A preliminary RCT of a mind body skills based intervention addressing mood and coping strategies in patients with acute orthopaedic trauma

Vranceanu, Ana‐Maria; Hageman, Michiel G.J.S.; Strooker, Joost A.; Meulen, Dirk Ter; Vrahas, Mark; Ring, David

doi:10.1016/j.injury.2014.11.001

Cited by 82 publications

(76 citation statements)

References 39 publications

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“…Ineffective coping strategies in patients with hand fractures are likely to be associated with prolonged symptoms and disability resulting from overcautious activity restriction, resulting in posttraumatic stiffness [16,25]. However, the effects on functional recovery of these mechanisms after hand fractures have not been investigated in depth.…”

Section: Discussionmentioning

confidence: 99%

“…The patient's coping strategies such as catastrophization (the tendency to expect the worst to occur when pain is present, an approach that can be thought of as the opposite of ''coping'') and pain anxiety are normal protective responses to initial nociception [10], but patients who depend on maladaptive and ineffective strategies to cope with pain often become impaired by their pain and maintain an inactive lifestyle [25]. For instance, patients with hand fractures often have pain, swelling, and stiffness in the joints of the hand, which may lead them to protect their hands, resulting in more stiffness and in delayed recovery [3].…”

Section: Introductionmentioning

confidence: 99%

“…For instance, patients with hand fractures often have pain, swelling, and stiffness in the joints of the hand, which may lead them to protect their hands, resulting in more stiffness and in delayed recovery [3]. Pain-coping strategies have been considered to be key factors that explain the magnitude of a disability or the intensity of pain for a painful illnesses [16,25], and maladaptive nociception (defined as disabling misconception regarding pain) with overcautious activity restriction has been associated with posttraumatic stiffness and delayed recovery in hand fractures [10].…”

Section: Introductionmentioning

confidence: 99%

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To What Degree Do Pain-coping Strategies Affect Joint Stiffness and Functional Outcomes in Patients with Hand Fractures?

Roh

Noh

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Patients with hand fractures often have pain, swelling, and stiffness in the joints of the hand, which may lead them to protect their hands, resulting in more stiffness and in delayed recovery. However, the effects of paincoping strategies and catastrophization (the tendency to expect the worst to occur when pain is present, an approach that can be thought of as the opposite of ''coping'') on functional recovery after hand fractures have not been investigated in depth. Questions/purposes Are preoperative catastrophization and anxiety in patients with hand fractures associated with (1) decreased grip strength; (2) decreased range of motion; and (3) increased disability at 3 and 6 months after surgical treatment for a hand fracture? Secondarily, we asked if there are other patient and injury factors that are associated with these outcomes at 3 and 6 months. Methods A total of 93 patients with surgically treated hand fractures were enrolled in this prospective study. Preoperative assessments measured coping strategies evaluated by measuring catastrophic thinking with the Pain Catastrophizing Scale and pain anxiety with the Pain Anxiety Symptom Scale. At 3 and 6 months postoperatively, grip strength, total active range of motion, and disability (Quick Disabilities of the Arm, Shoulder, and Hand score) were assessed. Bivariate and multivariate analyses were performed to identify patient demographic, injury, and coping skills factors that accounted for outcomes of strength, motion, and disability. Results Decreased grip strength was associated with catastrophic thinking (beta = À1.29 [95% confidence interval, À1.67 to À0.89], partial R 2 = 11%, p \ 0.001) and anxiety (beta = À0.83 [À1.16 to À0.50], partial R 2 = 7%, p = 0.007) at 3 months, but by 6 months, only anxiety (beta = À0.74 [À1.04 to À0.44], partial R 2 = 7%, p = 0.010) remained an important factor. Decreased total active range of motion was associated with pain catastrophizing (beta = À0.63 [À0.90 to À0.36], partial R 2 = 6 %, p = 0.024) and anxiety (beta = À0.28 [À0.42 to À0.14], partial R 2 = 3%, p = 0.035) at 3 months but not at 6 months. Similarly, increased disability was associated with pain catastrophizing (beta = 1.09 [1.39-0.79], partial R 2 = 12%, p \ 0.001) and anxiety (beta = 0.93 [1.21-

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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To What Degree Do Pain-coping Strategies Affect Joint Stiffness and Functional Outcomes in Patients with Hand Fractures?

Roh

Noh

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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“…More specifically, cognitive-restructuring strategies such as identifying automatic negative thoughts, constructing realistic alternative responses, and acquiring positive coping selfstatements may be beneficial for pain catastrophizing, whereas relaxation such as breathing and progressive muscle relaxation and mindfulness training can be useful techniques to address depression [24]. A pilot randomized controlled trial of a mind-body skills-based intervention, focusing on relaxation strategies, problem-solving, and cognitive restructuring, found that a biopsychosocial approach to rehabilitation was feasible, acceptable, and potentially efficacious in patients with acute orthopaedic trauma [61]. Additional research is needed to determine the large-scale effects of cognitive-behavioral-based interventions in patients at risk for poor outcomes after traumatic injury.…”

Section: Methodsmentioning

confidence: 99%

Psychosocial Factors Predict Pain and Physical Health After Lower Extremity Trauma

Archer

Abraham

Obremskey

2015

Clinical Orthopaedics &Amp; Related Research

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Background There has been increasing evidence to support the importance of psychosocial factors to poor outcomes after trauma. However, little is known about the contribution of pain catastrophizing and fear of movement to persistent pain and disability. Questions/purposes Therefore, we aimed to determine whether (1) high pain catastrophizing scores are independently associated with pain intensity or pain interference; (2) high fear of movement scores are independently associated with decreased physical health; and (3) depressive symptoms are independently associated with pain intensity, pain interference, or physical health at 1 year after accounting for patient characteristics of age and education. Methods Of 207 eligible patients, we prospectively enrolled 134 patients admitted to a Level I trauma center for surgical treatment of a fracture to the lower extremity. Sixty percent of patients (80 of 134) had an isolated lower extremity injury and the remainder sustained additional minor injury to the head/spine, abdomen/thorax, or upper extremity. Pain catastrophizing was measured with the Pain Catastrophizing Scale, fear of movement with the Tampa Scale for Kinesiophobia, and depressive symptoms with the Patient Health Questionnaire. Pain and physical health outcomes were assessed with the Brief Pain Inventory and the SF-12, respectively. Assessments were completed at 4 weeks and 1 year after hospitalization. Multiple variable hierarchical linear regression analyses were used to address study hypotheses. One hundred ten patients (82%)

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“…A study of patients with bone fractures showed greater pain reduction for the yogic prana energization technique (involving controlled breathing, chanting, and visualization) versus control (Oswal, Nagarathna, Ebnezar, & Nagendra, 2011). Another study demonstrated decreased pain with activity for a mind-body skills–based intervention plus standard of care versus only standard of care (Vranceanu et al, 2015). In a trial of patients with musculoskeletal trauma, an educational intervention involving training on breathing relaxation decreased pain levels more than usual care involving no educational intervention (Wong et al, 2010).…”

Section: Nonpharmacologic Optionsmentioning

confidence: 99%

Exploring Opioid-Sparing Multimodal Analgesia Options in Trauma: A Nursing Perspective

Sullivan

Lyons

Montgomery

et al. 2016

Journal of Trauma Nursing

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A preliminary RCT of a mind body skills based intervention addressing mood and coping strategies in patients with acute orthopaedic trauma

Cited by 82 publications

References 39 publications

To What Degree Do Pain-coping Strategies Affect Joint Stiffness and Functional Outcomes in Patients with Hand Fractures?

To What Degree Do Pain-coping Strategies Affect Joint Stiffness and Functional Outcomes in Patients with Hand Fractures?

Psychosocial Factors Predict Pain and Physical Health After Lower Extremity Trauma

Exploring Opioid-Sparing Multimodal Analgesia Options in Trauma: A Nursing Perspective

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