Comprehensiveness and validity of a multidimensional assessment in patients with chronic low back pain: a prospective cohort study

Giger

Lehmann

et al. 2021

Preprint

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Background. Data on mental health improvement after cardiac rehabilitation (CR) are contradicting. The aim was to examine the mental and psycho-social health of patients admitted to our rehabilitation center following hospital treatment for acute coronary syndrome, before and after multidisciplinary CR.Methods. Outcome was measured at admission and discharge by the 36-Item Short Form Survey (SF-36), the Symptom Checklist-90 Revised (SCL-90R), the Coping Strategy Questionnaire (CSQ) and the 6-minute-walking distance test. The patients’ health status was compared with norms of sex-, age- and comorbidity-matched data from the German general population. Score differences from norms were measured by standardized mean differences (SMDs); health changes were quantified by standardized effect sizes (ESs). Their importance for comprehensive assessment was quantified by explorative factor analysis.Results. Of n=70 patients followed-up (male: 79%; mean age: 66.6 years), 79% had ≥3 comorbidities. At baseline, SF-36 Physical functioning (SMD=–0.75), Role physical (–0.90), Social functioning (SMD=–0.44), and Role emotional (SMD=–0.45) were significantly worse than the norm. After CR, almost all scores significantly improved by ES=0.23 (SCL-90R Interpersonal sensitivity) to 1.04 (SF-36 Physical functioning). The strongest factor (up to 41.1% explained variance) for health state and change was the mental health domain, followed by function&pain (up to 26.3%).Conclusions. Normative deficits in physical and psycho-social health were reported at baseline. After CR, at follow-up, all scores, except phobia, showed significant improvement. The comprehensive measurement of bio-psycho-social health should not be limited to depression and anxiety but include, especially, the somatization and social participation dimensions.

Section: Discussionmentioning

confidence: 99%

Mental and Psycho-social Health and Quality-of-Life Before and After Cardiac Rehabilitation: A Prospective Cohort Study With Comparison to Specific Population Norms

Giger

Lehmann

et al. 2021

Preprint

Self Cite

“…On the basis of our experience with the comprehensive measurement of low back pain syndrome, factor analysis with varimax rotation was performed in order to quantify and compare the importance of the mental and psycho-social health dimensions and the physical dimensions [ 34 ]. Factor analysis is a multivariate correlation analysis designed to reduce the number of dimensions, identify common constructs and explain the nature of their interrelations [ 35 , 36 ].…”

Section: Methodsmentioning

confidence: 99%

Mental and psychosocial health and health related quality of life before and after cardiac rehabilitation: a prospective cohort study with comparison to specific population norms

Health Qual Life Outcomes

Giger

Lehmann

et al. 2022

Self Cite

Background Data on mental health improvement after cardiac rehabilitation (CR) are contradictory. The aim was to examine the mental and psycho-social health of patients admitted to our rehabilitation center following hospital treatment for acute coronary syndrome, before and after multidisciplinary CR. Methods Outcome was measured at admission and discharge by the 36-Item Short Form Survey (SF-36), the Symptom Checklist-90 Revised (SCL-90R), the Coping Strategy Questionnaire (CSQ) and the 6-min-walking distance test. The patients’ health status was compared with norms of sex-, age- and comorbidity-matched data from the German general population. Score differences from norms were measured by standardized mean differences (SMDs); health changes were quantified by standardized effect sizes (ESs). Their importance for comprehensive assessment was quantified by explorative factor analysis. Results Of n = 70 patients followed-up (male: 79%; mean age: 66.6 years), 79% had ≥ 3 comorbidities. At baseline, SF-36 Physical functioning (SMD = − 0.75), Role physical (− 0.90), Social functioning (SMD = − 0.44), and Role emotional (SMD = − 0.45) were significantly worse than the norm. After CR, almost all scores significantly improved by ES = 0.23 (SCL-90R Interpersonal sensitivity) to 1.04 (SF-36 Physical functioning). The strongest factor (up to 41.1% explained variance) for health state and change was the mental health domain, followed by function & pain (up to 26.3%). Conclusions Normative deficits in physical and psycho-social health were reported at baseline. After CR, at follow-up, all scores, except phobia, showed significant improvement. The comprehensive measurement of bio-psycho-social health should not be limited to depression and anxiety but include, especially, the somatization and social participation dimensions.

“…The questionnaire can be used to calculate the index (ODI), a measure for the respective functional limitations in various activities of daily living. 16 , 20 Each item is scored from 0 to 5 and the total ODI score is calculated as:…”

Section: Methodsmentioning

confidence: 99%

“…In addition, a category of “additional items” is included to help the care provider assess other aspects of a patient’s symptomatology (eg item 19, “poor appetite”). 16 …”

Section: Methodsmentioning

confidence: 99%

“…In addition, a category of "additional items" is included to help the care provider assess other aspects of a patient's symptomatology (eg item 19, "poor appetite"). 16 For the present study, the categories anxiety (10 items), depression (13 items) and somatization (12 items) will be assessed. Each item will be scored on a five-point Likert scale ranging from 0 "not at all" to 4 "very strong".…”

Section: Symptom Checklist-90 -Revisedmentioning

confidence: 99%

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Comparison of Swiss versus Standard Acupuncture in Patients with Chronic Low Back Pain. A Study Protocol for a Randomized, Controlled, Single-Blind, Parallel Trial

Pradhan

et al. 2022

JPR

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Introduction Chronic low back pain (CLBP) cannot sufficiently be treated by pharmacological therapy and generates substantial health-care costs worldwide. Acupuncture, a cost-effective, safe and non-pharmacological therapy, has shown promising results in relieving acute low back pain; however, the optimal acupuncture therapy for CLBP remains controversial. This study will compare two acupuncture methods for pain relief in CLBP. Methods and Analysis This randomized, controlled, single-blind, parallel trial will be conducted in patients with clinically diagnosed CLBP with a disease duration ≥3 months and an average pain intensity of ≥4 points on an 11-point Pain Intensity Numerical Rating Scale (pain-NRS) on the previous 7 days. Patients will be randomized to 9-week acupuncture therapy using Jiu Gong Points (termed Swiss low back acupuncture, SLBA) or standard acupuncture (SA) therapy (weeks 1–6: two sessions/week, weeks 7–9: one session/week, 15 sessions/patient in total). Measurements will be conducted before the first session (T1), at the end of the 9-week therapy (T2) and after 3- and 6-month follow-up (T3 and T4). The primary hypothesis is that 9 weeks of SLBA will be superior in reducing the pain severity assessed by the pain-NRS compared to SA therapy for CLBP. Secondary outcomes will be derived from the Short-Form 36, Oswestry Disability Index, Multidimensional Pain Inventory questionnaire, Symptom Checklist-90 – Revised questionnaire and a daily pain diary. Assuming a minimal clinically important difference in the pain-NRS of 0.39 and an effect size of ≥0.6 between SLBA and SA, 80% power, 0.05 alpha level and 20% dropouts, a total of 55 patients/arm will be required. The primary outcome will be analyzed in the intention-to-treat population using chained linear regression models. Patients, outcome assessors and data analysts will be blinded to the treatment arm. Trial Registration Clinicaltrials.gov Identifier: NCT05232487.