Mechanism-based classification and physical therapy management of persons with cancer pain: A prospective case series

Abstract

Context:Mechanism-based classification (MBC) was established with current evidence and physical therapy (PT) management methods for both cancer and for noncancer pain.Aims:This study aims to describe the efficacy of MBC-based PT in persons with primary complaints of cancer pain.Settings and Design:A prospective case series of patients who attended the physiotherapy department of a multispecialty university-affiliated teaching hospital.Material and Methods:A total of 24 adults (18 female, 6 male) aged 47.5 ± 10.6 years, with primary diagnosis of heterogeneous group of cancer, chief complaints of chronic disabling pain were included in the study on their consent for participation The patients were evaluated and classified on the basis of five predominant mechanisms for pain. Physical therapy interventions were recommended based on mechanisms identified and home program was prescribed with a patient log to ensure compliance. Treatments were given in five consecutive weekly sessions for five weeks each of 30 min duration.Statistical Analysis Used:Pre–post comparisons for pain severity (PS) and pain interference (PI) subscales of Brief pain inventory-Cancer pain (BPI-CP) and, European organization for research and treatment in cancer-quality of life questionnaire (EORTC-QLQ-C30) were done using Wilcoxon signed-rank test at 95% confidence interval using SPSS for Windows version 16.0 (SPSS Inc, Chicago, IL).Results:There were statistically significant (P < 0.05) reduction in pain severity, pain interference and total BPI-CP scores, and the EORTC-QLQ-C30.Conclusion:MBC-PT was effective for improving BPI-CP and EORTC-QLQ-C30 scores in people with cancer pain.

Exercise-based interventions for cancer survivors in India: a systematic review

“…In addition to yoga based exercise intervention, this review identified four physiotherapy based exercise interventions among cancer survivors (Gautam et al 2011 ; Chopra et al 2006 ; Samuel et al 2013 ; Kumar et al 2013 ). Among cancer survivors, the term ‘exercise intervention’ has conventionally been associated with interventions that focus on either or all of aerobic capacity, fitness, muscle strength and endurance, and physical activity; and are usually delivered at a given frequency and intensity.…”

“…Although these interventions have been delivered by many healthcare professions (such as physiotherapist s , exercise physiologists, fitness specialists and nurses); the interventions come under the realm of physiotherapy practice and thus we classified them as physiotherapy based interventions. Among the four studies, only one was an RCT (Samuel et al 2013 ), two were single group pre-post intervention design (Gautam et al 2011 ; Chopra et al 2006 ), and one was a case series (Kumar et al 2013 ). The three studies that were eligible for methodological quality rating got a score of 16 (maximum score 32) (Gautam et al 2011 ; Chopra et al 2006 ; Samuel et al 2013 ).…”

Modern pain neuroscience in clinical practice: applied to post-cancer, paediatric and sports-related pain

“…Patient-centred physical therapy for cancer pain, founded on a mechanisms-based classification of pain, has previously been shown to yield positive findings in a prospective case series. 59 Such mechanism-based pain classification includes the differentiation between nociceptive, neuropathic and central sensitization pain. 56 , 60 Recently, a clinical method for classifying any pain as either predominant central sensitization pain, neuropathic or nociceptive pain 2 was adopted to the cancer survivor population, 61 allowing clinicians to differentiate between these three pain types.…”

Pain following cancer treatment: Guidelines for the clinical classification of predominant neuropathic, nociceptive and central sensitization pain

“…For effective pain management, correct identification of the dominant type of pain may be beneficial. Physiotherapy for cancer pain, patient-centered and founded on a mechanisms-based classification of pain, has previously been shown to yield positive findings in a prospective case series [1]. Such mechanism-based pain classification includes the differential classification of nociceptive, neuropathic and central sensitization pain [2,3].…”