Effects of a patient-centered program including the cumulative-complexity model in women with chronic pelvic pain: a randomized controlled trial

Ariza-Mateos, María José; Cabrera‐Martos, Irene; López‐López, Laura; Rodríguez‐Torres, Janet; Torres‐Sánchez, Irene; Valenza, Marie Carmen

doi:10.1016/j.maturitas.2020.04.005

Cited by 8 publications

(13 citation statements)

References 28 publications

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“…Two different papers reported on one RCT [23,24]. Chronic pain diagnoses represented in the trials were fibromyalgia (n = 6) [23][24][25][26][27][28][29], low back pain (n = 1) [30], pelvic pain (n = 1) [31], unspecified musculoskeletal pain (n = 2 ) [32,33], and minor representation of mixed pain diagnoses, including cancer-related pain along with other (≥ 3) chronic pain diagnoses (n = 2) [33,34]. The included trials reported pain intensity and duration when describing their study samples, but none attempted any pain phenotyping [35].…”

Section: Characteristics Of the Included Trialsmentioning

confidence: 99%

“…We observed diversity in intervention approaches, contents, duration, and follow-up time. Although the trials' experimental content generally was client-centered and pain coping-oriented, they used different treatment strategies, such as education [25], behavioral approach [23-25, 27, 29, 32, 33], functional rehabilitation [30], and comprehensive self-management training including didactic information/ education, behavior change, and exercise [26,28,31]. One RCT compared two treatment strategies and a control group [25].…”

Section: Characteristics Of the Included Trialsmentioning

confidence: 99%

“…One RCT compared two treatment strategies and a control group [25]. The comparators were treatment regimens not including occupational engagement such as a brief physiotherapy consultation and advice or exercise prescription [28,[30][31][32][33], information/education with no tailored approach [23,24,27], waiting list with usual care allowing for variable regimens [26,29,34], or a waiting list with no treatment [25]. The intervention descriptions provided in the trials allowed identifying the occupational engagement component and distinguishing it from any alternative.…”

Section: Characteristics Of the Included Trialsmentioning

confidence: 99%

“…12). Three trials had no other follow-up than that postintervention [27,28,31]. One RCT had two follow-up assessments, 6 and 12 months after the ended intervention [24].…”

Section: Characteristics Of the Included Trialsmentioning

confidence: 99%

“…Four interventions (36.4%) involved occupational therapists in the multidisciplinary teams of intervention providers (n ≥ 2), among physicians, psychologists, physical therapists, occupational therapists, dieticians, or social workers [25,26,28,30]. Four trials had intervention providers representing a single health profession, such as psychologists [34] or physical therapists [31][32][33]. In three trials, the providers remained unspecified or described as researchers [23,24,27,29].…”

Section: Characteristics Of the Included Trialsmentioning

confidence: 99%

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The Effect of Occupational Engagement on Lifestyle in Adults Living with Chronic Pain: A Systematic Review and Meta-analysis

Nielsen

Skou

Larsen

et al. 2022

Occupational Therapy International

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Background. Healthy lifestyle is important to decrease health risks in individuals living with chronic pain. From an occupational therapy perspective, human health and lifestyle are linked to occupational engagement in meaningful everyday activities. This study is aimed at investigating the effect of including occupational engagement in chronic pain interventions on lifestyle. Methods. In this systematic review (PROSPERO reg. CRD42020159279), we included randomized controlled trials (RCTs) on interventions involving occupational engagement (i.e., occupational performance based on involvement, choice, positive meaning, and commitment) and assessing modifiable lifestyle factors: physical activity, body anthropometrics, alcohol consumption, smoking, stress, and sleep. We sought the databases Ovid MEDLINE, Embase, PsycINFO, CINAHL, Cochrane, Scopus, Web of Science, OTseeker, ClinicalTrials.gov, OpenGrey, and the web engine Google Scholar and citations and references of relevant publications. We evaluated methodological quality with the Cochrane risk-of-bias tool 2.0, determined the overall evidence certainty using the GRADE methodology, and performed meta-analysis when two or more trials reported on the outcomes. Results. Of the 9526 items identified, 286 were full text screened. We included twelve articles with eleven RCTs comprising 995 adults and assessing physical activity, sleep quality, stress, and Body Mass Index. Sufficient data for meta-analysis was only available for physical activity and sleep quality. The meta-analysis suggested a moderate increase in physical activity after behavioral interventions for fibromyalgia and musculoskeletal pain ( SMD = 0.69 (0.29; 1.09)) and a small increase in sleep quality up to 6 months after multidisciplinary self-management of fibromyalgia ( SMD = 0.35 (95% CI 0.08; 0.61)). The overall certainty of the evidence was deemed low. Conclusion. Including occupational engagement in chronic pain interventions may increase short-term physical activity and long-term sleep quality. Due to the few available RCTs including occupational engagement in chronic pain treatment for adults living with chronic pain, further high-quality RCTs are needed and will likely change the conclusion.

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Section: Characteristics Of the Included Trialsmentioning

confidence: 99%

Section: Characteristics Of the Included Trialsmentioning

confidence: 99%

Section: Characteristics Of the Included Trialsmentioning

confidence: 99%

“…12). Three trials had no other follow-up than that postintervention [27,28,31]. One RCT had two follow-up assessments, 6 and 12 months after the ended intervention [24].…”

Section: Characteristics Of the Included Trialsmentioning

confidence: 99%

Section: Characteristics Of the Included Trialsmentioning

confidence: 99%

See 3 more Smart Citations

The Effect of Occupational Engagement on Lifestyle in Adults Living with Chronic Pain: A Systematic Review and Meta-analysis

Nielsen

Skou

Larsen

et al. 2022

Occupational Therapy International

View full text Add to dashboard Cite

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Effectiveness of nonpharmacological conservative therapies for chronic pelvic pain in women: a systematic review and meta-analysis

Starzec-Proserpio,

Frawley,

Bø

et al. 2025

American Journal of Obstetrics and Gynecology

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Self-Management Programs for Chronic Non-Cancer Pain: A Rapid Review of Randomized Trials

Okoli

Lam

Reddy

et al. 2022

Can. J. Neurol. Sci.

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Background: The body of evidence regarding self-management programs (SMPs) for adult chronic non-cancer pain (CNCP) is steadily growing, and regular updates are needed for effective decision-making. Objectives: To systematically identify, critically appraise, and summarize the findings from randomized controlled trials (RCTs) of SMPs for CNCP. Methods: We searched relevant databases from 2009 to August 2021 and included English-language RCT publications of SMPs compared with usual care for CNCP among adults (18+ years old). The primary outcome was health-related quality of life (HR-QoL). We conducted meta-analysis using an inverse variance, random-effects model and calculated the standardized mean difference (SMD) and associated 95% confidence interval (CI) and statistical heterogeneity using the I2 statistic. Results: From 8538 citations, we included 28 RCTs with varying patient populations, standards for SMPs, and usual care. No RCTs were classified as having a low risk of bias. There was no evidence of a significant improvement in overall HR-QoL, irrespective of pain type, immediately post-intervention (SMD 0.01, 95%CI −0.21 to 0.24; I2 57%; 11 RCTs; 979 participants), 1–4 months post-intervention (SMD 0.02, 95%CI −0.16 to 0.20; I2 48.7%; 12 RCTs; 1160 participants), and 6–12 months post-intervention (SMD 0.07, 95%CI −0.06 to 0.21; I2 26.1%; 9 RCTs; 1404 participants). Similar findings were made for physical and mental HR-QoL, and for specific QoL assessment scales (e.g., SF-36). Conclusions: There is a lack of evidence that SMPs are efficacious for CNCP compared with usual care. Standardization of SMPs for CNCP and better planned/conducted RCTs are needed to confirm these conclusions.

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Effects of a patient-centered program including the cumulative-complexity model in women with chronic pelvic pain: a randomized controlled trial

Cited by 8 publications

References 28 publications

The Effect of Occupational Engagement on Lifestyle in Adults Living with Chronic Pain: A Systematic Review and Meta-analysis

The Effect of Occupational Engagement on Lifestyle in Adults Living with Chronic Pain: A Systematic Review and Meta-analysis

Effectiveness of nonpharmacological conservative therapies for chronic pelvic pain in women: a systematic review and meta-analysis

Self-Management Programs for Chronic Non-Cancer Pain: A Rapid Review of Randomized Trials

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