ORCID Profile
0000-0002-3714-4767
Current Organisation
University of Limerick
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Publisher: Wiley
Date: 20-07-2020
DOI: 10.1002/EJP.1624
Publisher: BMJ
Date: 19-10-2019
DOI: 10.1136/BJSPORTS-2019-100780
Abstract: One-size-fits-all interventions reduce chronic low back pain (CLBP) a small amount. An in idualised intervention called cognitive functional therapy (CFT) was superior for CLBP compared with manual therapy and exercise in one randomised controlled trial (RCT). However, systematic reviews show group interventions are as effective as one-to-one interventions for musculoskeletal pain. This RCT investigated whether a physiotherapist-delivered in idualised intervention (CFT) was more effective than physiotherapist-delivered group-based exercise and education for in iduals with CLBP. 206 adults with CLBP were randomised to either CFT (n=106) or group-based exercise and education (n=100). The length of the CFT intervention varied according to the clinical progression of participants (mean=5 treatments). The group intervention consisted of up to 6 classes (mean=4 classes) over 6–8 weeks. Primary outcomes were disability and pain intensity in the past week at 6 months and 12months postrandomisation. Analysis was by intention-to-treat using linear mixed models. CFT reduced disability more than the group intervention at 6 months (mean difference, 8.65 95% CI 3.66 to 13.64 p=0.001), and at 12 months (mean difference, 7.02 95% CI 2.24 to 11.80 p=0.004). There were no between-group differences observed in pain intensity at 6 months (mean difference, 0.76 95% CI -0.02 to 1.54 p=0.056) or 12 months (mean difference, 0.65 95% CI -0.20 to 1.50 p=0.134). CFT reduced disability, but not pain, at 6 and 12 months compared with the group-based exercise and education intervention. Future research should examine whether the greater reduction in disability achieved by CFT renders worthwhile differences for health systems and patients. ClinicalTrials.gov registry (NCT02145728 ).
Publisher: Elsevier BV
Date: 07-2016
DOI: 10.1016/J.JPAIN.2016.01.473
Abstract: Nonspecific chronic spinal pain (NSCSP) is highly disabling. Current conservative rehabilitation commonly includes physical and behavioral interventions, or a combination of these approaches. Physical interventions aim to enhance physical capacity by using methods such as exercise, manual therapy, and ergonomics. Behavioral sychologically informed interventions aim to enhance behaviors, cognitions, or mood by using methods such as relaxation and cognitive behavioral therapy. Combined interventions aim to target physical and also behavioral sychological factors contributing to patients' pain by using methods such as multidisciplinary pain management programs. Because it remains unclear whether any of these approaches are superior, this review aimed to assess the comparative effectiveness of physical, behavioral sychologically informed, and combined interventions on pain and disability in patients with NSCSP. Ten electronic databases were searched for randomized controlled trials (RCTs) including participants reporting NSCSP. Studies were required to have an "active" conservative treatment control group for comparison. Studies were not eligible if the interventions were from the same domain (eg, if the study compared 2 physical interventions). Study quality was assessed used the Cochrane Back Review Group risk of bias criteria. The treatment effects of physical, behavioral sychologically informed, and combined interventions were assessed using meta-analyses. Twenty-four studies were included. No clinically significant differences were found for pain and disability between physical, behavioral sychologically informed, and combined interventions. The simple categorization of interventions into physical, behavioral sychologically informed, and combined could be considered a limitation of this review, because these interventions may not be easily differentiated to allow accurate comparisons to be made. Further work should consider investigating whether tailoring rehabilitation to in idual patients and their perceived risk of chronicity, as seen in recent RCTs for low back pain, can enhance outcomes in NSCSP. In this systematic review of RCTs in NSCSP, only small differences in pain or disability were observed between physical, behavioral sychologically informed, and combined interventions.
Publisher: BMJ
Date: 24-06-2017
DOI: 10.1136/BJSPORTS-2015-095410
Abstract: Musculoskeletal pain is common and its treatment costly. Both group and in idual physiotherapy interventions which incorporate exercise aim to reduce pain and disability. Do the additional time and costs of in idual physiotherapy result in superior outcomes? To compare the effectiveness of group and in idual physiotherapy including exercise on musculoskeletal pain and disability. Eleven electronic databases were searched by two independent reviewers. Randomised controlled trials (RCTs) including participants with musculoskeletal conditions which compared group and in idual physiotherapy interventions that incorporated exercise were eligible. Study quality was assessed using the PEDro scale by two independent reviewers, and treatment effects were compared by meta-analyses. Fourteen RCTs were eligible, including patients with low back pain (7 studies), neck pain (4), knee pain (2) and shoulder pain (1). We found no clinically significant differences in pain and disability between group and in idual physiotherapy involving exercise. Only small, clinically irrelevant differences in pain or disability outcomes were found between group and in idual physiotherapy incorporating exercise. Since all but one study included other interventions together with exercise in either the group or in idual arm, deciphering the unique effect of the way in which exercise is delivered is difficult. Group interventions may need to be considered more often, given their similar effectiveness and potentially lower healthcare costs.
Publisher: Wiley
Date: 03-06-2015
DOI: 10.1111/SMS.12492
Abstract: Previous research in Irish dancing (ID) has recorded high levels of pain/injury. Screening protocols in other genres have been developed to identify at-risk dancers. The aims of the study were to examine the factors that relate to absence from dancing because of musculo-skeletal pain/injury in ID, and to inform guidelines for the development of an evidence-based screening protocol. Baseline subjective data (n = 85) and physical data (n = 84) were gathered. Subjects completed a monthly online questionnaire for 1 year providing data on general physical and psychological health and rates of pain/injury. Subjects were allocated to a "More Time Absent (MTA)" or "Less Time Absent (LTA)" category depending on their duration of absence from performance over the year. Eighty-four subjects completed the year-long follow-up (MTA: n = 32 LTA: n = 52). Two hundred seventy-eight complaints of pain/injury were recorded. Factors significantly associated with membership of the MTA group included greater anger-hostility (P = 0.003), more subjective health complaints (P = 0.026), more severe previous pain/injury (P = 0.017), more general everyday pain (P = 0.020), more body parts affected by pain/injury (P = 0.028), always/often dancing in pain (P = 0.028), and insufficient sleep (P = 0.043). Several biopsychosocial factors appear to be associated with absence from ID because of pain/injury. Biopsychosocial screening protocols and prevention strategies may best identify at-risk dancers.
Publisher: BMJ
Date: 06-2015
Publisher: Elsevier BV
Date: 05-2021
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 23-04-2018
DOI: 10.1097/J.PAIN.0000000000001251
Abstract: Pain significantly restricts the quality of life and well-being of older adults. With our increasingly ageing population, it is important to examine whether differing classes of biopsychosocial risk factors can predict the development of pain in older adults. Latent class analysis provides a model-based approach to identifying underlying subgroups in a population, based on some measured characteristics. In this study, latent class analysis was used to identify biopsychosocial risk classes in people aged 50 years and older, from The Irish Longitudinal Study on Ageing, who reported not often being troubled by pain at wave 1 and completed the 2-year follow-up at wave 2 (n = 4458). Four classes were identified based on 11 potential risk factors at wave 1. These classes were characterised as “Low Risk,” “Physical Health Risk,” “Mental Health Risk,” and “High Risk.” The Low-Risk class accounted for over half the s le (51.2%), whereas the High-Risk class represented 7.8% of the s le. At follow-up (wave 2), 797 (17.9%) participants reported being troubled by pain. Associations between the biopsychosocial risk classes and developing pain were examined using logistic regression, adjusting for sociodemographic variables. The High-Risk class was more likely to develop pain compared with the Low-Risk class (adjusted OR = 3.16, 95% CI = 2.40-4.16). These results add to existing data in other populations supporting the role of a range of biopsychosocial risk factors that increase the risk of developing pain. These findings have important implications for the identification, and potential moderation, of these risk factors.
Publisher: SAGE Publications
Date: 15-03-2015
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Helen Purtill.