scholarly journals Digital Pain Mapping and Tracking in Patients With Chronic Pain: Longitudinal Study

10.2196/21475 ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. e21475
Author(s):  
Maria Galve Villa ◽  
Thorvaldur S Palsson ◽  
Albert Cid Royo ◽  
Carsten R Bjarkam ◽  
Shellie A Boudreau
Keyword(s):  
Pain Intensity ◽  
Pain Catastrophizing ◽  
Neck Disability Index ◽  
Referred Pain ◽  
Multiple Time ◽  
Web Based ◽  
Descriptor Selection ◽  
Pain Drawings ◽  
Pain Reports ◽  
Pain Mapping

Background Digital pain mapping allows for remote and ecological momentary assessment in patients over multiple time points spanning days to months. Frequent ecological assessments may reveal tendencies and fluctuations more clearly and provide insights into the trajectory of a patient’s pain. Objective The primary aim of this study is to remotely map and track the intensity and distribution of pain and discomfort (eg, burning, aching, and tingling) in patients with nonmalignant spinal referred pain over 12 weeks using a web-based app for digital pain mapping. The secondary aim is to explore the barriers of use by determining the differences in clinical and user characteristics between patients with good (regular users) and poor (nonregular users) reporting compliance. Methods Patients (N=91; n=53 women) with spinal referred pain were recruited using web-based and traditional in-house strategies. Patients were asked to submit weekly digital pain reports for 12 weeks. Each pain report consisted of digital pain drawings on a pseudo–three-dimensional body chart and pain intensity ratings. The pain drawings captured the distribution of pain and discomfort (pain quality descriptors) expressed as the total extent and location. Differences in weekly pain reports were explored using the total extent (pixels), current and usual pain intensity ratings, frequency of quality descriptor selection, and Jaccard similarity index. Validated e-questionnaires were completed at baseline to determine the patients’ characteristics (adapted Danish National Spine Register), disability (Oswestry Disability Index and Neck Disability Index), and pain catastrophizing (Pain Catastrophizing Scale) profiles. Barriers of use were assessed at 6 weeks using a health care–related usability and acceptance e-questionnaire and a self-developed technology-specific e-questionnaire to assess the accessibility and ease of access of the pain mapping app. Associations between total extent, pain intensity, disability, and catastrophizing were explored to further understand pain. Differences between regular and nonregular users were assessed to understand the pain mapping app reporting compliance. Results Fluctuations were identified in pain reports for total extent and pain intensity ratings (P<.001). However, quality descriptor selection (P=.99) and pain drawing (P=.49), compared using the Jaccard index, were similar over time. Interestingly, current pain intensity was greater than usual pain intensity (P<.001), suggesting that the timing of pain reporting coincided with a more intense pain experience than usual. Usability and acceptance were similar between regular and nonregular users. Regular users were younger (P<.001) and reported a larger total extent of pain than nonregular users (P<.001). Conclusions This is the first study to examine digital reports of pain intensity and distribution in patients with nonmalignant spinal referred pain remotely for a sustained period and barriers of use and compliance using a digital pain mapping app. Differences in age, pain distribution, and current pain intensity may influence reporting behavior and compliance.

scholarly journals Digital Pain Mapping and Tracking in Patients With Chronic Pain: Longitudinal Study (Preprint)

2020 ◽  
Author(s):  
Maria Galve Villa ◽  
Thorvaldur S Palsson ◽  
Albert Cid Royo ◽  
Carsten R Bjarkam ◽  
Shellie A Boudreau
Keyword(s):  
Pain Intensity ◽  
Pain Catastrophizing ◽  
Neck Disability Index ◽  
Referred Pain ◽  
Multiple Time ◽  
Web Based ◽  
Descriptor Selection ◽  
Pain Drawings ◽  
Pain Reports ◽  
Pain Mapping

BACKGROUND Digital pain mapping allows for remote and ecological momentary assessment in patients over multiple time points spanning days to months. Frequent ecological assessments may reveal tendencies and fluctuations more clearly and provide insights into the trajectory of a patient’s pain. OBJECTIVE The primary aim of this study is to remotely map and track the intensity and distribution of pain and discomfort (eg, burning, aching, and tingling) in patients with nonmalignant spinal referred pain over 12 weeks using a web-based app for digital pain mapping. The secondary aim is to explore the barriers of use by determining the differences in clinical and user characteristics between patients with good (regular users) and poor (nonregular users) reporting compliance. METHODS Patients (N=91; n=53 women) with spinal referred pain were recruited using web-based and traditional in-house strategies. Patients were asked to submit weekly digital pain reports for 12 weeks. Each pain report consisted of digital pain drawings on a pseudo–three-dimensional body chart and pain intensity ratings. The pain drawings captured the distribution of pain and discomfort (pain quality descriptors) expressed as the total extent and location. Differences in weekly pain reports were explored using the total extent (pixels), current and usual pain intensity ratings, frequency of quality descriptor selection, and Jaccard similarity index. Validated e-questionnaires were completed at baseline to determine the patients’ characteristics (adapted Danish National Spine Register), disability (Oswestry Disability Index and Neck Disability Index), and pain catastrophizing (Pain Catastrophizing Scale) profiles. Barriers of use were assessed at 6 weeks using a health care–related usability and acceptance e-questionnaire and a self-developed technology-specific e-questionnaire to assess the accessibility and ease of access of the pain mapping app. Associations between total extent, pain intensity, disability, and catastrophizing were explored to further understand pain. Differences between regular and nonregular users were assessed to understand the pain mapping app reporting compliance. RESULTS Fluctuations were identified in pain reports for total extent and pain intensity ratings (<i>P</i>&lt;.001). However, quality descriptor selection (<i>P</i>=.99) and pain drawing (<i>P</i>=.49), compared using the Jaccard index, were similar over time. Interestingly, current pain intensity was greater than usual pain intensity (<i>P</i>&lt;.001), suggesting that the timing of pain reporting coincided with a more intense pain experience than usual. Usability and acceptance were similar between regular and nonregular users. Regular users were younger (<i>P</i>&lt;.001) and reported a larger total extent of pain than nonregular users (<i>P</i>&lt;.001). CONCLUSIONS This is the first study to examine digital reports of pain intensity and distribution in patients with nonmalignant spinal referred pain remotely for a sustained period and barriers of use and compliance using a digital pain mapping app. Differences in age, pain distribution, and current pain intensity may influence reporting behavior and compliance.

Spatiotemporal patterns of pain distribution and recall accuracy: a dose-response study

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Maria Galve Villa ◽  
Thorvaldur S. Palsson ◽  
Shellie A. Boudreau
Keyword(s):  
Pain Intensity ◽  
Dose Response ◽  
Pain Catastrophizing ◽  
Spatiotemporal Patterns ◽  
Recall Accuracy ◽  
Pain Experience ◽  
Pain Drawings ◽  
Pain Area ◽  
Over Time ◽  
Pain Distribution

Abstract Objectives Clinical decisions rely on a patient’s ability to recall and report their pain experience. Monitoring pain in real-time (momentary pain) may reduce recall errors and optimize the clinical decision-making process. Tracking momentary pain can provide insights into detailed changes in pain intensity and distribution (area and location) over time. The primary aims of this study were (i) to measure the temporal changes of pain intensity, area, and location in a dose-response fashion and (ii) to assess recall accuracy of the peak pain intensity and distribution seven days later, using a digital pain mapping application. The secondary aims were to (i) evaluate the influence of repeated momentary pain drawings on pain recall accuracy and (ii) explore the associations among momentary and recall pain with psychological variables (pain catastrophizing and perceived stress). Methods Healthy participants (N=57) received a low (0.5 ml) or a high (1.0 ml) dose of hypertonic saline (5.8%) injection into the right gluteus medius muscle and, subsequently, were randomized into a non-drawing or a drawing group. The non-drawing groups reported momentary pain intensity every 30-s. Whereas the drawing groups reported momentary pain intensity and distribution on a digital body chart every 30-s. The pain intensity, area (pixels), and distribution metrics (compound area, location, radiating extent) were compared at peak pain and over time to explore dose-response differences and spatiotemporal patterns. All participants recalled the peak pain intensity and the peak (most extensive) distribution seven days later. The peak pain intensity and area recall error was calculated. Pain distribution similarity was determined using a Jaccard index which compares pain drawings representing peak distribution at baseline and recall. The relationships were explored among peak intensity and area at baseline and recall, catastrophizing, and perceived stress. Results The pain intensity, area, distribution metrics, and the duration of pain were lower for the 0.5 mL than the 1.0 mL dose over time (p<0.05). However, the pain intensity and area were similar between doses at peak pain (p>0.05). The pain area and distribution between momentary and recall pain drawings were similar (p>0.05), as reflected in the Jaccard index. Additionally, peak pain intensity did not correlate with the peak pain area. Further, peak pain intensity, but not area, was correlated with catastrophizing (p<0.01). Conclusions This study showed differences in spatiotemporal patterns of pain intensity and distribution in a dose-response fashion to experimental acute low back pain. Unlike pain intensity, pain distribution and area may be less susceptible in an experimental setting. Higher intensities of momentary pain do not appear to influence the ability to recall the pain intensity or distribution in healthy participants. Implications The recall of pain distribution in experimental settings does not appear to be influenced by the intensity despite differences in the pain experience. Pain distribution may add additional value to mechanism-based studies as the distribution reports do not vary with pain catastrophizing. REC# N-20150052

scholarly journals Menstrual Pain Intensity, Coping, and Disability: The Role of Pain Catastrophizing

Pain Medicine ◽  
2003 ◽  
Vol 4 (4) ◽  
pp. 352-361 ◽  
Author(s):  
Trudi M. Walsh ◽  
Leeanne LeBlanc ◽  
Patrick J. McGrath
Keyword(s):  
Pain Intensity ◽  
Pain Catastrophizing ◽  
Menstrual Pain

Pain Catastrophizing Is Independently Associated with Quality of Life in Patients with Severe Hip Osteoarthritis

Pain Medicine ◽  
2018 ◽  
Vol 20 (11) ◽  
pp. 2220-2227 ◽  
Author(s):  
Kazuhiro Hayashi ◽  
Takkan Morishima ◽  
Tatsunori Ikemoto ◽  
Hirofumi Miyagawa ◽  
Takuya Okamoto ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Intensity ◽  
Gait Speed ◽  
Pain Catastrophizing ◽  
Hip Osteoarthritis ◽  
Cross Sectional ◽  
Japanese Orthopedic Association ◽  
Affected Side ◽  
Tertiary Center

AbstractObjective. Pain catastrophizing is an important pain-related variable, but its impact on patients with osteoarthritis is uncertain. The aim of the current study was to determine whether pain catastrophizing was independently associated with quality of life (QOL) in patients with osteoarthritis of the hip. Design. Cross-sectional study conducted between June 2017 and February 2018. Setting. Tertiary center. Subjects. Seventy consecutively enrolled patients with severe hip osteoarthritis who had experienced pain for six or more months that limited daily function, and who were scheduled for primary unilateral total hip arthroplasty. Methods. QOL was measured using the EuroQOL-5 Dimensions questionnaire, the Japanese Orthopedic Association Hip Disease Evaluation Questionnaire, and a dissatisfaction visual analog scale. Covariates included pain intensity, pain catastrophizing, range of hip motion, and gait speed. The variables were subjected to multivariate analysis with each QOL scale. Results. The median age was 68 years, and the median Pain Catastrophizing Scale score was 26. In multiple regression analysis, pain catastrophizing, pain intensity in both hips, pain intensity on the affected side, hip flexion on the affected side, and gait speed were independently correlated with QOL. Conclusions. Pain catastrophizing was independently associated with each QOL scale in preoperative patients with severe hip osteoarthritis. Pain catastrophizing had either the strongest or second strongest effect on QOL, followed by pain intensity.

scholarly journals The Challenge of Converting “Failed Spinal Cord Stimulation Syndrome” Back to Clinical Success, Using SCS Reprogramming as Salvage Therapy, through Neurostimulation Adapters Combined with 3D-Computerized Pain Mapping Assessment: A Real Life Retrospective Study

2022 ◽  
Vol 11 (1) ◽  
pp. 272
Author(s):  
Philippe Rigoard ◽  
Amine Ounajim ◽  
Lisa Goudman ◽  
Tania Banor ◽  
France Héroux ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Pain Intensity ◽  
Spinal Cord Stimulation ◽  
Pulse Generator ◽  
Clinical Success ◽  
Real Life ◽  
Intensity Rating ◽  
Pain Mapping

While paresthesia-based Spinal Cord Stimulation (SCS) has been proven effective as treatment for chronic neuropathic pain, its initial benefits may lead to the development of “Failed SCS Syndrome’ (FSCSS) defined as decrease over time related to Loss of Efficacy (LoE) with or without Loss of Coverage (LoC). Development of technologies associating new paresthesia-free stimulation waveforms and implanted pulse generator adapters provide opportunities to manage patients with LoE. The main goal of our study was to investigate salvage procedures, through neurostimulation adapters, in patients already implanted with SCS and experiencing LoE. We retrospectively analyzed a cohort of patients who were offered new SCS programs/waveforms through an implanted adapter between 2018 and 2021. Patients were evaluated before and at 1-, 3-, 6- and 12-month follow-ups. Outcomes included pain intensity rating with a Visual Analog Scale (VAS), pain/coverage mappings and stimulation preferences. Last follow-up evaluations (N = 27) showed significant improvement in VAS (p = 0.0001), ODI (p = 0.021) and quality of life (p = 0.023). In the 11/27 patients with LoC, SCS efficacy on pain intensity (36.89%) was accompanied via paresthesia coverage recovery (55.57%) and pain surface decrease (47.01%). At 12-month follow-up, 81.3% preferred to keep tonic stimulation in their waveform portfolio. SCS conversion using adapters appears promising as a salvage solution, with an emphasis on paresthesia recapturing enabled via spatial retargeting. In light of these results, adapters could be integrated in SCS rescue algorithms or should be considered in SCS rescue.

scholarly journals Effectiveness of Progressive Resisted Exercise along with Conventional Exercise and Conventional Exercise Program alone in Subjects with Text Neck Syndrome

2021 ◽  
pp. 536-542
Author(s):  
Divya Jain ◽  
Swapna Jawade ◽  
Neha Chitale
Keyword(s):  
Neck Pain ◽  
Pain Intensity ◽  
Conventional Therapy ◽  
Rating Scale ◽  
Neck Disability Index ◽  
Exercise Program ◽  
Pain Rating ◽  
Numerical Pain Rating Scale ◽  
Neck Disability ◽  
Pain Rating Scale

Background: "Text neck" is a term coined to describe the posture created by leaning forward for lengthy periods of time, such as when reading and texting on a cellphone which has been linked to stress injuries. Neck pain, upper back discomfort, shoulder pain, frequent headaches, and greater curvature of the spine are all dangerous indications of text neck. According to a survey, 35% of smartphone users suffer from text neck syndrome. People between the ages of 15 and 18 are more likely to have neck pain. This protocol has been created that describes the design of comparative study to evaluate effectiveness of progressive resisted exercise along with conventional exercise and conventional exercise program alone in text neck syndrome. Methods: The participants (n=80) will be recruited in the study suffering from text neck syndrome and meeting the inclusion criteria. Two groups will be formed such that patients in group A will be treated with conventional therapy and group B will be treated with progressive resisted exercise (PRE) along with conventional therapy. The protocol will cover 4 weeks of treatment. In the rehabilitation period, we will evaluate the pain intensity, strength of neck muscles and functional activity. Our outcome measures will be- Numerical pain rating scale (NPRS) and Neck disability index (NDI). Discussion: Efficacy of the intervention will be evaluated by analyzing the pain intensity by using Numerical pain rating scale (NPRS) and level of functional disability by using Neck disability index (NDI). The result of the study will significantly provide affirmation on either using combination therapy of PRE with conventional exercise or conventional exercise alone.

scholarly journals The Influence of Psychological Factors on the Michigan Hand Questionnaire

Hand ◽  
2016 ◽  
Vol 12 (2) ◽  
pp. 197-201 ◽  
Author(s):  
Yekyoo Oh ◽  
Tessa Drijkoningen ◽  
Mariano E. Menendez ◽  
Femke M. A. P. Claessen ◽  
David Ring
Keyword(s):  
Upper Extremity ◽  
Emotional Health ◽  
Pain Catastrophizing ◽  
Pain Interference ◽  
Measurement Information ◽  
Web Based ◽  
Psychological Measures ◽  
Symptoms Of Depression ◽  
Patient Reported ◽  
Multivariable Regression

Background: Psychosocial factors help account for the gap between impairment and disability. This study examines the relationship between the Michigan Hand Questionnaire (MHQ) and commonly used psychological measures in patients with upper extremity illness. Methods: A cohort of 135 new or follow-up patients presenting to an urban academic hospital–based hand surgeon were invited to complete a web-based version of the MHQ, Abbreviated Pain Catastrophizing Scale (PCS), and two Patient-Reported Outcomes Measurement Information System (PROMIS)-based questionnaires: Pain Interference and Depression. Bivariate and multivariable analyses measured the correlation of these psychological measures with MHQ. Results: Accounting for potential confounding factors in multivariable regression, upper extremity disability as rated by the MHQ was independently associated with PROMIS Depression, PROMIS Pain Interference, visit type, and working status. The model accounted for 37% of the variability in MHQ scores, with PROMIS Pain Interference having the most influence. Conclusion: Among the non-pathophysiological factors that contribute to patient-to-patient variation in MHQ scores, the measure of less effective coping strategies and symptoms of depression were most influential. Our data add to the evidence of the pivotal role of emotional health in upper extremity symptoms and limitations and the importance of psychosocial considerations in the care of hand illness.

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