Definition of Nonresponse to Analgesic Treatment of Arthritic Pain: An Analytical Literature Review of the Smallest Detectable Difference, the Minimal Detectable Change, and the Minimal Clinically Important Difference on the Pain Visual Analog Scale

Stauffer, Melissa E.; Taylor, Stephanie; Watson, Douglas J.; Peloso, Paul M.; Morrison, Alan

doi:10.4061/2011/231926

Cited by 97 publications

(68 citation statements)

References 25 publications

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“…Applying KT decreased this discomfort but seemed not to produce the minimal clinically important improvement in OA patients, and its effect was not much different from that of sham KT application. 16 Similar to the results of this study, the findings of previous studies have shown that KT decreased the discomfort of acute whiplashassociated disorders 21 and rotator cuff tendinitis/ impingement 8 by 10 and 2.2, respectively; however, these changes did not constitute a clinically important difference. The effects of KT on pain at rest could not be clearly characterized because the discomfort at rest in this study and previous studies was not of a high intensity.…”

Section: Discussionsupporting

confidence: 92%

Kinesio Taping Improves Pain, Range of Motion, and Proprioception in Older Patients with Knee Osteoarthritis

Cho

Kim

et al. 2015

American Journal of Physical Medicine &Amp; Rehabilitation

138

101

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Section: Discussionsupporting

confidence: 92%

Kinesio Taping Improves Pain, Range of Motion, and Proprioception in Older Patients with Knee Osteoarthritis

Cho

Kim

et al. 2015

American Journal of Physical Medicine &Amp; Rehabilitation

138

101

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“…Determination of clinically relevant changes in pain is contextual and probably depends on the nature and risk of the procedure required to attain a given improvement [10,18]. However, the numeric pain scale is typically associated with an MCID of approximately 2 points [50], and the mean differences observed in pain outcomes in our study were substantially smaller. Small increments (2°-58) of higher knee flexion mean values, likely of no clinical significance, were observed without tourniquet use at all testing intervals (preoperative until 3 months postoperatively).…”

Section: Discussionmentioning

confidence: 39%

Does Tourniquet Use in TKA Affect Recovery of Lower Extremity Strength and Function? A Randomized Trial

Dennis

Kittelson

Yang

et al. 2016

Clinical Orthopaedics &Amp; Related Research

170

148

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Background Tourniquet use during total knee arthroplasty (TKA) improves visibility and reduces intraoperative blood loss. However, tourniquet use may also have a negative impact on early recovery of muscle strength and lower extremity function after TKA. Questions/purposes The purpose of this study was (1) to determine whether tourniquet use affects recovery of quadriceps strength (primary outcome) during the first 3 postoperative months; and (2) to examine the effects of tourniquet application on secondary outcomes: voluntary quadriceps activation, hamstring strength, unilateral limb balance as well as the effect on operative time and blood loss.Methods Twenty-eight patients (mean age 62 ± 6 years; 16 men) undergoing same-day bilateral TKA (56 lower extremities) were enrolled in a prospective, randomized study. Subjects were randomized to receive a tourniquetassisted knee arthroplasty on one lower extremity while the contralateral limb underwent knee arthroplasty without extended tourniquet use. In the former group, the tourniquet was inflated just before the incision was made and released after cementation; in the latter group, a tourniquet was not used (10 of 28 [36%]) or inflated only during component cementation (18 of 28 [64%]). The choice of no tourniquet or use just during cementation was based on surgeon choice, because some surgeons felt a tourniquet during cementation was necessary to achieve a dry surgical field to maximize cement fixation. A median parapatellar approach and the One or more of the authors (DAD, CCY, TMM, RHK) has received funding from Porter Adventist Hospital, during the study period, in the amount of USD 10,000 to USD 100,000. One of the authors (DAD) has or may receive payments or benefits from DePuy (Warsaw, IN, USA) in the amount of USD more than USD 1,000,001 not related to this work. One of the authors certifies that he (RHK) has or may receive payments or benefits from Stryker (Kalamazoo, MI, USA) and Innomed (Savannah, GA, USA) in the amount of USD 100,001 to USD 1,000,001 not related to this work. One of the authors (TMM) has or may receive payments or benefits from Zimmer (Warsaw, IN, USA) in the amount of less than USD 10,000 not related to this work. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Clinical Orthopaedics and Related Research 1 neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDAapproval status, of any drug or device prior to clinical use. Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.The surgeries for this study were performed at Porter Adventist Hospital, Denver, CO, USA, and the postoperative patient te...

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“…We used VAS to evaluate pain over time which is a widely accepted method but can be difficult to manage because statistical significant difference is not always the same as clinical significant difference. The minimally clinical important difference when using VAS in pain evaluation may vary with the level of pain [29,30], but several authors suggest that the changes in VAS \18 mm cannot be regarded as a clinical relevant change [20,31,32]. It can also be doubtful to use these limits to changes in VAS on a group level since significant individual variations may not be detected [33].…”

Section: Discussionmentioning

confidence: 99%

Pain from donor site after anterior cervical fusion with bone graft: a prospective randomized study with 12 months of follow-up

Skeppholm

Olerud

2012

Eur Spine J

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Introduction Harvesting bone graft from the iliac crest in spinal fusion surgery is a widely used technique. However, complications can occur and there are also reports of patients with persistent graft site pain after surgery. The aim of this study was to evaluate pain from the donor site (DS) over time, and register associated complications and if it affected health-related quality of life (HRQoL). Material and methods One hundred and seven patients participating in an RCT between two different methods of reconstruction after cervical decompression were included in this study. One group underwent surgery with bone graft (BG) from the iliac crest and the other with no bone graft (NBG). All patients were evaluated concerning pain at DS and HRQoL preoperatively, at 4 weeks, 3 months and 1 year. Pain was evaluated with visual analog scale (VAS) and HRQoL with EQ-5D. Results A statistically significant difference was found at all times of follow-up in the BG group compared to preoperative levels and the NBG group. The VAS levels at follow-ups at 3 months and 1 year were however of questionable clinical importance. Two patients in the BG group had superficial wound infections postoperatively and five patients still had sensory disturbance in the area of graft site at 12 months. No major complications were registered. No difference could be seen in EQ-5D at any time of follow-up between the groups. Conclusion Harvesting of iliac crest bone graft is associated with significant pain. However, at 3 months postoperatively, the negative effect of clinical importance seemed to have disappeared compared to when no bone graft was harvested. The pain from bone graft harvesting does not seem to affect the quality of life at 4 weeks postoperatively and onward.

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Definition of Nonresponse to Analgesic Treatment of Arthritic Pain: An Analytical Literature Review of the Smallest Detectable Difference, the Minimal Detectable Change, and the Minimal Clinically Important Difference on the Pain Visual Analog Scale

Cited by 97 publications

References 25 publications

Kinesio Taping Improves Pain, Range of Motion, and Proprioception in Older Patients with Knee Osteoarthritis

Kinesio Taping Improves Pain, Range of Motion, and Proprioception in Older Patients with Knee Osteoarthritis

Does Tourniquet Use in TKA Affect Recovery of Lower Extremity Strength and Function? A Randomized Trial

Pain from donor site after anterior cervical fusion with bone graft: a prospective randomized study with 12 months of follow-up

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