Effect of Individually Tailored Biopsychosocial
Workplace Interventions on Chronic
Musculoskeletal Pain and Stress Among Laboratory
Technicians: Randomized Controlled Trial

Background: Chronic musculoskeletal pain is prevalent among laboratory technicians and work-related stress may aggravate the problem. Objectives: This study investigated the effect of a multifaceted worksite intervention on pain and stress among laboratory technicians with chronic musculoskeletal pain using individually tailored physical and cognitive elements. Study Design: This trial uses a single-blind randomized controlled design with allocation concealment in a 2-armed parallel group format among laboratory technicians. The trial “Implementation of physical exercise at the Workplace (IRMA09) – Laboratory technicians“ was registered at ClinicalTrials.gov prior to participant enrolment. Setting: The study was conducted at the head division of a large private pharmaceutical company’s research and development department in Denmark. The study duration was March 2014 (baseline) to July 2014 (follow-up). Methods: Participants (n = 112) were allocated to receive either physical, cognitive, and mindfulness group-based training (PCMT group) or a reference group (REF) for 10 weeks at the worksite. PCMT consisted of 4 major elements: 1) resistance training individually tailored to the pain affected area, 2) motor control training, 3) mindfulness, and 4) cognitive and behavioral therapy/education. Participants of the REF group were encouraged to follow ongoing company health initiatives. The predefined primary outcome measure was pain intensity (VAS scale 0 – 10) in average of the regions: neck, shoulder, lower and upper back, elbow, and hand at 10 week follow-up. The secondary outcome measure was stress assessed by Cohen´s perceived stress questionnaire. In addition, an explorative dose-response analysis was performed on the adherence to PCMT with pain and stress, respectively, as outcome measures. Results: A significant (P < 0.0001) treatment by time interaction in pain intensity was observed with a between-group difference at follow-up of -1.0 (95%CI: -1.4 to -0.6). No significant effect on stress was observed (treatment by time P = 0.16). Exploratory analyses for each body region separately showed significant pain reductions of the neck, shoulders, upper back and lower back, as well as a tendency for hand pain. Within the PCMT group, general linear models adjusted for age, baseline pain, and stress levels showed significant associations for the change in pain with the number of physical-cognitive training sessions per week (-0.60 [95%CI -0.95 to -0.25]) and the number of mindfulness sessions (0.15 [95%CI 0.02 to 0.18]). No such associations were found with the change in stress as outcome. Limitations: Limitations of behavioral interventions include the inability to blind participants to which intervention they receive. Self-reported outcomes are a limitation as they may be influenced by placebo effects and outcome expectations

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Combining technology and research to prevent scald injuries: results from Cool Runnings randomised controlled trial (Preprint)

10.2196/preprints.10361 ◽

2018 ◽

Author(s):

Jacqueline Burgess ◽

Kerrianne Watt ◽

Roy M Kimble ◽

Cate M Cameron

Keyword(s):

Social Media ◽

Young Children ◽

Primary Outcome ◽

Outcome Measure ◽

Controlled Trial ◽

First Aid ◽

Secondary Outcome ◽

Secondary Outcome Measure ◽

Post Test

BACKGROUND New technologies, widespread availability of the internet, the rise of social media and increased ownership of smartphones provide new opportunities for health researchers to communicate and engage with target audiences. OBJECTIVE This new technology was used to recruit mothers of young children to a smartphone application (app) to increase their knowledge about childhood burns (specifically hot beverage scalds) and correct burn first-aid. This six-month intervention deployed on the Cool Runnings app, used gamification techniques to reinforce intervention messages and engage participants. METHODS A two-group, parallel, single blinded, randomized controlled trial (RCT) to evaluate the efficacy of a smartphone app-based burn prevention intervention. Participants were women aged 18+, living in Queensland, Australia, with at least one child aged 5-12 months at the time of enrolment. The primary outcome measure was change in knowledge around burn risk and correct burn first-aid assessed via two methods: overall score; and categorised as adequate (score =4) vs inadequate (score less than 4). The secondary outcome measure was the efficacy of gamification techniques (measured by: app opens, photo uploads, pop quiz completions and content views). RESULTS In total, 498 participants were recruited via social media and enrolled. At 6-month follow-up, 244 participants completed the post-test questionnaire. Attrition rates in both groups were similar. Participants who remained in the study did not differ from those who were lost to follow up on any characteristics except for education level. Although similar at baseline, intervention group participants achieved significantly greater improvement in overall knowledge post-test than control group participants on both primary outcome measures (overall knowledge intervention: mean=2.68± 1.00 vs control mean:2.13±1.03; intervention: 20.47% adequate vs control: 7.3%). Consequently, the NNT was 7.46. Logistic regression showed participants exposed to the highest level of disadvantage were 7.3 times more likely to improve overall knowledge scores than participants in other levels of disadvantage. There were also significant correlations between each of the four gamification techniques and knowledge change (p<0.001). In addition, participants with low/moderate ‘app activity’ were 8.59 times more likely to have improved knowledge between baseline and 6-month follow-up than those who had no app activity (95%CI=2.9-25.02); participants with high app activity were 18.26 times more likely to have improved knowledge (95%CI=7.1-46.8). CONCLUSIONS Despite substantial loss to follow-up, this RCT demonstrates the Cool Runnings app was an effective intervention for improving knowledge about hot beverage scald risks and burn first-aid in mothers of young children. The benefits of combining gamification elements in the intervention were also highlighted. Given the low cost and large reach of smartphone apps to deliver content to, and engage with targeted populations, results from this RCT provides important information on how smartphone applications can be used for widespread injury prevention campaigns, and public health campaigns generally. CLINICALTRIAL This trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12616000019404)

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Effects of Pilates-Based Core Stability Training in Ambulant People With Multiple Sclerosis: Multicenter, Assessor-Blinded, Randomized Controlled Trial

Physical Therapy ◽

10.2522/ptj.20150166 ◽

2016 ◽

Vol 96 (8) ◽

pp. 1170-1178 ◽

Cited By ~ 27

Author(s):

Esther E. Fox ◽

Alan D. Hough ◽

Siobhan Creanor ◽

Margaret Gear ◽

Jennifer A. Freeman

Keyword(s):

Multiple Sclerosis ◽

Randomized Controlled Trial ◽

Confidence Interval ◽

Outcome Measure ◽

Controlled Trial ◽

Exercise Group ◽

Core Stability ◽

Secondary Outcome ◽

Secondary Outcome Measure ◽

Randomized Controlled

Abstract Background Pilates exercise is often undertaken by people with multiple sclerosis (MS) who have balance and mobility difficulties. Objectives The primary aim of the study was to compare the effects of 12 weeks of Pilates exercises with relaxation on balance and mobility. Secondary aims were: (1) to compare standardized exercises with relaxation and (2) to compare Pilates exercises with standardized exercises. Methods A multicenter, assessor-blinded, randomized controlled trial was conducted. Participants with Expanded Disability Status Scale scores of 4.0 to 6.5 were randomly allocated to groups receiving 12 weeks of Pilates exercises, standardized exercises, or relaxation. Assessments were undertaken at baseline and weeks 12 and 16 (primary outcome measure: 10-Meter Timed Walk Test [10MTW]). Results One hundred participants (mean age=54 years, 74% female) were randomized to study groups. Six participants relapsed (withdrew from the study), leaving 94 participants for intention-to-treat analysis. There was no significant difference in mean 10MTW measurements between the Pilates and relaxation groups. At 12 weeks, there was a mean reduction of 4.2 seconds for the standardized exercise group compared with the relaxation group (95% confidence interval [relaxation group minus standardized exercise group measurements]=0.0, 8.4) and a mean reduction of 3.7 seconds for the Pilates group compared with the standardized exercise group (95% confidence interval [Pilates group minus standardized exercise group measurements]=−0.4 to 7.8). At 16 weeks, mean 10MTW times for the standardized exercise group remained quicker than those for the Pilates and relaxation groups, although the differences were nonsignificant. There were no significant differences between the Pilates and relaxation groups for any secondary outcome measure. Limitations In this study, therapists were limited to a standardized basket of exercises that may have affected the study outcomes. Furthermore, choosing measures such as posturography to assess balance, accelerometry to assess walking, or a specific trunk assessment scale might have been more responsive in detecting changes in outcome. Conclusion Participants did not improve significantly, either in the short term or at the 4-week follow-up, on the 10MTW after 12 weeks of Pilates exercises compared with 12 weeks of relaxation.

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The Effects of Mind-Body Interventions on Sleep Quality: A Systematic Review

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2015/902708 ◽

2015 ◽

Vol 2015 ◽

pp. 1-17 ◽

Cited By ~ 41

Author(s):

Rachel Neuendorf ◽

Helané Wahbeh ◽

Irina Chamine ◽

Jun Yu ◽

Kimberly Hutchison ◽

...

Keyword(s):

Systematic Review ◽

Sleep Quality ◽

Beneficial Effect ◽

Outcome Measure ◽

Secondary Outcome ◽

Secondary Outcome Measure ◽

Direct Impact ◽

Randomized Controlled ◽

Objective Outcomes ◽

Outcome Type

Study Objectives. To evaluate the effect of mind-body interventions (MBI) on sleep.Methods. We reviewed randomized controlled MBI trials on adults (through 2013) with at least one sleep outcome measure. We searched eleven electronic databases and excluded studies on interventions not considering mind-body medicine. Studies were categorized by type of MBI, whether sleep was primary or secondary outcome measure and outcome type.Results. 1323 abstracts were screened, and 112 papers were included. Overall, 67 (60%) of studies reported a beneficial effect on at least one sleep outcome measure. Of the most common interventions, 13/23 studies using meditation, 21/30 using movement MBI, and 14/25 using relaxation reported at least some improvements in sleep. There were clear risks of bias for many studies reviewed, especially when sleep was not the main focus.Conclusions. MBI should be considered as a treatment option for patients with sleep disturbance. The benefit of MBI needs to be better documented with objective outcomes as well as the mechanism of benefit elucidated. There is some evidence that MBI have a positive benefit on sleep quality. Since sleep has a direct impact on many other health outcomes, future MBI trials should consider including sleep outcome measurements.

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A Novel Technique for the Reconstructive Formation of an Annular Hymen in Cases of Postpubertal Imperforate Hymen

Sultan Qaboos University Medical Journal [SQUMJ] ◽

10.18295/squmj.2021.21.01.015 ◽

2021 ◽

Vol 21 (1) ◽

pp. e110-115

Author(s):

Atef M. Darwish

Keyword(s):

Minimally Invasive ◽

Outcome Measure ◽

Reconstructive Surgical Procedures ◽

Intraoperative Complications ◽

University Hospital ◽

Secondary Outcome ◽

Secondary Outcome Measure ◽

Imperforate Hymen ◽

Novel Technique

Objectives: Imperforate hymen (IH) is a common genital tract anomaly in women which usually presents after puberty. However, surgical treatment is often considered controversial in religious or conservative communities for sociocultural reasons. This study therefore aimed to assess the efficacy of a novel reconstructive technique involving the preservation of the annular hymen. Methods: This prospective interventional study was performed between July 2013 and October 2019 at the minimally invasive surgery unit of a tertiary university hospital in Egypt. A total of 36 women presenting with primary amenorrhoea and haematocolpus were diagnosed with postpubertal IH. A circular hymenotomy was performed on each patient using a 10 mm laparoscopy trocar tip and sleeve to form a new annular hymen under general anaesthesia while preserving the annular hymen. The primary outcome measure was the persistence of hymenal patency and integrity at follow-up. The secondary outcome measure included post-operative patient satisfaction and pain relief. Results: The reported technique was feasible in all cases without intraoperative complications. Patency of the reconstructed annular hymen was confirmed at follow-up in all cases; moreover, no intraoperative complications were reported. There was a significant post-operative improvement in pain scores (P <0.001). Both the patients and their parents/guardians reported a high level of satisfaction with the technique. Conclusion: This novel technique for the correction of IH involving the reconstruction of an annular hymen was found to be a safe, minimally invasive and effective procedure. This technique should be considered a feasible alternative to a conventional hymenotomy as it allows for the resumption of normal hymenal anatomy without overtreatment. KEYWORDS Congenital Abnormalities; Imperforate Hymen; Hematocolpos; Amenorrhea; Colpotomy; Reconstructive Surgical Procedures; Treatment Outcome; Egypt.

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Double blinded randomized placebo-controlled comparative study between sucralfate ointment and lidocaine ointment after Milligan Morgan hemorrhoidectomy

International Surgery Journal ◽

10.18203/2349-2902.isj20175111 ◽

2017 ◽

Vol 4 (12) ◽

pp. 3822

Author(s):

Yahia Alkhateep ◽

Abdelmieniem Fareed

Keyword(s):

Wound Healing ◽

Postoperative Pain ◽

Pain Intensity ◽

Outcome Measure ◽

Secondary Outcome ◽

Control Group ◽

Secondary Outcome Measure ◽

Lidocaine Group ◽

Significant Difference ◽

Double Blinded

Background: Post haemorrhoidectomy pain and delayed wound healing are the most annoying drawbacks to the patients and the surgeons. Topical application of sucralfate or lidocaine may help in reducing postoperative pain and promoting wound healing after Milligan Morgan hemorrhoidectomy.Methods: This study was designed as a single-center double blinded randomized placebo controlled trial at the Department of general Surgery Menoufia University, immediately after Milligan Morgan Hemorrhoidectomy, a total of 150 patients were randomly assigned to receive either 10% Sucralfate ointment, 5% lidocaine ointment or placebo ointment (control group). The primary outcome measure was pain intensity measured by a visual analogue scale at different time points after hemorrhoidectomy and the secondary outcome measure was wound healing.Results: There was no significant difference in age, gender, and number of excised hemorrhoid piles between the two groups. At the 1st ,3rd and 7th days after surgery pain intensity was significantly lower in sucralfate group (4.18±0.82, 3.92±0.72, 3.56±0.67) when compared to lidocaine group (5.06±1.11, 4.70±0.84, 3.93±0.75) and placebo group (6.17±1.26, 5.42±0.98, 4.55±0.84). At the 21st and 28th days no significant difference in pain intensity between groups (p > 0.05) with better wound healing in sucralfate group (P<0.05).Conclusions: Sucralfate was able to reduce the acute postoperative pain and improve wound healing after hemorrhoidectomy, local anesthetic lidocaine could help in pain control but without effect on healing.

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Outcomes of Coccygectomy Using the “Z” Plasty Technique of Wound Closure

Global Spine Journal ◽

10.1177/2192568219831963 ◽

2019 ◽

Vol 9 (8) ◽

pp. 802-806 ◽

Cited By ~ 2

Author(s):

Arvind G. Kulkarni ◽

Sandeep Tapashetti ◽

Viraj S. Tambwekar

Keyword(s):

Wound Healing ◽

Wound Closure ◽

Outcome Measure ◽

Surgical Site Infections ◽

Wound Dehiscence ◽

Secondary Outcome ◽

Secondary Outcome Measure ◽

Patient Reported ◽

The Mean

Study Design: Technical note. Objectives: Coccygectomy for chronic coccydynia has a high rate of successful clinical outcome. However, the procedure is associated with increased incidence of wound dehiscence and surgical site infection. The main objective was to evaluate the clinical outcomes of coccygectomy using the Z plasty technique of wound closure. Methods: Patients with chronic coccydynia refractory to conservative treatment underwent coccygectomy followed by Z plasty technique of wound closure between January 2013 and February 2018. Primary outcome measure was evaluation of the wound healing in the postoperative period and at follow-up; secondary outcome measure included visual analogue scale (VAS) score for coccygeal pain. Results: Ten patients (male:female 6:4) fulfilled the inclusion criteria. The mean age of patients was 40.78 years (range 19-55 years). The mean follow-up was 1.75 years (range 6 months to 5 years). All wounds healed well with no incidence of wound dehiscence or surgical site infections. The mean VAS improved from 7.33 ± 0.5 to 2.11 ± 1.2 ( P < .05). Nine patients reported excellent outcomes and 1 patient reported poor outcome with regards to relief from coccydynia. Conclusion: Z plasty technique of wound closure is recommended as procedure of choice to avoid wound healing problems and surgical site infections associated with coccygectomy. Coccygectomy remains a successful treatment modality for chronic coccydynia.

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Sensitivity to Change and Responsiveness of the Global Physiotherapy Examination (GPE-52) in Patients With Long-Lasting Musculoskeletal Pain

Physical Therapy ◽

10.1093/ptj/85.8.712 ◽

2005 ◽

Vol 85 (8) ◽

pp. 712-726 ◽

Cited By ~ 12

Author(s):

Alice Kvåle ◽

Jan Sture Skouen ◽

Anne Elisabeth Ljunggren

Keyword(s):

Musculoskeletal Pain ◽

Intervention Studies ◽

Outcome Measure ◽

Important Change ◽

Controlled Study ◽

Sensitivity To Change ◽

Randomized Controlled ◽

Before And After ◽

Composite Scores

Abstract Background and Purpose. The sensitivity to change and the responsiveness of the Global Physiotherapy Examination (GPE-52) were examined in patients with localized and widespread long-lasting musculoskeletal pain. Subjects. All included patients were on sick leave and constituted the treatment group in a randomized controlled study. Two hundred forty-seven patients (64% women; mean age=43.6 years, SD=10.4) were included. At entry, the patients were categorized into 3 groups according to pain localization. Patients who returned fully to work were compared with those who did not. Methods. The GPE-52 has composite scores in 5 main domains—posture (8 tests), respiration (8 tests), movement (16 tests), muscle (12 tests), and skin (8 tests)—and was administered before and after 4 weeks of multidisciplinary outpatient treatment and at a 6-month follow-up examination. The first 61 patients also were re-examined after 18 months. Results. In this study, the GPE-52 and its 5 main domains were demonstrated to be sensitive to change, measured 6 and 18 months after treatment, in different groups of patients with long-lasting musculoskeletal pain. Responsiveness to important change, defined in this study as return to work, was found only for the total GPE-52 score and within the movement and respiration domains. Responsiveness to important change was greater in patients with localized pain than in patients with widespread pain. Discussion and Conclusion. Although the total GPE-52 score was sensitive to change in patients with long-lasting musculoskeletal pain, a shorter test battery including only the respiration and movement domain scores might be appropriate as an outcome measure in intervention studies for patients with long-lasting musculoskeletal pain.

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Non-surgical oral hygiene interventions on disease activity of Rheumatoid arthritis patients with periodontitis: A randomized controlled trial

Journal of Dental Research Dental Clinics Dental Prospects ◽

10.34172/joddd.2020.004 ◽

2020 ◽

Vol 14 (1) ◽

pp. 26-36

Author(s):

William Buwembo ◽

Ian Guyton Munabi ◽

Mark Kaddumukasa ◽

Haruna Kiryowa ◽

Muhammad Mbabali ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Oral Hygiene ◽

Outcome Measure ◽

Secondary Outcome ◽

Control Group ◽

Secondary Outcome Measure ◽

Das 28 ◽

Periodontal Index

Background . Periodontitis and rheumatoid arthritis have similar epidemiology and pathophysiology. Understanding the interaction between these two diseases is vital in our settings. We set out to assess the effect of oral hygiene interventions on disease activity of rheumatoid arthritis patients with periodontitis in Kampala, Uganda. Methods. Fifty-eight patients attending an arthritis clinic with rheumatoid arthritis and periodontitis were randomly assigned to either an intervention group or a control group. Patients diagnosed with rheumatoid arthritis at least two years before, who were on the same medication, dose, or formulation for RA treatment during the preceding three months, were included. The patients were >18 years of age, would be available for all the study visits in the next six months, had at least six natural teeth, had periodontal disease classified as Dutch Periodontal Index (DPSI) >3 and provided written informed consent. Those who had a chronic disorder requiring chronic or intermittent use of antibiotics, were pregnant, were lactating, or had intent to become pregnant were excluded. The primary outcome measure was a change in Disease Activity Score of 28 Joints (DAS28 score) in two 3-month follow-up periods after the intervention. The secondary outcome measure was a change in periodontal status. Results. There was a statistically significant improvement in the DAS-28 score in both the intervention and control arms during the follow-up period (P<0.01). The participants carrying more than one bacterial species had worse DAS-28 scores. Conclusion. Oral hygiene interventions given to RA patients could drastically improve their RA treatment outcomes, especially in resource-limited settings.

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Repetition of Suicide Attempts

Crisis ◽

10.1027/0027-5910/a000052 ◽

2010 ◽

Vol 31 (4) ◽

pp. 194-201 ◽

Cited By ~ 49

Author(s):

José M. Bertolote ◽

Alexandra Fleischmann ◽

Diego De Leo ◽

Michael R. Phillips ◽

Neury J. Botega ◽

...

Keyword(s):

Educational Intervention ◽

Emergency Departments ◽

Attempted Suicide ◽

Suicide Attempts ◽

Outcome Measure ◽

Secondary Outcome ◽

Secondary Outcome Measure ◽

Suicidal Behaviors ◽

Suicide Attempters

Background: Attempted suicide is a strong risk factor for subsequent suicidal behaviors. Innovative strategies to deal with people who have attempted suicide are needed, particularly in resource-poor settings. Aims: To evaluate a brief educational intervention and periodic follow-up contacts (BIC) for suicide attempters in five culturally different sites (Campinas, Brazil; Chennai, India; Colombo, Sri Lanka; Karaj, Islamic Republic of Iran; and Yuncheng, People’s Republic of China) as part of the WHO Multisite Intervention Study on Suicidal Behaviors (SUPRE-MISS). Methods: Among the 1,867 suicide attempters enrolled in the emergency departments of the participating sites, 922 (49.4%) were randomly assigned to a brief intervention and contact (BIC) group and 945 (50.6%) to a treatment as usual (TAU) group. Repeated suicide attempts over the 18 months following the index attempt – the secondary outcome measure presented in this paper – were identified by follow-up calls or visits. Subsequent completed suicide – the primary outcome measure – has been reported in a previous paper. Results: Overall, the proportion of subjects with repeated suicide attempts was similar in the BIC and TAU groups (7.6% vs. 7.5%, χ² = 0.013; p = .909), but there were differences in rates across the five sites. Conclusions: This study from five low- and middle-income countries does not confirm the effectiveness of brief educational intervention and follow-up contacts for suicide attempters in reducing subsequent repetition of suicide attempts up to 18 months after discharge from emergency departments.

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Comparison of Outcomes of Colorectal Polypectomy Using Traditional Snare and Rotary Snare: A Prospective Randomized Controlled Trial

Gastroenterology Research and Practice ◽

10.1155/2019/9123521 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8

Author(s):

Lu Xu ◽

Zhixing Zhang ◽

Jiarong Xie ◽

Lei Xu ◽

Weihong Wang

Keyword(s):

Randomized Controlled Trial ◽

Outcome Measure ◽

Controlled Trial ◽

Colorectal Polyps ◽

Secondary Outcome ◽

Secondary Outcome Measure ◽

Traditional Group ◽

Randomized Controlled ◽

Level 1 ◽

Level 2

Background and Objective. The aim of the current study was to compare the efficacy and safety of polypectomy by using rotary snare vs. traditional snare during colonoscopy. Methods. A single-center randomized controlled trial, which included consecutive participants who were ≥18 years old and detected with polyp(s) during routine colonoscopy between July and September 2018, was conducted. Participants with colorectal polyps were randomized to receive polypectomy using rotary snares or traditional snares. The primary outcome measure was the comparison of the average time of removing a polyp between those two groups. The secondary outcome measure was to compare the polyp resection time by using SMSA (size, morphology, site, and access) scores. Results. A total of two hundred participants were included in this study. Of them, 100 participants were randomly assigned to the rotary snare group (214 polyps) and the other 100 participants were randomly assigned to the traditional group (232 polyps). The mean resection time was significantly shorter in the rotary snare group than in the traditional snare group (24.41±18.14 seconds vs. 29.53±25.74 seconds, P=0.021). In the subgroup analysis, the resection time was also shorter in the rotary snare group than in the traditional snare group in SMSA level 1 (18.51±8.26 seconds vs.23.84±15.07 seconds, P=0.013) and in SMSA level 2 (25.03±15.32 seconds vs.29.15±24.82 seconds, P=0.009), respectively. Conclusion. Colorectal polyps could be removed more efficient by using rotary snares than by using traditional snares in SMSA level 1 and SMSA level 2.

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