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Domains of Chronic Low Back Pain and Assessing Treatment Effectiveness: A Clinical Perspective.

Identifieur interne : 000240 ( Main/Exploration ); précédent : 000239; suivant : 000241

Domains of Chronic Low Back Pain and Assessing Treatment Effectiveness: A Clinical Perspective.

Auteurs : Scott D. Tagliaferri [Australie] ; Clint T. Miller [Australie] ; Patrick J. Owen [Australie] ; Ulrike H. Mitchell [États-Unis] ; Helena Brisby [Suède] ; Bernadette Fitzgibbon [Australie] ; Hugo Masse-Alarie [Canada] ; Jessica Van Oosterwijck [Belgique] ; Daniel L. Belavy [Australie]

Source :

RBID : pubmed:31610090

Descripteurs français

English descriptors

Abstract

Nonspecific chronic low back pain (CLBP) is a common clinical condition that has impacts at both the individual and societal level. Pain intensity is a primary outcome used in clinical practice to quantify the severity of CLBP and the efficacy of its treatment; however, pain is a subjective experience that is impacted by a multitude of factors. Moreover, differences in effect sizes for pain intensity are not observed between common conservative treatments, such as spinal manipulative therapy, cognitive behavioral therapy, acupuncture, and exercise training. As pain science evolves, the biopsychosocial model is gaining interest in its application for CLBP management. The aim of this article is to discuss our current scientific understanding of pain and present why additional factors should be considered in conservative CLBP management. In addition to pain intensity, we recommend that clinicians should consider assessing the multidimensional nature of CLBP by including physical (disability, muscular strength and endurance, performance in activities of daily living, and body composition), psychological (kinesiophobia, fear-avoidance, pain catastrophizing, pain self-efficacy, depression, anxiety, and sleep quality), social (social functioning and work absenteeism), and health-related quality-of-life measures, depending on what is deemed relevant for each individual. This review also provides practical recommendations to clinicians for the assessment of outcomes beyond pain intensity, including information on how large a change must be for it to be considered "real" in an individual patient. This information can guide treatment selection when working with an individual with CLBP.

DOI: 10.1111/papr.12846
PubMed: 31610090


Affiliations:


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Le document en format XML

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<div type="abstract" xml:lang="en">Nonspecific chronic low back pain (CLBP) is a common clinical condition that has impacts at both the individual and societal level. Pain intensity is a primary outcome used in clinical practice to quantify the severity of CLBP and the efficacy of its treatment; however, pain is a subjective experience that is impacted by a multitude of factors. Moreover, differences in effect sizes for pain intensity are not observed between common conservative treatments, such as spinal manipulative therapy, cognitive behavioral therapy, acupuncture, and exercise training. As pain science evolves, the biopsychosocial model is gaining interest in its application for CLBP management. The aim of this article is to discuss our current scientific understanding of pain and present why additional factors should be considered in conservative CLBP management. In addition to pain intensity, we recommend that clinicians should consider assessing the multidimensional nature of CLBP by including physical (disability, muscular strength and endurance, performance in activities of daily living, and body composition), psychological (kinesiophobia, fear-avoidance, pain catastrophizing, pain self-efficacy, depression, anxiety, and sleep quality), social (social functioning and work absenteeism), and health-related quality-of-life measures, depending on what is deemed relevant for each individual. This review also provides practical recommendations to clinicians for the assessment of outcomes beyond pain intensity, including information on how large a change must be for it to be considered "real" in an individual patient. This information can guide treatment selection when working with an individual with CLBP.</div>
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<Abstract>
<AbstractText>Nonspecific chronic low back pain (CLBP) is a common clinical condition that has impacts at both the individual and societal level. Pain intensity is a primary outcome used in clinical practice to quantify the severity of CLBP and the efficacy of its treatment; however, pain is a subjective experience that is impacted by a multitude of factors. Moreover, differences in effect sizes for pain intensity are not observed between common conservative treatments, such as spinal manipulative therapy, cognitive behavioral therapy, acupuncture, and exercise training. As pain science evolves, the biopsychosocial model is gaining interest in its application for CLBP management. The aim of this article is to discuss our current scientific understanding of pain and present why additional factors should be considered in conservative CLBP management. In addition to pain intensity, we recommend that clinicians should consider assessing the multidimensional nature of CLBP by including physical (disability, muscular strength and endurance, performance in activities of daily living, and body composition), psychological (kinesiophobia, fear-avoidance, pain catastrophizing, pain self-efficacy, depression, anxiety, and sleep quality), social (social functioning and work absenteeism), and health-related quality-of-life measures, depending on what is deemed relevant for each individual. This review also provides practical recommendations to clinicians for the assessment of outcomes beyond pain intensity, including information on how large a change must be for it to be considered "real" in an individual patient. This information can guide treatment selection when working with an individual with CLBP.</AbstractText>
<CopyrightInformation>© 2019 World Institute of Pain.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y">
<Author ValidYN="Y">
<LastName>Tagliaferri</LastName>
<ForeName>Scott D</ForeName>
<Initials>SD</Initials>
<Identifier Source="ORCID">0000-0003-3669-4131</Identifier>
<AffiliationInfo>
<Affiliation>School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Miller</LastName>
<ForeName>Clint T</ForeName>
<Initials>CT</Initials>
<Identifier Source="ORCID">0000-0001-7743-6986</Identifier>
<AffiliationInfo>
<Affiliation>School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Owen</LastName>
<ForeName>Patrick J</ForeName>
<Initials>PJ</Initials>
<Identifier Source="ORCID">0000-0003-3924-9375</Identifier>
<AffiliationInfo>
<Affiliation>School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Mitchell</LastName>
<ForeName>Ulrike H</ForeName>
<Initials>UH</Initials>
<AffiliationInfo>
<Affiliation>Department of Exercise Sciences, Brigham Young University, Provo, Utah, U.S.A.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Brisby</LastName>
<ForeName>Helena</ForeName>
<Initials>H</Initials>
<AffiliationInfo>
<Affiliation>Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>Department of Orthopaedics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Fitzgibbon</LastName>
<ForeName>Bernadette</ForeName>
<Initials>B</Initials>
<Identifier Source="ORCID">0000-0002-5339-5304</Identifier>
<AffiliationInfo>
<Affiliation>Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>Epworth Centre for Innovation in Mental Health, Epworth HealthCare, Melbourne, Victoria, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Masse-Alarie</LastName>
<ForeName>Hugo</ForeName>
<Initials>H</Initials>
<Identifier Source="ORCID">0000-0003-4472-9656</Identifier>
<AffiliationInfo>
<Affiliation>Centre Interdisciplinaire de Recherche en Réadaptation et Integration Sociale (CIRRIS), Université Laval, Québec City, Québec, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Van Oosterwijck</LastName>
<ForeName>Jessica</ForeName>
<Initials>J</Initials>
<Identifier Source="ORCID">0000-0002-8946-4383</Identifier>
<AffiliationInfo>
<Affiliation>SPINE Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerpen, Belgium.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>Research Foundation - Flanders (FWO), Brussels, Belgium.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>Pain in Motion International Research Group.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Belavy</LastName>
<ForeName>Daniel L</ForeName>
<Initials>DL</Initials>
<Identifier Source="ORCID">0000-0002-9307-832X</Identifier>
<AffiliationInfo>
<Affiliation>School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList>
<PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType>
<PublicationType UI="D016454">Review</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic">
<Year>2019</Year>
<Month>11</Month>
<Day>11</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo>
<Country>United States</Country>
<MedlineTA>Pain Pract</MedlineTA>
<NlmUniqueID>101130835</NlmUniqueID>
<ISSNLinking>1530-7085</ISSNLinking>
</MedlineJournalInfo>
<CitationSubset>IM</CitationSubset>
<CommentsCorrectionsList>
<CommentsCorrections RefType="CommentIn">
<RefSource>Pain Pract. 2020 Nov;20(8):946-947</RefSource>
<PMID Version="1">32306493</PMID>
</CommentsCorrections>
</CommentsCorrectionsList>
<MeshHeadingList>
<MeshHeading>
<DescriptorName UI="D000203" MajorTopicYN="N">Activities of Daily Living</DescriptorName>
<QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D059350" MajorTopicYN="N">Chronic Pain</DescriptorName>
<QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName>
<QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D015928" MajorTopicYN="N">Cognitive Behavioral Therapy</DescriptorName>
<QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D003863" MajorTopicYN="N">Depression</DescriptorName>
<QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName>
<QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D015444" MajorTopicYN="N">Exercise</DescriptorName>
<QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D005239" MajorTopicYN="N">Fear</DescriptorName>
<QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D017116" MajorTopicYN="N">Low Back Pain</DescriptorName>
<QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName>
<QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D011788" MajorTopicYN="N">Quality of Life</DescriptorName>
<QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D057566" MajorTopicYN="N">Self Report</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM">
<Keyword MajorTopicYN="Y">exercise</Keyword>
<Keyword MajorTopicYN="Y">manual therapy</Keyword>
<Keyword MajorTopicYN="Y">physical therapy</Keyword>
<Keyword MajorTopicYN="Y">physiotherapy</Keyword>
<Keyword MajorTopicYN="Y">spine</Keyword>
</KeywordList>
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<PubMedPubDate PubStatus="received">
<Year>2019</Year>
<Month>07</Month>
<Day>03</Day>
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<PubMedPubDate PubStatus="revised">
<Year>2019</Year>
<Month>09</Month>
<Day>26</Day>
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<PubMedPubDate PubStatus="accepted">
<Year>2019</Year>
<Month>10</Month>
<Day>09</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="pubmed">
<Year>2019</Year>
<Month>10</Month>
<Day>15</Day>
<Hour>6</Hour>
<Minute>0</Minute>
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<PubMedPubDate PubStatus="medline">
<Year>2020</Year>
<Month>9</Month>
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<Hour>6</Hour>
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