Applicability of pain neuroscience education: Where are we now?

BACKGROUND: Explaining pain to patients through pain neuroscience education (PNE) is currently a widespread treatment studied in the musculoskeletal context. Presently, there is sufficient evidence supporting the effectiveness of PNE in patients with chronic musculoskeletal disorders. However, clinicians must pay attention to the actual possibility to transfer research findings in their specific clinical context. OBJECTIVE: We analysed the applicability of results of studies focused on PNE, which has not been done previously. METHODS: A detailed discussion on PNE applicability is provided, starting from published randomized controlled trials that investigated the effectiveness of PNE. RESULTS: This paper markedly points out the awareness of clinicians on the need for an accurate contextualization when choosing PNE as an intervention in clinical practice.

Effects of motivational interviewing with conventional physical therapy on rehabilitation of chronic musculoskeletal disorders: a quasi-experimental study

Objective: To compare effects of motivational interviewing with conventional physical therapy in rehabilitation of chronic musculoskeletal disorders versus conventional physical therapy alone. Methods: This quasi-experimental study was conducted at outpatient physical therapy clinics of Lahore from September 2017 to March 2018. Purposive sampling technique was used and participants with chronic musculoskeletal disorders were alternatively allocated to experimental group or control group. Motivational interviewing with conventional physical therapy was given in experimental group whereas control group received conventional physical therapy only. Pain intensity, functional status and exercise compliance were outcome measures. The effects of interventions were measured through visual analogue scale, patient specific functional scale and exercise compliance chart with follow-up of two weeks. Results: Results of independent sample t-test showed that pain score was significantly reduced by mean of 7.19 to 1.66 in experimental group compared to 6.83 to 2.39 in control group from 1st to 14th day (p=0.00). Functional status was significantly improved in experimental group by mean of 3.22 to 8.75 than in control group from 3.17 to 7.63 from 1st to 14th day (p=0.00). Exercise compliance was significant in experimental group with mean repetition of 12.89 and 13.93 whereas 9.48 and 10.33 in control group at 1st and 2nd week respectively (p=0.00). Within-group effects of pain intensity, functional status and exercise compliance were also significant using paired sample t-test (p=0.00). Conclusion: Integration of Motivational Interviewing with conventional physical therapy was found to decrease pain and functional limitations and improve exercise compliance. Continuous.....

FEATURES OF PSYCHOPATHOLOGICAL REACTION IN PARENTS WHOSE CHILDREN SUFFER FROM CHRONIC MUSCULOSKELETAL DISORDERS

The aim: Was exploring features of psychopathological reaction in parents whose children suffer from chronic musculoskeletal disorders. Materials and methods: Clinically, 40 fathers and 64 mothers of children suffering from chronic muscular motor pathologies using M. Hamilton’s Depression and Anxiety Scale and Buss-Durkee Hostility Invertory were examined. Results: It was revealed that the foundation of psychopathological reactions of parents to the chronic illness of children is depressive (from 68,2% to 97,0%) and anxiety (from 40.9% to 100.0%) disorders, and dyssomic disorders as well (from 18.2% to 93.9%), asthenic (from 9.1% to 81.8.%), affective lability (from 9.1% to 36.4%), apathetic (from 4.5% to 42.4%), cognitive (from 4.5% to 42.4%) and obsessive-phobic (from 4.5% to 39.4%) disorders. Mothers with longer and shorter periods of illness in children showed higher levels of depression (20.82 ± 5.94 and 20.26 ± 6.59 respectively) and anxiety (19.06 ± 5.00 and 17, 77 ± 5.65) compared with fathers (17.44 ± 8.78 and 10.82 ± 6.21, respectively; 14.72 ± 5.57 and 14.95 ± 4.45), but fathers showed higher levels of aggression 65.59 ± 10.42 and 63.21 ± 10.31 (respectively versus 55.27 ± 6.97 and 49.72 ± 10.00). Conclusions: А high level of psychopathological reaction in mothers is detected at short periods of disease, and in fathers it significantly grows as the duration of child’s illness increases.

A Scoping Review of The Efficacy of Virtual Reality and Exergaming on Patients of Musculoskeletal System Disorder

To assess the effects of virtual reality on patients with musculoskeletal disorders by means of a scoping review of randomized controlled trials (RCTs). The databases included PubMed, IEEE, and the MEDLINE database. Articles involving RCTs with higher than five points on the Physiotherapy Evidence Database (PEDro) scale were reviewed for suitability and inclusion. The methodological quality of the included RCT was evaluated using the PEDro scale. The three reviewers extracted relevant information from the included studies. Fourteen RCT articles were included. When compared with simple usual care or other forms of treatment, there was significant pain relief, increased functional capacity, reduced symptoms of the disorder, and increased joint angles for the virtual reality treatment of chronic musculoskeletal disorders. Furthermore, burn patients with acute pain were able to experience a significant therapeutic effect on pain relief. However, virtual reality treatment of patients with non-chronic pain such as total knee replacement, ankle sprains, as well as those who went through very short virtual reality treatments, did not show a significant difference in parameters, as compared with simple usual care and other forms of treatment. Current evidence supports VR treatment as having a significant effect on pain relief, increased joint mobility, or motor function of patients with chronic musculoskeletal disorders. VR seems quite effective in relieving the pain of patients with acute burns as well.