Non-pharmacological interventions for chronic pain in multiple sclerosis.
Identifieur interne : 000D66 ( Main/Exploration ); précédent : 000D65; suivant : 000D67Non-pharmacological interventions for chronic pain in multiple sclerosis.
Auteurs : Bhasker Amatya ; Jamie Young ; Fary KhanSource :
- The Cochrane database of systematic reviews [ 1469-493X ] ; 2018.
Descripteurs français
- KwdFr :
- Douleur chronique (thérapie), Douleur musculosquelettique (thérapie), Essais contrôlés randomisés comme sujet (MeSH), Humains (MeSH), Hydrothérapie (MeSH), Hypnose (MeSH), Massage (MeSH), Neurostimulation électrique transcutanée (méthodes), Psychothérapie (MeSH), Qualité de vie (MeSH), Rétroaction neurologique (MeSH), Sclérose en plaques (complications), Stimulation transcrânienne par courant continu (MeSH), Thérapie par la relaxation (MeSH), Traitement par les exercices physiques (méthodes), Éducation du patient comme sujet (méthodes).
- MESH :
- méthodes : Neurostimulation électrique transcutanée, Traitement par les exercices physiques, Éducation du patient comme sujet.
- thérapie : Douleur chronique, Douleur musculosquelettique.
- complications : Essais contrôlés randomisés comme sujet, Humains, Hydrothérapie, Hypnose, Massage, Psychothérapie, Qualité de vie, Rétroaction neurologique, Sclérose en plaques, Stimulation transcrânienne par courant continu, Thérapie par la relaxation.
English descriptors
- KwdEn :
- Chronic Pain (therapy), Exercise Therapy (methods), Humans (MeSH), Hydrotherapy (MeSH), Hypnosis (MeSH), Massage (MeSH), Multiple Sclerosis (complications), Musculoskeletal Pain (therapy), Neurofeedback (MeSH), Patient Education as Topic (methods), Psychotherapy (MeSH), Quality of Life (MeSH), Randomized Controlled Trials as Topic (MeSH), Relaxation Therapy (MeSH), Transcranial Direct Current Stimulation (MeSH), Transcutaneous Electric Nerve Stimulation (methods).
- MESH :
- complications : Multiple Sclerosis.
- methods : Exercise Therapy, Patient Education as Topic, Transcutaneous Electric Nerve Stimulation.
- therapy : Chronic Pain, Musculoskeletal Pain.
- Humans, Hydrotherapy, Hypnosis, Massage, Neurofeedback, Psychotherapy, Quality of Life, Randomized Controlled Trials as Topic, Relaxation Therapy, Transcranial Direct Current Stimulation.
Abstract
BACKGROUND
Chronic pain is common and significantly impacts on the lives of persons with multiple sclerosis (pwMS). Various types of non-pharmacological interventions are widely used, both in hospital and ambulatory/mobility settings to improve pain control in pwMS, but the effectiveness and safety of many non-pharmacological modalities is still unknown.
OBJECTIVES
This review aimed to investigate the effectiveness and safety of non-pharmacological therapies for the management of chronic pain in pwMS. Specific questions to be addressed by this review include the following.Are non-pharmacological interventions (unidisciplinary and/or multidisciplinary rehabilitation) effective in reducing chronic pain in pwMS?What type of non-pharmacological interventions (unidisciplinary and/or multidisciplinary rehabilitation) are effective (least and most effective) and in what setting, in reducing chronic pain in pwMS?
SEARCH METHODS
A literature search was performed using the specialised register of the Cochrane MS and Rare Diseases of the Central Nervous System Review Group, using the Cochrane MS Group Trials Register which contains CENTRAL, MEDLINE, Embase, CINAHL, LILACUS, Clinical trials.gov and the World Health Organization International Clinical Trials Registry Platform on 10 December 2017. Handsearching of relevant journals and screening of reference lists of relevant studies was carried out.
SELECTION CRITERIA
All published randomised controlled trials (RCTs)and cross-over studies that compared non-pharmacological therapies with a control intervention for managing chronic pain in pwMS were included. Clinical controlled trials (CCTs) were eligible for inclusion.
DATA COLLECTION AND ANALYSIS
All three review authors independently selected studies, extracted data and assessed the methodological quality of the studies using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) tool for best-evidence synthesis. Pooling data for meta-analysis was not possible due to methodological, clinical and statistically heterogeneity of the included studies.
MAIN RESULTS
Overall, 10 RCTs with 565 participants which investigated different non-pharmacological interventions for the management of chronic pain in MS fulfilled the review inclusion criteria. The non-pharmacological interventions evaluated included: transcutaneous electrical nerve stimulation (TENS), psychotherapy (telephone self-management, hypnosis and electroencephalogram (EEG) biofeedback), transcranial random noise stimulation (tRNS), transcranial direct stimulation (tDCS), hydrotherapy (Ai Chi) and reflexology.There is very low-level evidence for the use of non-pharmacological interventions for chronic pain such as TENS, Ai Chi, tDCS, tRNS, telephone-delivered self-management program, EEG biofeedback and reflexology in pain intensity in pwMS. Although there were improved changes in pain scores and secondary outcomes (such as fatigue, psychological symptoms, spasm in some interventions), these were limited by methodological biases within the studies.
AUTHORS' CONCLUSIONS
Despite the use of a wide range of non-pharmacological interventions for the treatment of chronic pain in pwMS, the evidence for these interventions is still limited or insufficient, or both. More studies with robust methodology and greater numbers of participants are needed to justify the effect of these interventions for the management of chronic pain in pwMS.
DOI: 10.1002/14651858.CD012622.pub2
PubMed: 30567012
PubMed Central: PMC6516893
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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sortKey="Young, Jamie" sort="Young, Jamie" uniqKey="Young J" first="Jamie" last="Young">Jamie Young</name></author><author><name sortKey="Khan, Fary" sort="Khan, Fary" uniqKey="Khan F" first="Fary" last="Khan">Fary Khan</name></author></analytic><series><title level="j">The Cochrane database of systematic reviews</title><idno type="eISSN">1469-493X</idno><imprint><date when="2018" type="published">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Chronic Pain (therapy)</term><term>Exercise Therapy (methods)</term><term>Humans (MeSH)</term><term>Hydrotherapy (MeSH)</term><term>Hypnosis (MeSH)</term><term>Massage (MeSH)</term><term>Multiple Sclerosis (complications)</term><term>Musculoskeletal Pain (therapy)</term><term>Neurofeedback (MeSH)</term><term>Patient Education as Topic (methods)</term><term>Psychotherapy (MeSH)</term><term>Quality of Life (MeSH)</term><term>Randomized Controlled Trials as Topic (MeSH)</term><term>Relaxation Therapy (MeSH)</term><term>Transcranial Direct Current Stimulation (MeSH)</term><term>Transcutaneous Electric Nerve Stimulation (methods)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Douleur chronique (thérapie)</term><term>Douleur musculosquelettique (thérapie)</term><term>Essais contrôlés randomisés comme sujet (MeSH)</term><term>Humains (MeSH)</term><term>Hydrothérapie (MeSH)</term><term>Hypnose (MeSH)</term><term>Massage (MeSH)</term><term>Neurostimulation électrique transcutanée (méthodes)</term><term>Psychothérapie (MeSH)</term><term>Qualité de vie (MeSH)</term><term>Rétroaction neurologique (MeSH)</term><term>Sclérose en plaques (complications)</term><term>Stimulation transcrânienne par courant continu (MeSH)</term><term>Thérapie par la relaxation (MeSH)</term><term>Traitement par les exercices physiques (méthodes)</term><term>Éducation du patient comme sujet (méthodes)</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Multiple Sclerosis</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Exercise Therapy</term><term>Patient Education as Topic</term><term>Transcutaneous Electric Nerve Stimulation</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Neurostimulation électrique transcutanée</term><term>Traitement par les exercices physiques</term><term>Éducation du patient comme sujet</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Chronic Pain</term><term>Musculoskeletal Pain</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Douleur chronique</term><term>Douleur musculosquelettique</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Humans</term><term>Hydrotherapy</term><term>Hypnosis</term><term>Massage</term><term>Neurofeedback</term><term>Psychotherapy</term><term>Quality of Life</term><term>Randomized Controlled Trials as Topic</term><term>Relaxation Therapy</term><term>Transcranial Direct Current Stimulation</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="fr"><term>Essais contrôlés randomisés comme sujet</term><term>Humains</term><term>Hydrothérapie</term><term>Hypnose</term><term>Massage</term><term>Psychothérapie</term><term>Qualité de vie</term><term>Rétroaction neurologique</term><term>Sclérose en plaques</term><term>Stimulation transcrânienne par courant continu</term><term>Thérapie par la relaxation</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Chronic pain is common and significantly impacts on the lives of persons with multiple sclerosis (pwMS). Various types of non-pharmacological interventions are widely used, both in hospital and ambulatory/mobility settings to improve pain control in pwMS, but the effectiveness and safety of many non-pharmacological modalities is still unknown.</p></div><div type="abstract" xml:lang="en"><p><b>OBJECTIVES</b></p><p>This review aimed to investigate the effectiveness and safety of non-pharmacological therapies for the management of chronic pain in pwMS. Specific questions to be addressed by this review include the following.Are non-pharmacological interventions (unidisciplinary and/or multidisciplinary rehabilitation) effective in reducing chronic pain in pwMS?What type of non-pharmacological interventions (unidisciplinary and/or multidisciplinary rehabilitation) are effective (least and most effective) and in what setting, in reducing chronic pain in pwMS?</p></div><div type="abstract" xml:lang="en"><p><b>SEARCH METHODS</b></p><p>A literature search was performed using the specialised register of the Cochrane MS and Rare Diseases of the Central Nervous System Review Group, using the Cochrane MS Group Trials Register which contains CENTRAL, MEDLINE, Embase, CINAHL, LILACUS, Clinical trials.gov and the World Health Organization International Clinical Trials Registry Platform on 10 December 2017. Handsearching of relevant journals and screening of reference lists of relevant studies was carried out.</p></div><div type="abstract" xml:lang="en"><p><b>SELECTION CRITERIA</b></p><p>All published randomised controlled trials (RCTs)and cross-over studies that compared non-pharmacological therapies with a control intervention for managing chronic pain in pwMS were included. Clinical controlled trials (CCTs) were eligible for inclusion.</p></div><div type="abstract" xml:lang="en"><p><b>DATA COLLECTION AND ANALYSIS</b></p><p>All three review authors independently selected studies, extracted data and assessed the methodological quality of the studies using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) tool for best-evidence synthesis. Pooling data for meta-analysis was not possible due to methodological, clinical and statistically heterogeneity of the included studies.</p></div><div type="abstract" xml:lang="en"><p><b>MAIN RESULTS</b></p><p>Overall, 10 RCTs with 565 participants which investigated different non-pharmacological interventions for the management of chronic pain in MS fulfilled the review inclusion criteria. The non-pharmacological interventions evaluated included: transcutaneous electrical nerve stimulation (TENS), psychotherapy (telephone self-management, hypnosis and electroencephalogram (EEG) biofeedback), transcranial random noise stimulation (tRNS), transcranial direct stimulation (tDCS), hydrotherapy (Ai Chi) and reflexology.There is very low-level evidence for the use of non-pharmacological interventions for chronic pain such as TENS, Ai Chi, tDCS, tRNS, telephone-delivered self-management program, EEG biofeedback and reflexology in pain intensity in pwMS. Although there were improved changes in pain scores and secondary outcomes (such as fatigue, psychological symptoms, spasm in some interventions), these were limited by methodological biases within the studies.</p></div><div type="abstract" xml:lang="en"><p><b>AUTHORS' CONCLUSIONS</b></p><p>Despite the use of a wide range of non-pharmacological interventions for the treatment of chronic pain in pwMS, the evidence for these interventions is still limited or insufficient, or both. More studies with robust methodology and greater numbers of participants are needed to justify the effect of these interventions for the management of chronic pain in pwMS.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">30567012</PMID><DateCompleted><Year>2019</Year><Month>03</Month><Day>27</Day></DateCompleted><DateRevised><Year>2020</Year><Month>04</Month><Day>16</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1469-493X</ISSN><JournalIssue CitedMedium="Internet"><Volume>12</Volume><PubDate><Year>2018</Year><Month>12</Month><Day>19</Day></PubDate></JournalIssue><Title>The Cochrane database of systematic reviews</Title><ISOAbbreviation>Cochrane Database Syst Rev</ISOAbbreviation></Journal><ArticleTitle>Non-pharmacological interventions for chronic pain in multiple sclerosis.</ArticleTitle><Pagination><MedlinePgn>CD012622</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1002/14651858.CD012622.pub2</ELocationID><Abstract><AbstractText Label="BACKGROUND">Chronic pain is common and significantly impacts on the lives of persons with multiple sclerosis (pwMS). Various types of non-pharmacological interventions are widely used, both in hospital and ambulatory/mobility settings to improve pain control in pwMS, but the effectiveness and safety of many non-pharmacological modalities is still unknown.</AbstractText><AbstractText Label="OBJECTIVES">This review aimed to investigate the effectiveness and safety of non-pharmacological therapies for the management of chronic pain in pwMS. Specific questions to be addressed by this review include the following.Are non-pharmacological interventions (unidisciplinary and/or multidisciplinary rehabilitation) effective in reducing chronic pain in pwMS?What type of non-pharmacological interventions (unidisciplinary and/or multidisciplinary rehabilitation) are effective (least and most effective) and in what setting, in reducing chronic pain in pwMS?</AbstractText><AbstractText Label="SEARCH METHODS">A literature search was performed using the specialised register of the Cochrane MS and Rare Diseases of the Central Nervous System Review Group, using the Cochrane MS Group Trials Register which contains CENTRAL, MEDLINE, Embase, CINAHL, LILACUS, Clinical trials.gov and the World Health Organization International Clinical Trials Registry Platform on 10 December 2017. Handsearching of relevant journals and screening of reference lists of relevant studies was carried out.</AbstractText><AbstractText Label="SELECTION CRITERIA">All published randomised controlled trials (RCTs)and cross-over studies that compared non-pharmacological therapies with a control intervention for managing chronic pain in pwMS were included. Clinical controlled trials (CCTs) were eligible for inclusion.</AbstractText><AbstractText Label="DATA COLLECTION AND ANALYSIS">All three review authors independently selected studies, extracted data and assessed the methodological quality of the studies using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) tool for best-evidence synthesis. Pooling data for meta-analysis was not possible due to methodological, clinical and statistically heterogeneity of the included studies.</AbstractText><AbstractText Label="MAIN RESULTS">Overall, 10 RCTs with 565 participants which investigated different non-pharmacological interventions for the management of chronic pain in MS fulfilled the review inclusion criteria. The non-pharmacological interventions evaluated included: transcutaneous electrical nerve stimulation (TENS), psychotherapy (telephone self-management, hypnosis and electroencephalogram (EEG) biofeedback), transcranial random noise stimulation (tRNS), transcranial direct stimulation (tDCS), hydrotherapy (Ai Chi) and reflexology.There is very low-level evidence for the use of non-pharmacological interventions for chronic pain such as TENS, Ai Chi, tDCS, tRNS, telephone-delivered self-management program, EEG biofeedback and reflexology in pain intensity in pwMS. Although there were improved changes in pain scores and secondary outcomes (such as fatigue, psychological symptoms, spasm in some interventions), these were limited by methodological biases within the studies.</AbstractText><AbstractText Label="AUTHORS' CONCLUSIONS">Despite the use of a wide range of non-pharmacological interventions for the treatment of chronic pain in pwMS, the evidence for these interventions is still limited or insufficient, or both. More studies with robust methodology and greater numbers of participants are needed to justify the effect of these interventions for the management of chronic pain in pwMS.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Amatya</LastName><ForeName>Bhasker</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Department of Rehabilitation Medicine, Royal Melbourne Hospital, Royal Park Campus, Poplar Road, Parkville, Melbourne, Victoria, Australia, 3052.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Young</LastName><ForeName>Jamie</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Khan</LastName><ForeName>Fary</ForeName><Initials>F</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D017418">Meta-Analysis</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType><PublicationType UI="D000078182">Systematic Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2018</Year><Month>12</Month><Day>19</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Cochrane Database Syst Rev</MedlineTA><NlmUniqueID>100909747</NlmUniqueID><ISSNLinking>1361-6137</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>NeuroRehabilitation. 2019;45(2):291-293</RefSource><PMID Version="1">31498133</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D059350" MajorTopicYN="N">Chronic Pain</DescriptorName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005081" MajorTopicYN="N">Exercise Therapy</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006875" MajorTopicYN="N">Hydrotherapy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006990" MajorTopicYN="N">Hypnosis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008405" MajorTopicYN="N">Massage</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009103" MajorTopicYN="N">Multiple Sclerosis</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D059352" MajorTopicYN="N">Musculoskeletal Pain</DescriptorName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D058765" MajorTopicYN="N">Neurofeedback</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010353" MajorTopicYN="N">Patient Education as 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