demands, musculoskeletal disorders, high sickness presenteeism - and absenteeism. METHODS: FRIDOM aimed to reduce neck and shoulder pain. Secondary aims were to decrease sickness presenteeism, sickness absenteeism and lifestyle-diseases such as other musculoskeletal disorders as well as metabolic-, and cardiovascular disorders - and to maintain participation to regular physical exercise training, after a one year intervention period. The entire concept was tailored to a population of female health care workers. This was done through a multi-component intervention including 1) intelligent physical exercise training (IPET), dietary advice and weight loss (DAW) and cognitive behavioural training (CBT). DISCUSSION: The FRIDOM program has the potential to provide evidence-based knowledge of the pain reducing effect of a multi component WHP among a female group of employees with a high prevalence of musculoskeletal disorders and in a long term perspective evaluate the effects on sickness presenteeism and absenteeism as well as risk of life-style diseases. TRIAL REGISTRATION: NCT02843269 , 06.27.2016 - retrospectively registered.
[Mh] Termos MeSH primário: Pessoal de Saúde
Promoção da Saúde
Dor Musculoesquelética/prevenção & controle
Mialgia/prevenção & controle
Exposição Ocupacional/efeitos adversos
Saúde do Trabalhador
Local de Trabalho
[Mh] Termos MeSH secundário: Absenteísmo
Adulto
Exercício
Feminino
Seres Humanos
Estilo de Vida
Masculino
Doenças Musculoesqueléticas/etiologia
Doenças Musculoesqueléticas/prevenção & controle
Dor Musculoesquelética/etiologia
Pescoço
Cervicalgia
Presenteísmo
Projetos de Pesquisa
Ombro
Dor de Ombro
Trabalho
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171227
[Lr] Data última revisão:
171227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE


  7 / 2034 MEDLINE  
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[PMID]:29029553
[Au] Autor:Hernon MJ; Hall AM; O'Mahony JF; Normand C; Hurley DA
[Ad] Endereço:School of Public Health, Physiotherapy, and Sports Science, A101 Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland.
[Ti] Título:Systematic Review of Costs and Effects of Self-Management Interventions for Chronic Musculoskeletal Pain: Spotlight on Analytic Perspective and Outcomes Assessment.
[So] Source:Phys Ther;97(10):998-1019, 2017 10 01.
[Is] ISSN:1538-6724
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Background: Evidence for the cost-effectiveness of self-management interventions for chronic musculoskeletal pain (CMP) lacks consensus, which may be due to variability in the costing methods employed. Purpose: The purposes of the study were to identify how costs and effects have been assessed in economic analysis of self-management interventions for CMP and to identify the effect of the chosen analytical perspective on cost-effectiveness conclusions. Data Sources: Five databases were searched for all study designs using relevant terms. Study Selection: Two independent researchers reviewed all titles for predefined inclusion criteria: adults (≥18 years of age) with CMP, interventions with a primary aim of promoting self-management, and conducted a cost analysis. Data Extraction: Descriptive data including population, self-management intervention, analytical perspective, and costs and effects measured were collected by one reviewer and checked for accuracy by a second reviewer. Data Synthesis: Fifty-seven studies were identified: 65% (n = 37) chose the societal perspective, of which 89% (n = 33) captured health care utilization, 92% (n = 34) reported labor productivity, 65% (n = 24) included intervention delivery, and 59% (n = 22) captured patient/family costs. Types of costs varied in all studies. Eight studies conducted analyses from both health service and societal perspectives; cost-effectiveness estimates varied with perspective chosen, but in no case was the difference sufficient to change overall policy recommendations. Limitations: Chronic musculoskeletal pain conditions where self-management is recommended, but not as a primary treatment, were excluded. Gray literature was excluded. Conclusion: Substantial heterogeneity in the cost components captured in the assessment of self-management for CMP was found; this was independent of the analytic perspective used. Greater efforts to ensure complete and consistent costings are required if reliable cost-effectiveness evidence of self-management interventions is to be generated and to inform the most appropriate perspective for economic analyses in this field.
[Mh] Termos MeSH primário: Dor Crônica/terapia
Análise Custo-Benefício
Dor Musculoesquelética/terapia
Autocuidado/economia
[Mh] Termos MeSH secundário: Adulto
Dor Crônica/economia
Bases de Dados Factuais/estatística & dados numéricos
Seres Humanos
Dor Musculoesquelética/economia
Avaliação de Resultados (Cuidados de Saúde)
Educação de Pacientes como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171017
[Lr] Data última revisão:
171017
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171015
[St] Status:MEDLINE
[do] DOI:10.1093/ptj/pzx073


  8 / 2034 MEDLINE  
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[PMID]:28796805
[Au] Autor:Schäfer AGM; Joos LJ; Roggemann K; Waldvogel-Röcker K; Pfingsten M; Petzke F
[Ad] Endereço:University of Applied Sciences Bremen, Faculty of Social Sciences, Degree Programme Applied Sciences Speech and Language Therapy and Physiotherapy, Bremen, Germany.
[Ti] Título:Pain experiences of patients with musculoskeletal pain + central sensitization: A comparative Group Delphi Study.
[So] Source:PLoS One;12(8):e0182207, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Central sensitization (CS) is regarded as an important contributing factor for chronification of musculoskeletal pain (MSP). It is crucial to identify CS, as targeted multimodal treatment may be indicated. The primary objective of this study was therefore to explore pain experience of individuals with MSP+CS in order to gain a better understanding of symptoms in relation to CS from a patient perspective. The secondary objective was to investigate whether pain experiences of patients with MSP+CS differ from those of individuals with neuropathic pain (NP). METHODS: We conducted a comparative Group Delphi Study including patients with MSP+CS and neuropathic pain (NP). 13 guiding questions were used to gather information about sensory discriminatory, affective and associated bodily, mental and emotional phenomena related to the pain experience of patients. Descriptions were categorized using qualitative content analysis. Additionally, patients completed several pain related questionnaires. RESULTS: Nine participants with MSP+CS and nine participants with NP participated. The Delphi procedure revealed three main themes: psycho-emotional factors, bodily factors and environmental factors. Descriptions of patients with MSP+CS showed a complex picture, psycho-emotional factors seem to have a considerable impact on pain provocation, aggravation and relief. Impairments associated with mental ability and psyche affected many aspects of daily life. In contrast, descriptions of patients with NP revealed a rather mechanistic and bodily oriented pain experience. DISCUSSION: Patients with MSP+CS reported distinct features in relation to their pain that were not captured with current questionnaires. Insight in patient's pain experience may help to choose and develop appropriate diagnostic instruments.
[Mh] Termos MeSH primário: Sensibilização do Sistema Nervoso Central/fisiologia
Dor Crônica/psicologia
Emoções/fisiologia
Dor Musculoesquelética/psicologia
Neuralgia/psicologia
Qualidade de Vida/psicologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Dor Crônica/fisiopatologia
Estudos Transversais
Técnica Delfos
Feminino
Seres Humanos
Masculino
Meia-Idade
Dor Musculoesquelética/fisiopatologia
Neuralgia/fisiopatologia
Medição da Dor
Pesquisa Qualitativa
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171009
[Lr] Data última revisão:
171009
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170811
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0182207


  9 / 2034 MEDLINE  
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[PMID]:28792953
[Au] Autor:Telfer S; Obradovich N
[Ad] Endereço:Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, United States of America.
[Ti] Título:Local weather is associated with rates of online searches for musculoskeletal pain symptoms.
[So] Source:PLoS One;12(8):e0181266, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Weather conditions are commonly believed to influence musculoskeletal pain, however the evidence for this is mixed. This study aimed to examine the relationship between local meteorological conditions and online search trends for terms related to knee pain, hip pain, and arthritis. Five years of relative online search volumes for these terms were obtained for the 50 most populous cities in the contiguous United States, along with corresponding local weather data for temperature, relative humidity, barometric pressure, and precipitation. Methods from the climate econometrics literature were used to assess the casual impact of these meteorological variables on the relative volumes of searches for pain. For temperatures between -5°C and 30°C, search volumes for hip pain increased by 12 index points, and knee pain increased by 18 index points. Precipitation had a negative effect on search volumes for these terms. At temperatures >30°C, search volumes for arthritis related pain decreased by 7 index points. These patterns were not seen for pain searches unrelated to the musculoskeletal system. In summary, selected local weather conditions are significantly associated with online search volumes for specific musculoskeletal pain symptoms. We believe the predominate driver for this to be the relative changes in physical activity levels associated with meteorological conditions.
[Mh] Termos MeSH primário: Internet/estatística & dados numéricos
Internet/tendências
Dor Musculoesquelética/patologia
Tempo (Meteorologia)
[Mh] Termos MeSH secundário: Pressão Atmosférica
Clima
Seres Humanos
Medição da Dor
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170810
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0181266


  10 / 2034 MEDLINE  
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[PMID]:28719557
[Au] Autor:Li W; Ayers DC; Lewis CG; Bowen TR; Allison JJ; Franklin PD
[Ad] Endereço:1University of Massachusetts Medical School, Worcester, Massachusetts 2Hartford Hospital, Hartford, Connecticut 3Geisinger Health System, Danville, Pennsylvania.
[Ti] Título:Functional Gain and Pain Relief After Total Joint Replacement According to Obesity Status.
[So] Source:J Bone Joint Surg Am;99(14):1183-1189, 2017 Jul 19.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Obesity has been associated with lower function and more pain before and after total hip or knee replacement (THR or TKR). We examined the changes between preoperative and postoperative function and pain in a large representative U.S. cohort to determine if there was a relationship to obesity status. METHODS: Preoperative and 6-month postoperative data on function (Short Form-36 Physical Component Summary [PCS] score), joint pain (Hip disability and Osteoarthritis Outcome Score and Knee injury and Osteoarthritis Outcome Score), and body mass index (BMI) were collected from a national sample of 2,040 patients who had undergone THR and 2,964 who had undergone TKR from May 2011 to March 2013. Preoperative and postoperative function and pain were evaluated according to BMI status, defined as under or of normal weight, overweight, obese, severely obese, or morbidly obese. RESULTS: Patients undergoing THR were an average of 65 years of age; 59% were women, 94% were white, and 14% were severely or morbidly obese. A greater obesity level was associated with a lower (worse) PCS score at baseline and 6 months postoperatively. Severely and morbidly obese patients had less postoperative functional gain than the other BMI groups. A greater obesity level was associated with more pain at baseline but greater postoperative pain relief, so the average postoperative pain scores did not differ significantly according to BMI status. Patients undergoing TKR had an average age of 69 years; 61% were women, 93% were white, and 25% were severely or morbidly obese. A greater obesity level was associated with a lower PCS score at baseline and 6 months. The postoperative gain in PCS score did not differ by BMI level. A greater obesity level was associated with worse pain at baseline but greater pain relief at 6 months, so the average pain scores at 6 month were similar across the BMI levels. CONCLUSIONS: Six months after total joint replacement (TJR), severely or morbidly obese patients reported excellent pain relief and substantial functional gain that was similar to the findings in other patients. While obesity is associated with a greater risk of early complications, obesity in itself should not be a deterrent to undergoing TJR to relieve symptoms. LEVEL OF EVIDENCE: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
[Mh] Termos MeSH primário: Artroplastia de Quadril
Artroplastia do Joelho
Dor Musculoesquelética/prevenção & controle
Obesidade Mórbida/complicações
[Mh] Termos MeSH secundário: Atividades Cotidianas
Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Obesidade Mórbida/fisiopatologia
Osteoartrite do Quadril/fisiopatologia
Osteoartrite do Quadril/cirurgia
Osteoartrite do Joelho/fisiopatologia
Osteoartrite do Joelho/cirurgia
Medição da Dor
Dor Pós-Operatória/etiologia
Resultado do Tratamento
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170719
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.16.00960



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