ORCID Profile
0000-0002-5050-8940
Current Organisations
University of Sydney
,
Univeristy of Otago
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Publisher: Elsevier BV
Date: 04-2023
Publisher: Wiley
Date: 18-11-2021
DOI: 10.1111/DMCN.15113
Abstract: This commentary is on the original article by Noten et al. on pages 569–577 of this issue.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2019
DOI: 10.1097/PR9.0000000000000788
Abstract: Before determining the pain research priorities for a country, a comprehensive literature review of existing research is warranted. We aimed to (1) identify and describe the extent and nature of pain research performed in Nepal, (2) identify existing knowledge and significant knowledge gaps, and (3) provide recommendations for future studies. We conducted a systematic scoping review of the literature, in accordance with recommended guidelines. We searched local and international databases to identify research conducted in Nepal on in iduals with a diagnosis of clinical pain conditions. A pair of independent reviewers screened the studies for inclusion. We identified 1396 records and included 116 studies. Most studies were published in Nepalese journals (75%) and were conducted in clinical settings (73%). Postsurgical pain was the most commonly studied pain condition (33%), followed by musculoskeletal pain (16%), headache (14%), and low back pain (13%). The most common research topics, in order of frequency, were (1) medical management (40%), (2) pain prevalence/incidence (21%), (3) diagnostic procedures (15%), (4) surgical management (8%), and (5) patient-reported outcome measurement (8%). Research gaps and potential areas of research waste were identified. Although a large number of research articles about pain in Nepal have been published, the majority of these have focused on the biomedical diagnosis and management of pain. Other topic areas (eg, psychological and social aspects of pain) are under-represented. The findings may inform future research directions for maximizing the knowledge that could be gained.
Publisher: Informa UK Limited
Date: 10-2018
DOI: 10.2147/JPR.S173851
Publisher: Informa UK Limited
Date: 11-2016
DOI: 10.2147/JPR.S119212
Publisher: Elsevier BV
Date: 12-2021
DOI: 10.1016/J.MSKSP.2021.102439
Abstract: Exercise therapy is known to be an effective intervention for patients with osteoarthritis, however the evidence is limited as to whether adding manual therapy or booster sessions are cost-effective strategies to extend the duration of benefits. To investigate the cost-effectiveness, at 2-year follow-up, of adding manual therapy and/or booster sessions to exercise therapy. 2-by-2 factorial randomized controlled trial. Participants with knee osteoarthritis were randomly allocated (1:1:1:1) to: exercise therapy delivered in consecutive sessions within 9 weeks (control group), exercise therapy distributed over 1 year using booster sessions, exercise therapy plus manual therapy delivered within 9 weeks, and exercise therapy plus manual therapy with booster sessions. The primary outcome was incremental cost-effectiveness from health system and societal perspectives interpreted as incremental net monetary benefit (INMB). Of 75 participants, 66 (88 %) were retained at 1-year and 40 (53 %) at 2-year follow-up. All three interventions were cost-effective from both the health system and societal perspectives (INMBs, at 0.5 × GDP/capita willingness to pay (WTP) threshold: $3278 (95%CI -3244 to 9800) and $3904 (95%CI -2823 to 10,632) respectively for booster sessions $2941 (95%CI -3686 to 9568) and $2618 (95%CI -4005 to 9241) for manual therapy $270 (95%CI -6139 to 6679) and $404 (95%CI -6097 to 6905) for manual therapy with booster sessions). Manual therapy or booster sessions in addition to exercise therapy are cost-effective at 2-year follow-up. The evidence did not support combining both booster sessions and manual therapy in addition to exercise therapy.
Publisher: Oxford University Press (OUP)
Date: 16-03-2019
DOI: 10.1093/PM/PNY319
Abstract: Pain intensity is the most commonly assessed domain in pain research and clinical settings. To facilitate cross-cultural research, knowledge regarding the psychometric properties of pain intensity measures in in iduals from different countries is needed. However, the majority of this research has been conducted in English-speaking countries. Survey study. University. Four hundred nineteen college students. Participants were asked to complete four measures assessing average pain intensity: 1) the 0–10 numerical rating scale (NRS-11), 2) the 100-mm visual analog scale (VAS), 3) the four-point verbal rating scale (VRS-4), and 4) the Faces Pain Scale–Revised (FPS-R). The rates of incorrect completion of the four scales were uniformly low (range = 1–2%). The NRS-11 had the highest preference rate (31%), although a substantial number of participants also preferred each of the other three scales (range = 22–24%). The findings support the utility and construct validity of all four pain intensity scales in this Spanish-speaking s le. When considered in light of research from other non-English-speaking s les indicating significant psychometric weaknesses for the NRS-11 and VAS and relative strengths of the FPS-R in some groups, the findings suggest that the FPS-R might be the most appropriate pain intensity scale to use when comparisons across populations from different countries is a goal. More research is needed to determine the extent to which demographic (i.e., age, education levels, socioeconomic status) vs cultural factors (i.e., country of origin) influence the reliability, validity, and utility of different pain measures.
Publisher: Springer Science and Business Media LLC
Date: 10-06-2022
DOI: 10.1186/S12891-022-05488-2
Abstract: Elastic knee sleeves are often worn following anterior cruciate ligament reconstruction (ACLR) but their effects on movement patterns are unclear. To determine the immediate and six-week effects of wearing a knee sleeve on biomechanics of the knee during a step-down hop task. Using a cross-over design, we estimated sagittal plane knee kinematics and kinetics and stance duration during a step-down hop for 31 participants (age 26.0 [SD 6.6] years, 15 women) after ACLR (median 16 months post-surgery) with and without wearing a knee sleeve. In a subsequent randomised clinical trial, participants in the ‘Sleeve Group’ ( n = 9) then wore the sleeve for 6 weeks at least 1 h daily, while a ‘Control Group’ ( n = 9) did not wear the sleeve. We used statistical parametric mapping to compare (1) knee flexion/extension angle and external flexion/extension moment trajectories between three conditions at baseline (uninjured side, unsleeved injured side and sleeved injured side) (2) within-participant changes for knee flexion angles and external flexion/extension moment trajectories from baseline to follow-up between groups. We compared discrete flexion angles and moments, and stance duration between conditions and between groups. Without sleeves, knee flexion was lower for the injured than the uninjured sides during mid-stance phase. When wearing the sleeve on the injured side, knee flexion increased during the loading phase of the stance phase. Discrete initial and peak knee flexion angles increased by (mean difference, 95% CIs) 2.7° (1.3, 4.1) and 3.0° (1.2, 4.9), respectively, when wearing the knee sleeve. Knee external flexion moments for the unsleeved injured sides were lower than the uninjured sides for 80% of stance phase, with no change when sleeved. The groups differenced for within-group changes in knee flexion trajectories at follow-up. Knee flexion angles increased for the Control group only. Stance duration decreased by 22% for the Sleeve group from baseline to follow-up (-89 ms -153, -24) but not for the Controls. Application of knee sleeves following ACLR is associated with improved knee flexion angles during hop landing training. Longer term (daily) knee sleeve application may help improve hop stance duration, potentially indicating improved hop performance. The trial was prospectively registered with the Australia New Zealand Clinical Trials Registry No: ACTRN12618001083280, 28/06/2018. ANZCTR
Publisher: Elsevier BV
Date: 11-2023
Publisher: MDPI AG
Date: 12-01-2021
Abstract: This study sought to better understand the associations between perfectionistic self-presentation and measures of pain intensity, pain catastrophizing, pain interference, and fatigue in children and adolescents with pain. In the study, 218 adolescents responded to measures of perfectionistic self-presentation (i.e., perfectionistic self-promotion, nondisplay of imperfection and nondisclosure of imperfection), pain intensity, pain catastrophizing, pain interference, and fatigue. Four hierarchical regression analyses and three mediation analyses were conducted. Our results showed that perfectionistic self-promotion was significantly and independently associated with pain intensity and that nondisplay of imperfection was significantly and independently associated with pain catastrophizing, pain interference, and fatigue. Nondisclosure of imperfection was not significantly associated with any criterion variable. Pain catastrophizing mediated the association between both perfectionistic self-presentation and nondisplay imperfection and pain interference but not between nondisclosure of imperfection and pain interference. The findings provide new information about the role of perfectionistic self-presentation in children and adolescents’ experience of pain. These findings, if replicated, support perfectionism as a potential target of pain treatment in young people.
Publisher: Elsevier BV
Date: 03-2018
Publisher: Wiley
Date: 24-11-2022
DOI: 10.1002/ACR.24821
Abstract: The Osteoarthritis Research Society International (OARSI) recommends assessment of physical function using a performance‐based test of stair negotiation but was unable to recommend any specific test. We assessed the reliability, validity, responsiveness, measurement error, and minimum important change (MIC) of the 6‐step timed Stair Climb Test (SCT). We used pooled data from 397 participants with hip or knee osteoarthritis (54% women) from 4 clinical trials (86% retained at 12‐week follow‐up). Construct validity was assessed by testing 6 a priori hypotheses against other OARSI‐recommended physical function measures. A self‐reported Global Rating of Change scale was used to classify participants as worsened, improved, and stable. Participants who worsened in physical function were excluded from all analyses. Responsiveness and MIC were assessed using multiple anchor‐based and distribution‐based approaches. Test–retest reliability, standard error of measurement (SEM), and smallest detectable change (SDC) were assessed on stable participants. Five of 6 hypotheses (83%) for construct validity were met. Test–retest reliability was excellent (intraclass correlation coefficient 2,1 0.83 95% confidence interval 0.71–0.90). The SEM and SDC values were 0.44 and 1.21 seconds, respectively. We did not find adequate support for responsiveness. The MIC values ranged from 0.78 to 1.95 seconds using different approaches (median 1.37 seconds). The 6‐step timed SCT adequately assesses the construct of physical function in in iduals with hip or knee osteoarthritis with excellent 12‐week test–retest reliability. However, support for its responsiveness was inadequate to recommend its use as an outcome measure in people with osteoarthritis for research and clinical practice.
Publisher: Elsevier BV
Date: 10-2023
Publisher: Springer Science and Business Media LLC
Date: 23-09-2020
DOI: 10.1007/S11136-020-02640-0
Abstract: The Patient-Specific Functional Scale (PSFS) is a routinely used measure of physical function with a 0-10 response scale. We aimed to develop verbal response options for the PSFS, pre-test it for use in a multilingual, low-literacy country- Nepal, and compare preference and error rates between numeric and verbal scale. We hypothesized that a verbal scale would be preferred by respondents and yield fewer errors. We interviewed 42 in iduals with musculoskeletal, neurological, and cardiopulmonary conditions to understand how people describe varying levels of physical ability. Transcripts were thematically analyzed, and through consensus, we developed two sets of verbal responses for the PSFS. Next, we pre-tested the scales on an additional 119 respondents following which participants were asked to specify their preferred scale. Error rates were analyzed retrospectively using pre-specified criteria. Participants described their ability in terms of the quality (95%) and the quantity of task performance (88%). Although the verbal scales were preferred over the numeric scale (50% versus 12%), there was no significant difference in error rates between numeric (34%) and verbal scales (32% and 36%). Higher error rates were associated with greater age, fewer years of education, and inexperience with numeric scales. Despite a higher preference for verbal scale, 1 out of 3 patients made errors in using the PSFS, even with an interview format. The error rates were higher among participants with low literacy. The findings raise questions about the utility of PROMs in countries with low literacy rates.
Publisher: Springer Science and Business Media LLC
Date: 27-07-2020
DOI: 10.1186/S12883-020-01867-1
Abstract: Central sensitization is thought to be an important contributing factor in many chronic pain disorders. The Central Sensitization Inventory (CSI) is a patient-reported measure frequently used to assess symptoms related to central sensitization. The aims of the study were to translate and cross-culturally adapt the CSI into Nepali (CSI-NP) and assess its measurement properties. The CSI was translated into Nepali using recommended guidelines. The CSI-NP was then administered on 100 Nepalese adults with sub-acute and chronic musculoskeletal pain with additional demographic and pain-related questions. The CSI-Nepali was administered again about 2 weeks later. Four measurement properties of the CSI-NP were evaluated: (1) internal consistency using Cronbach’s alpha, (2) test-retest reliability using intraclass correlation coefficient (ICC 2,1 ), (3) measurement errors, and (4) construct validity testing five a priori hypotheses. Confirmation of construct validity was determined if a minimum of 75% of the hypotheses were met. The CSI was successfully translated into Nepali. Internal consistency and test-retest reliability were both excellent (Cronbach’s alpha = 0.91, and ICC = 0.98). The standard error of measurement was 0.31 and the smallest detectable change was 0.86. Four out of five (80%) a priori hypotheses were met, confirming the construct validity: the CSI-NP correlated strongly with the Pain Catastrophizing Scale total scores ( r = 0.50) moderately with the total number of pain descriptors ( r = 0.35) weakly with the Numerical Rating Scale ( r = 0.25) and women had significantly higher CSI scores than men. However, the CSI scores did not correlate significantly with the total duration of pain, as hypothesized ( r = 0.10). The Nepali translation of the CSI demonstrated excellent reliability and construct validity in adults with musculoskeletal pain. It is now available to Nepali health care providers to help assess central sensitization-related signs and symptoms in in iduals with musculoskeletal pain in research or clinical practice to advance the understanding of central sensitization in Nepalese s les.
Publisher: Elsevier BV
Date: 03-2018
Publisher: Springer Science and Business Media LLC
Date: 03-04-2018
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2018
DOI: 10.1097/PR9.0000000000000672
Abstract: Pain intensity is the domain most often assessed in pain research. Although the Numerical Rating Scale is recommended for use in western countries, the utility and validity of this scale, relative to others, has not been established in non–western developing countries, such as Nepal. Here, we sought to (1) identify which of 4 commonly used pain scales is most preferred by Nepalese, (2) compare error rates, (3) determine whether preference and error rates are influenced by age or education level, and (4) evaluate construct validity of each scale using factor analysis. Two hundred two adults with musculoskeletal pain from Nepal rated their worst and average pain intensity using all 4 scales and selected their most preferred scale. The results indicate that the Faces Pain Scale-Revised is the most preferred scale, followed by a Verbal Rating Scale. The Numerical Rating Scale and Visual Analogue Scale were both least preferred and had higher rates of incorrect responses, especially among the older participants. However, all the scales demonstrated adequate construct validity as measures of pain intensity among those participants who could accurately use all 4 scales. The findings indicate that the Faces Pain Scale-Revised should be the first choice for assessing pain intensity in Nepalese adults. Research is needed to determine whether these findings replicate in other non–western and developing countries, to identify the pain intensity measure that would be the best choice for use in cross-cultural pain research.
No related grants have been discovered for Anupa Pathak.