How do psychologically based interventions for chronic musculoskeletal pain work? A systematic review and meta-analysis of specific moderators and mediators of treatment

Murillo, Carlos A.; Vo, Tat‐Thang; Vansteelandt, Stijn; Harrison, Lauren E.; Cagnie, Barbara; Coppieters, Iris; Chys, Marjolein; Timmers, Inge; Meeus, Mira

doi:10.1016/j.cpr.2022.102160

Cited by 31 publications

(43 citation statements)

References 129 publications

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“… 97 , 148 As an alternative approach, mediation analyses have been used within trials of active psychological treatments to advance understanding of purported mechanisms of change. 118 , 145 …”

Section: Discussionmentioning

confidence: 99%

Blinding and sham control methods in trials of physical, psychological, and self-management interventions for pain (article I): a systematic review and description of methods

Hohenschurz-Schmidt

Draper-Rodi

Vase

et al. 2022

Pain

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Section: Discussionmentioning

confidence: 99%

Blinding and sham control methods in trials of physical, psychological, and self-management interventions for pain (article I): a systematic review and description of methods

Hohenschurz-Schmidt

Draper-Rodi

Vase

et al. 2022

Pain

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“…We found an association between changes in mood scales and changes in the outcomes. Murillo et al [25] found that depression is a commonly used mediator in mediation analysis. They also found that the mediated proportion for cognitive behavioral treatment did not exceed 20% for any mediator.…”

Section: How Does the Treatment Work?mentioning

confidence: 99%

“…Therefore, based on only the data we cannot conclude whether pain and disability are reduced because of reduced depression/mood symptoms or the other way round. Further research is highly needed, as in general, treatment mechanisms for chronic pain are scarcely investigated and heterogeneous in most cases [25].…”

Section: How Does the Treatment Work?mentioning

confidence: 99%

Effectiveness and mechanisms of a multimodal treatment for low back pain: a pragmatic matched cohort study

Schäfer

Niederer

Levenig

et al. 2022

Preprint

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Objective: To investigate the effectiveness and mechanisms of a multimodal treatment including perturbation exercise directly applied in health care. Methods: A pragmatic, matched cohort study was conducted. Participants from the intervention group had chronic or recurrent low back pain and participated in a 12-week back pain prevention program. Coaches were trained to deliver multimodal care. Controls (usual care) were matched from a multi-center RCT. Outcomes were pain, disability, isokinetic trunk strength (extension/flexion) and balance (center of pressure trace). A Bayesian, sequential analysis along 8 matching procedures and moderation/mediation analyses incorporating the biopsychological avoidance-endurance model were conducted. Median values with highest posterior density intervals (HPDI) from baseline-adjusted analyses are presented. Results: Over 12 weeks, intervention and control experienced a similar decrease in pain and disability, which led to negligible average treatment effects for pain (0.5 HPDI95% [-3.6; 4.6]) and disability (1.5 HPDI95% [-2.3; 5.4]) for the intervention. Changes in functional strength and balance showed small but favorable effects for the intervention group, in particular for trunk extension (-4.1 Nm HPDI95% [-18.2, 10.0]) and monopedal stances (standardized score: 0.49 HPDI95% [0.13, 0.79]). Depression was higher in drop-outs and decreases in pain and disability were associated with decreases in depression. Distress-endurance subgroups experienced higher baseline pain and disability and showed the highest reductions in both parameters upon completion of the intervention. Conclusion: Multimodal treatments for low back pain without tailoring are possibly less effective in the context of health care than their efficacy in RCTs suggests. Targeting distress-endurance subgroups with a multimodal treatment approach is probably an effective strategy in treatment tailoring.

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“…Similarly, low back pain, the most commonly reported MSKP, has been found to be significantly associated with the quality of sleep quality [ 13 ], and on the other hand, a night of poor sleep quality has been reported to be followed by worsened MSKP intensity [ 14 ]. Therefore, targeting the treatment of psychological and sleep elements to improve MSKP and its related disability has recently grown in importance [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Musculoskeletal Pain in Undergraduate Students Is Significantly Associated with Psychological Distress and Poor Sleep Quality

Alsaadi

2022

IJERPH

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Musculoskeletal pain (MSKP), psychological distress, and poor sleep quality are common among undergraduate university students. Yet, few studies have assessed the association between MSKP and psychological distress and poor sleep quality. This cross-sectional study was conducted to determine this association among undergraduate students at a major public university in Saudi Arabia. MSKP was assessed using the Nordic Musculoskeletal Questionnaire, psychological distress using the Depression, Anxiety and Stress (DASS-21) questionnaire, and sleep quality using the Pittsburgh Sleep Quality Index. A total of 339 undergraduate students from various specialties provided complete responses and were included. The most common site of MSKP in the past 12 months and the past 7 days were neck pain (54.6% and 41.9%, respectively) and low back pain (49.4% and 48.2%, respectively). There was no difference in the prevalence of MSKP across colleges. The reported MSKP in the past 12 months and 7 days were significantly associated with the students’ level of anxiety and stress as well as sleep quality (p < 0.05 for all), while depression was only significantly associated with MSKP in the past 7 days.

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How do psychologically based interventions for chronic musculoskeletal pain work? A systematic review and meta-analysis of specific moderators and mediators of treatment

Cited by 31 publications

References 129 publications

Blinding and sham control methods in trials of physical, psychological, and self-management interventions for pain (article I): a systematic review and description of methods

Blinding and sham control methods in trials of physical, psychological, and self-management interventions for pain (article I): a systematic review and description of methods

Effectiveness and mechanisms of a multimodal treatment for low back pain: a pragmatic matched cohort study

Musculoskeletal Pain in Undergraduate Students Is Significantly Associated with Psychological Distress and Poor Sleep Quality

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