scholarly journals A Scoping Review of the Evidence regarding Assessment and Management of Psychological Features of Shoulder Pain

2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Maryam Farzad ◽  
Joy C. MacDermid ◽  
David C. Ring ◽  
Erfan Shafiee
Keyword(s):  
Pain Intensity ◽  
Shoulder Pain ◽  
Scoping Review ◽  
Psychological Factors ◽  
Psychological Aspects ◽  
Secondary Outcome ◽  
Treatment Targets ◽  
Catastrophic Thinking ◽  
Graded Exercise Therapy ◽  
Cognitive Approaches

Background and Aim. Shoulder pain is second only to low back pain among costs associated with the care of musculoskeletal disorders. Psychological factors, social factors, and mental health can contribute to shoulder pain and resulting functional disability. The purpose of this scoping review was to identify the nature of the research that has integrated psychological assessment and treatment in the management of shoulder pain. Methods. A scoping review of research studies identified through PubMed, EMBASE, and CINAHL and graduate theses identified using Google Scholar was conducted to determine studies and systematic reviews that addressed the management of psychological aspects of shoulder pain with or without neck pain. The search terms included psychological factors, anxiety, depression, catastrophic thinking, fear of movement, and psychological treatments. Two investigators screened study titles and abstracts. Data extraction, content analysis, and thematic coding focused on the dimensions of pain addressed (emotional, behavioural, and cognitive) and treatment approaches used (dimensions targeted, specific treatment parameters) and the linkage between treatment targets/rationale with interventions/outcomes measured. Results. Ten studies (seven randomized trials and three cohorts) were identified that addressed the psychological aspects of shoulder pain. Out of seven RCTs, four compared psychological interventions with usual care. Eight studies used cognitive approaches, including emotional freedom techniques (EFT), pain coping strategies (PCS), physical-cognitive-mindfulness training (PCMT), psychological flexibility, face-to-face cognitive-behavioural treatment (CBT), and cognitive therapy using virtual reality (V.R.). Three studies used the behavioural approaches as their intervention, including behavioural therapy and Graded Exercise Therapy (GET). Pain intensity was addressed as the primary outcome in two studies and as a secondary outcome in five studies. Cognitive factors were evaluated in 50% of the articles using nine different measures. Emotional factors were evaluated in 80% of articles using ten different measures. Reduction of pain intensity and catastrophic thinking concerning pain was achieved in most studies using a biopsychosocial approach (70%). Applying a behavioural approach was associated with reductions in kinesiophobia and pain catastrophizing. Cognitive approaches had a positive association with reductions in the emotional aspect of pain. Only one study specifically linked rationale or specific physical and psychosocial treatment targets with the treatments provided and outcomes measured. Conclusions. Small pools of studies indicate that the rationale and treatment targeting are poorly defined in biopsychosocial interventions for shoulder pain. However, these benefits have been demonstrated when cognitive or behavioural components are added to the standard physical treatment of shoulder pain. A better definition of treatment targets, description of intervention components, and linkage of outcomes to targets are needed to advance our understanding of optimizing bio-psychosocial approaches.

scholarly journals The role of psychological factors in the perpetuation of pain intensity and disability in people with chronic shoulder pain: a systematic review

BMJ Open ◽  
2018 ◽  
Vol 8 (4) ◽  
pp. e020703 ◽  
Author(s):  
Javier Martinez-Calderon ◽  
Mira Meeus ◽  
Filip Struyf ◽  
Jose Miguel Morales-Asencio ◽  
Gabriel Gijon-Nogueron ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pain Intensity ◽  
Shoulder Pain ◽  
Psychological Factors ◽  
Chronic Shoulder Pain

Ganglions of the hand and wrist: determinants of treatment choice

2012 ◽  
Vol 38 (2) ◽  
pp. 151-157 ◽  
Author(s):  
F. Peters ◽  
A.-M. Vranceanu ◽  
M. Elbon ◽  
D. Ring
Keyword(s):  
Pain Intensity ◽  
Operative Treatment ◽  
Psychological Factors ◽  
Pain Catastrophizing ◽  
Ganglion Cyst ◽  
Treatment Choice ◽  
Pain Anxiety ◽  
Catastrophic Thinking ◽  
Ordinal Measure ◽  
Pain Anxiety Symptoms Scale

The aim of this study was to determine whether psychological factors (depression, catastrophic thinking, and pain anxiety) and pain intensity are associated with choice of operative treatment. Ninety new patients with a ganglion cyst on their hand or wrist completed psychological questionnaires (Pain Catastrophizing Scale, Pain Anxiety Symptoms Scale, and Center for the Epidemiological Study of Depression instrument) and an ordinal measure of pain intensity. After a minimum of 4 months, patients were contacted to determine if they chose operative treatment, to rate their pain intensity, and to complete the Disabilities of the Arm, Shoulder, and Hand questionnaire. Younger patients were more likely to choose operative treatment. Psychological factors were associated with pain intensity at enrolment, but not with treatment choice. Operative treatment did not result in less pain intensity or disability, or higher satisfaction compared with non-operative treatment.

scholarly journals Comparison of the clinical effectiveness of treatments for aromatase inhibitor-induced arthralgia in breast cancer patients: a protocol for a systematic review and network meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e033461
Author(s):  
Kyeore Bae ◽  
Si Yeon Song
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Pain Intensity ◽  
Aromatase Inhibitor ◽  
Cancer Patients ◽  
Meta Analysis ◽  
Indirect Evidence ◽  
Secondary Outcome ◽  
Breast Cancer Patients ◽  
Patient Reported

IntroductionAromatase inhibitor-induced arthralgia (AIA) is a major adverse event of aromatase inhibitors (AIs) and leads to premature discontinuation of AI therapy in breast cancer patients. The objective of this protocol for a systematic review and network meta-analysis (NMA) is to provide the methodology to compare the change in pain intensity between different AIA treatments and demonstrate the rank probabilities for different treatments by combining all available direct and indirect evidence.Methods and analysisPubMed, the Cochrane Controlled Register of Trials (CENTRAL), EMBASE, Web of Science and ClinicalTrials.gov will be searched to identify publications in English from inception to November 2019. We will include randomised controlled trials (RCTs) assessing the effects of different treatments for AIA in postmenopausal women with stage 0–III hormone receptor-positive breast cancer. The primary endpoints will be the change in patient-reported pain intensity from baseline to post-treatment. The number of adverse events will be presented as a secondary outcome.Both pairwise meta-analysis and NMA with the Frequentist approach will be conducted. We will demonstrate summary estimates with forest plots in meta-analysis and direct and mixed evidence with a ranking of the treatments as the P-score in NMA. The revised Cochrane risk-of-bias tool for randomised trials will be used to assess the methodological quality within individual RCTs. The quality of evidence will be assessed.Ethics and disseminationAs this review does not involve individual patients, ethical approval is not required. The results of this systematic review and NMA will be published in a peer-reviewed journal. This review will provide valuable information on AIA therapeutic options for clinicians, health practitioners and breast cancer survivors.PROSPERO registration numberCRD42019136967.

Assessing individual readiness for change in healthcare: a review of measurement scales

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Lisa Beasley ◽  
Sandra Grace ◽  
Louise Horstmanshof
Keyword(s):  
Scoping Review ◽  
Literature Search ◽  
Readiness For Change ◽  
Secondary Outcome ◽  
Individual Response ◽  
Content Type ◽  
Healthcare Environment ◽  
Scoping Reviews ◽  
Change Leaders ◽  
Response To Change

PurposeUnderstanding how individuals respond and adapt to change is essential to assist leaders to manage transformational change effectively. Contemporary health care environments are characterised by frequent and rapid change, often with unrealistic and challenging timeframes. Researchers have employed a range of assessment scales to assess individual readiness for change. Hence, to select the appropriate scale, it is critical to compare the properties of these instruments. A scoping review will be conducted to identify scales that measure an individual's response to change in the healthcare environment.Design/methodology/approachIn this article the authors used the PIC (Population or Problem, Interest, and Context) design and undertook a comprehensive literature search conducted in Eric, MEDLINE, EmCare, CINAHL, PsychINFO and PubMed. Management databases were also searched including Business Source Premium (Ebesco) and Business Collection (InfoRMIT). Reference lists were scrutinized, and citation searches were performed of the included studies. The primary outcome was the quality of the literature searches and the secondary outcome was time spent on the literature search when the PIC model was used as a search strategy tool, compared to the use of another conceptualizing tool or unguided searching.FindingsThis scoping review identified eight scales used to measure an individual's response to change. This scoping review did not identify any individual change readiness scales specifically designed for use in the healthcare environment. However, two scales (the Acceptance of Change Scale and the Resistance to Change Scale) had applicability across a wide variety of organisational settings.Research limitations/implicationsScoping reviews do not set out to comprehensively source all relevant literature but rather to ascertain the nature and extent of the published literature in the field. Therefore, it is possible that a systematic review might uncover additional relevant papers.Practical implicationsThis scoping review will assist change leaders to gain a better understanding of the different scales used to measure individual response to change.Originality/valueTo manage change effectively, change leaders first need to develop an understanding of how individuals respond and adapt to change. Change leaders require the necessary scales to assist them to understand change processes, providing an understanding of where individuals are placed on the change continuum. To the best of the authors' knowledge, this scoping review is the first of its kind to identify and review scales to measure individual response to change.

scholarly journals Effectiveness of Acromioclavicular Joint Mobilization and Physical Therapy vs Physical Therapy Alone in Patients with Frozen Shoulder: A Randomized Clinical Trial

2021 ◽  
Author(s):  
Mohammad Rahbar ◽  
Sepideh Ranjbar Kiyakalayeh ◽  
Bina Eftekharsadat ◽  
Behzad Izadseresht ◽  
Neda Dolatkhah
Keyword(s):  
Clinical Trial ◽  
Physical Therapy ◽  
Randomized Clinical Trial ◽  
Shoulder Pain ◽  
Acromioclavicular Joint ◽  
Frozen Shoulder ◽  
Secondary Outcome ◽  
Control Group ◽  
Joint Mobilization ◽  
Active Abduction

Abstract Background: Frozen shoulder (FS) is a prevalent musculoskeletal condition characterized by an often prolonged pain, disability and limited active and passive range of motion (ROM), however its management remains challenging yet. The objective of this trial was to compare the efficacy of acromioclavicular joint mobilization and physical therapy versus physical therapy in treatment of FS.Methods: In this single-blind randomized clinical trial, patients with diagnosis of FS were randomly allocated into mobilization + physical therapy (n=28) as experiment group, and physical therapy (n=28) as control group in two outpatient clinics of Tabriz University of Medical Sciences, Iran. The primary outcomes were self-reported shoulder pain-related disability measured by the Shoulder Pain and Disability Index (SPADI) questionnaire and goniometric assessment of shoulder ROM. The secondary outcome was the Visual Analogue Scale (VAS). Measures were performed at the baseline, immediately and one month after beginning the treatments.Results: Totally 51 patients with 25.73 ± 6.88 years old of age completed the study and their data were analyzed. VAS, SPADI, pain and disability improved more significantly in experiment group compared to control group immediately [-4.63 (-5.58- -3.67) vs. -2.22 (-2.96- -1.47), p<0.001; -23.08 (-28.63- -17.53) vs. -13.04 (-17.93- -8.16), p=0.008; -26.00 (-31.71- -20.29) vs. -16.35 (-23.39- -9.31), p=0.034 and -21.25 (-29.11- -13.39) vs. -10.98 (-17.53- -4.43), p=0.042, respectively] and one month after beginning of treatment [-5.58 (-6.45- -4.72) vs. -3.61 (-4.60- -2.62), p<0.001; -33.43 (-40.85- -26.01) vs. -20.03 (-26.00- -14.07), p=0.001; --42.83 (-49.09- -36.57) vs. -25.57 (-33.92- -17.21), p<0.001 and -27.55 (-36.19- -15.94) vs. -16.58 (-24.48- -8.67), p=0.041, respectively]. Active abduction ROM was also improved more significantly immediately after treatment in experiment group compared to control group [25.83 (11.45- 40.13) vs. 10.17 (1.02- 19.15), p=0.025], however there were no significant differences between two groups concerning other measured ROMs immediately and one month after treatment (all p>0.05). Conclusions: Acromioclavicular mobilization along with conventional physical therapy was more efficient in decreasing pain and disability and improving active abduction ROM compared to physical therapy in patients with FS. These findings would suggest a new therapeutic method for shoulder disorders with pain and disability.Trial registrationwww.irct.ir, IRCT20100605004104N7, registered 06.01.2019 (https://www.irct.ir/trial/35900)

Platelet-Rich Plasma versus Corticosteroid Injections in Rotator Cuff Related Shoulder Pain: A Comparative Study with Up to 18 Months of Follow-Up

2021 ◽  
Author(s):  
Juho Annaniemi ◽  
Jüri Pere ◽  
Salvatore Giordano
Keyword(s):  
Rotator Cuff ◽  
Shoulder Pain ◽  
Platelet Rich Plasma ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Subacromial Injection ◽  
Western Ontario Rotator Cuff ◽  
Feasible Alternative ◽  
Cuff Repair

Abstract Purpose: Given the complications involved in corticosteroid (CS) injections, subacromial platelet-rich plasma (PRP) injections may provide a valid alternative to CS in the treatment of rotator cuff related shoulder pain (RCRSP).Methods: We retrospectively reviewed a total of 98 patients affected by RCRSP who were treated with either subacromial injection of PRP or CS. The PRP group received three injections of autologous PRP at two weeks interval, and the CS group received one injection of CS. Western Ontario Rotator Cuff Index (WORC) was the primary outcome measure, while secondary outcome measures were the Visual Analogue Scale (VAS), Range of Motion (ROM) and need for cuff repair surgery, which were analyzed at interval of 6, 12, and 18 months.Results: A total of 75 patients were included in the analysis (PRP n = 35, CS n = 40). Mean follow-up was (PRP 21.1 ± 8.7 months vs CS 33.6 ± 16.3 months, p <0.001). Both groups showed improvement in WORC, VAS and ROM. No significant differences were detected between the two groups in any of the primary (WORC) or secondary outcomes during 6, 12 and 18 months (all p > 0.05). No adverse events were detected.Conclusion: Both treatments improve RCRSP patient’s symptoms, but none of them seems to result in a significant better outcome in this series of patients. PRP can be a safe and feasible alternative to CS in treatment of RCRSP even at long follow-up, to reduce local and systemic effects involved with CS injections.

Is rotator cuff related shoulder pain a multidimensional disorder? An exploratory study

2020 ◽  
Vol 20 (2) ◽  
pp. 297-305 ◽  
Author(s):  
Luca Maestroni ◽  
Michele Marelli ◽  
Massimiliano Gritti ◽  
Fabio Civera ◽  
Martin Rabey
Keyword(s):  
Rotator Cuff ◽  
Pain Intensity ◽  
Shoulder Pain ◽  
Management Strategies ◽  
Future Research ◽  
Multivariable Model ◽  
Cross Sectional ◽  
Need To Evaluate ◽  
Symptom Persistence ◽  
Multivariable Regression Models

AbstractBackground and aimsRotator cuff related shoulder pain has been associated with factors from multiple dimensions such as strength changes, psychosocial measures, comorbidities and level of education. However, to date little research has been undertaken to evaluate which factors explain the greatest variance in pain and disability levels in people with rotator cuff related shoulder pain. The objective of this study was therefore to evaluate which multidimensional examination findings were associated with higher pain and disability in a primary care cohort with rotator cuff related shoulder pain.MethodsThis was an exploratory cross-sectional cohort study. Sixty-seven participants with rotator cuff related shoulder pain were assessed for: pain intensity, disability; demographic, psychological, social and lifestyle characteristics, and isometric strength of shoulder internal and external rotator muscles. Univariable associations between pain intensity/disability and each variable were assessed using linear regression. Variables with univariable associations (p < 0.1) were entered into backwards stepwise multivariable regression models.ResultsThe multivariable model for pain intensity included sleep and perceived persistence and explained 46.5% of the variance (37.6% uniquely by sleep, 5.4% uniquely by perceived persistence). The multivariable model for disability included sleep and sex and explained 26.8% of the variance (4.5% shared by predictors, 16.4% uniquely by sleep, 5.9% uniquely by sex).ConclusionsRotator cuff-related shoulder pain and disability are associated with sleep disturbance, perceived symptom persistence and sex. Rotator cuff related shoulder pain may be considered a multidimensional disorder.ImplicationsClinicians need to evaluate sleep and perceived symptom persistence in people with rotator cuff related shoulder pain. Future research may examine whether management strategies for RCRSP directed towards these factors afford improved treatment outcomes.

Are Illness Perceptions Associated with Pain and Disability in Complex Regional Pain Syndrome? A Cross-Sectional Study

Pain Medicine ◽  
2020 ◽  
Author(s):  
Dana R Antunovich ◽  
Juliette C Horne ◽  
Natalie L Tuck ◽  
Debbie J Bean
Keyword(s):  
Pain Intensity ◽  
Complex Regional Pain Syndrome ◽  
Psychological Factors ◽  
Illness Perceptions ◽  
Pain Syndrome ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pain Disability ◽  
Regulation Model

Abstract Objective Complex regional pain syndrome (CRPS) is a complex and often poorly understood condition, and people with CRPS will have diverse beliefs about their symptoms. According to the self-regulation model, these beliefs (termed “illness perceptions”) influence health behaviors and outcomes. Previous studies have found that psychological factors influence CRPS outcomes, but few studies have investigated CRPS patients’ illness perceptions specifically. The present study examined whether illness perceptions were related to pain intensity and other relevant outcomes in people with CRPS. Methods In this cross-sectional study, 53 patients with CRPS (type 1 and type 2) completed questionnaires assessing illness perceptions, pain, disability, and psychological factors. Multiple regression analyses were used to determine whether illness perceptions were associated with pain intensity, disability, depression, and kinesiophobia, after controlling for possible covariates (including clinical and demographic factors, pain catastrophizing, and negative affect). Results Negative illness perceptions were associated with greater pain, disability, and kinesiophobia, but not depression. Specifically, attributing more symptoms to CRPS (more negative illness identity perceptions) was associated with greater pain intensity, and reporting a poorer understanding of CRPS (lower illness coherence scores) was associated with greater disability and kinesiophobia. Conclusions Patients with CRPS with more negative illness perceptions (particularly perceptions indicating a poor understanding of their condition) also experience greater pain, disability, and kinesiophobia. Future research could investigate whether altering CRPS patients’ illness perceptions influences clinical outcomes.

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