Learned pacing for adults with chronic pain: A randomised controlled trial feasibility study

Guy, Lauren; McKinstry, Carol; Bruce, Chris

doi:10.1111/1440-1630.12653

Cited by 3 publications

(2 citation statements)

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“…Given these findings, guideline recommendations urge clinicians to maximize nonpharmacologic and non-opioid therapies before considering opioid-based approaches [10,11]. Many nonpharmacologic treatment methods, such as lifestyle redesign programs, learned pacing, and energy conservation techniques, amongst other integrative and complementary approaches, have demonstrated significant and consistent longterm improvements in pain and function with minimal risk for harm [28][29][30][31][32].…”

Section: Chronic Pain Management Best Practice Recommendationsmentioning

confidence: 99%

Empowering Patients, Enriching Outcomes: An Integrative and Occupational Approach to Addressing Chronic Pain in Primary Care

Hernandez,

Rider

2023

OBM Integr Complement Med

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Concept PaperEmpowering Patients, Enriching Outcomes: An Integrative and Occupational Approach to Addressing Chronic Pain in Primary CareKazandra Lopez Hernandez *, John V. Rider School of Occupational Therapy, Touro University Nevada, 874 American Pacific Dr., Henderson, NV, USA; E-Mails: <a href="mailto:kazandralopezhernandez@gmail.com">kazandralopezhernandez@gmail.com</a>; <a href="mailto:jrider@touro.edu">jrider@touro.edu</a>* Correspondence: Kazandra Lopez Hernandez; E-Mail: <a href="mailto:kazandralopezhernandez@gmail.com">kazandralopezhernandez@gmail.com</a> Academic Editor: Enrica SantarcangeloSpecial Issue: <a href="https://www.lidsen.com/journals/icm/icm-special-issues/occupational-therapy-interventions-treatment-pain">Occupational Therapy Interventions for the Treatment of Pain</a>OBM Integrative and Complementary Medicine2023, volume 8, issue 4 doi:10.21926/obm.icm.2304053Received: July 26, 2023Accepted: November 15, 2023Published: November 20, 2023AbstractChronic pain imposes significant personal and societal challenges. The concerning impact across all population levels has led to several federal agencies dedicating considerable efforts to developing clinically guiding recommendations to improve how chronic pain is addressed, specifically in primary care practice. These guidelines recognize and emphasize the importance of comprehensive evaluation, appropriate diagnosis, and treatment interventions that target multifactorial influences of pain for improved quality of life outcomes through function and participation in activities of daily living. Similarly, guideline recommendations encourage optimizing nonpharmacologic and non-opioid interventions and thorough risk assessment before initiating opioid treatment therapy. This paper proposes a clinical practice pathway demonstrating the integration of occupational therapy (OT) into primary care practice to address chronic pain through an interprofessional, collaborative, patient-centered approach that recognizes biopsychosocial components of chronic pain. Keywords Biopsychosocial; evaluation; occupational therapy; pain; primary care; treatment

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Section: Chronic Pain Management Best Practice Recommendationsmentioning

confidence: 99%

Empowering Patients, Enriching Outcomes: An Integrative and Occupational Approach to Addressing Chronic Pain in Primary Care

Hernandez,

Rider

2023

OBM Integr Complement Med

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“…Neither pacing intervention significantly improve pain, fatigue, and self-reported physical disability compared to usual care. Three pilot trials have revealed mixed findings (Guy et al, 2020;Murphy et al, 2012;Racine et al, 2019;Schepens et al, 2012). Researchers have suggested that pain intensity may not be the most appropriate outcome measure to evaluate activity pacing interventions (Thompson, 2018) and have advocated for research to optimize how a pacing intervention is delivered and evaluated (Murphy et al, 2016;Racine et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Clinical utility of a mHealth assisted intervention for activity modulation in chronic pain: The pilot implementation of pain ROADMAP

Andrews

Ireland

Deen

et al. 2023

European Journal of Pain

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Background: Being able to successfully self-regulate one's activity levels is a key adaptation strategy for many people with chronic pain. This study aimed to explore the clinical utility of a mobile health platform (Pain ROADMAP) for assisting with the delivery of a tailored activity modulation intervention for people with persistent pain. Methods: Twenty adults with chronic pain undertook 1-week monitoring intervals which involved wearing an Actigraph activity monitor and entering pain, opioid use, and activity participation data into a custom-made phone app. The Pain ROADMAP online portal integrated and analysed the data to detect activities that caused a severe pain exacerbation and provided summary statistics pertaining the data collected. As part of a 15-week treatment protocol, participants received feedback from three dispersed Pain ROADMAP monitoring periods. Treatment focused on adapting pain-provoking activities, gradually increase goal-related activity and optimizing routine. Results: Results revealed good participant acceptability of monitoring procedures and reasonable adherence to both monitoring procedures and clinical follow-up appointments. Preliminary efficacy was established through clinically meaningful decreases in overactivity behaviour, pain variation, opioid use, depression, activity avoidance, and increases in productivity. No adverse outcomes were observed. Conclusion: The results of this study provide initial support for the clinical utility of mHealth assisted activity modulation interventions that involve remote monitoring.Significance: This is the first study to demonstrate how mHealth innovations that utilise ecological momentary assessment can be successfully integrated with wearable technologies to provide a tailored activity modulation intervention that is both highly valued by people with chronic pain and assists individuals to make

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An Investigation of Occupational Therapy Utilizing Sensory Modulation to Manage Co-Morbid Chronic Pain and Substance Use in Order to Promote Occupational Performance and Recovery

Ruth¹

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Background: Those with chronic pain have worse drug and alcohol treatment outcomes and higher rates of relapse compared to those without pain or with reduced pain (Ilgen et al., 2020). Methods: A descriptive study was employed with the aim of determining what are the sensory processing pattens of those with co-morbid chronic pain and in recovery for substance use. All participants completed the Adolescent and Adult Sensory Profile, the Brief Pain Inventory, and the Personal Recovery Outcome Measure (PROM). Results: From the preliminary findings, individuals with co-morbid chronic pain and substance use may have atypical sensory processing in areas of sensation sensitive, sensation avoiding, and low registration, compared to the normative sample. Individuals within this clinical setting in general were not receiving non-pharmacological treatment for their pain. With pain fluctuating between mild (2.2/10) and severe (6.0/10) throughout the day. Results of the PROM were an average of 21/30. Item 21 states “I can manage stress”. From these findings a 5-week sensory based OT Group was implemented at a PHP/IOP treatment center focusing on self-management, health-management, and stress reduction strategies to improve overall occupational performance. A pain management OT Group is also included in the manual. Conclusion: Individuals with co-morbid chronic pain and substance use may have sensory processing patterns that are impacting function and recovery. This highlights the potential value of further research and consideration in clinical practice of these unique patterns and how they may be impacting recovery and long-term sobriety.

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Learned pacing for adults with chronic pain: A randomised controlled trial feasibility study

Cited by 3 publications

References 34 publications

Empowering Patients, Enriching Outcomes: An Integrative and Occupational Approach to Addressing Chronic Pain in Primary Care

Empowering Patients, Enriching Outcomes: An Integrative and Occupational Approach to Addressing Chronic Pain in Primary Care

Clinical utility of a mHealth assisted intervention for activity modulation in chronic pain: The pilot implementation of pain ROADMAP

An Investigation of Occupational Therapy Utilizing Sensory Modulation to Manage Co-Morbid Chronic Pain and Substance Use in Order to Promote Occupational Performance and Recovery

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