Showing papers by "David Beckwée published in 2022"

It Hurts to Move! Assessing and Treating Movement-Evoked Pain in Patients With Musculoskeletal Pain: A Systematic Review With Meta-analysis.

Abstract: OBJECTIVE To estimate the effects of musculoskeletal rehabilitation interventions on movement-evoked pain and to explore the methods/protocols used to evaluate movement-evoked pain in adults with musculoskeletal pain. DESIGN Systematic review with meta-analysis. LITERATURE SEARCH Three electronic databases (PubMed, Web of Science, and Scopus) were searched. STUDY SELECTION CRITERIA Randomized controlled trials investigating musculoskeletal rehabilitation interventions on movement-evoked pain in adults with musculoskeletal pain were included. DATA SYNTHESIS Meta-analysis was conducted for outcomes with homogeneous data from at least 2 trials. The mean change in movement-evoked pain was the primary outcome measure. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. RESULTS Thirty-eight trials were included, and 60 different interventions were assessed. There was moderate-certainty evidence of a beneficial effect of exercise therapy compared to no treatment (SMD=-0.65; 95%CI -0.83,-0.47; p<0.001) on movement-evoked pain in adults with musculoskeletal pain. There was low-certainty evidence of a beneficial effect of transcutaneous electrical nerve stimulation compared to no treatment (SMD=-0.46; 95%CI -0.71,-0.21; p=0.0004). There was no benefit of transcutaneous electrical nerve stimulation when compared to sham transcutaneous electrical nerve stimulation (SMD=-0.28; 95%CI: -0.60,0.05; p=0.09; moderate-certainty evidence). CONCLUSIONS There was moderate-certainty evidence that exercise therapy is effective for reducing movement-evoked pain in patients with musculoskeletal pain compared to no treatment. Consider exercise therapy as the first-choice treatment for movement-evoked pain in clinical practice. J Orthop Sports Phys Ther, Epub 5 Feb 2022. doi:10.2519/jospt.2022.10527.

The Mediating Effect of Perceived Injustice and Pain Catastrophizing in the Relationship of Pain on Fatigue and Sleep in Breast Cancer Survivors: A Cross-Sectional Study.

Abstract: OBJECTIVE Multidimensional aspects of pain have raised awareness about cognitive appraisals, such as perceived injustice (PI) and pain catastrophizing (PC). It has been demonstrated that they play an important role in patients' pain experience. However, the mediating effect of these appraisals has not been investigated in breast cancer survivors (BCS), nor have they been related to fatigue and sleep. METHODS Cross-sectional data from 128 BCS were analysed by structural path analysis with the aim to examine the mediating effect of PI and PC in the relationship of pain on fatigue and sleep. RESULTS The indirect mediating effects of PI on fatigue (CSI*PI = 0.21; P < 0.01 and VAS*PI = 1.19; P < 0.01) and sleep (CSI*PI = 0.31; P < 0.01 and VAS*PI = 1.74; P < 0.01) were found significant for both pain measures (Central Sensitization Inventory (CSI) and Visual Analogue Scale (VAS)). PC, on the other hand, only mediated the relationship between pain measured by VAS and fatigue (VAS*PC = 0.80; P = 0.03). Positive associations were found, indicating that higher pain levels are positively correlated with PI and PC, which go hand in hand with higher levels of fatigue and sleep problems. CONCLUSION PI is an important mediator in the relationship of pain on fatigue and sleep, while PC is a mediator on fatigue after cancer treatment. These findings highlight that both appraisals are understudied and open new perspectives regarding treatment strategies in BCS.

Skeletal muscle changes in the first three months of stroke recovery: a systematic review

Abstract: Background Rehabilitation is important in the first months after a stroke for recovery of functional ability, but it is also challenging, since distinct recovery trajectories are seen. Therefore, studying the early changes in muscle characteristics over time (e.g. muscle strength, muscle mass and muscle volume), which are known to be associated with functional abilities, may deepen our understanding of underlying recovery mechanisms of stroke survivors. Objective This systematic review aims to describe the longitudinal changes in skeletal muscles, including muscle strength, muscle mass and muscle volume, during the first 3 months post-stroke. Methods Electronic searches were conducted in Medline, Scopus and CENTRAL. Longitudinal cohort studies or controlled interventional trials that report data about patients in the first 3 months after stroke were identified. Skeletal muscle characteristics should be measured at least twice within 3 months post-stroke by objective, quantitative assessment methods (e.g. dynamometry, ultrasound, computed tomography). Effect sizes were calculated as Hedges’ g using standardized mean differences. Results A total of 38 studies (1,097 subjects) were found eligible. Results revealed an mean increase on the paretic side for upper and lower limb muscle strength (small to moderate effect sizes), whereas muscle thickness decreased (moderate to large effect sizes). Similar, but smaller, effects were found on the non-paretic side. There were insufficient data available to draw conclusions about lean muscle mass and muscle cross-sectional area. No studies aimed at investigating distinct trajectories of the muscle changes. Conclusion Muscle strength and thickness changes during the first 3 months after stroke in both the paretic and non-paretic side. Future studies should aim to understand “how” the stroke-induced muscle strength changes are achieved. Exploring existing data from longitudinal studies, by using cluster analyses, such as pattern recognition, could add to the current knowledge-base. LAY ABSTRACT After a stroke, it is important to restore functional ability as much as possible. Studying changes in the muscles (e.g. muscle strength, muscle thickness, muscle volume) during the first months post-stroke can help to elucidate individual variations and the underlying repair mechanisms. A systematic search of the literature was performed for studies of objective quantifiable measurements of muscles at least 2 times during the first 3 months after stroke. A total of 38 studies (with in total 1,097 patients) met these criteria. Overall, an improvement in strength was measured on the paretic side for both the upper and lower limbs, but muscle thickness decreased. Similar, but smaller, effects were found on the non-paretic side. For other muscle parameters insufficient data were found to draw conclusions. Because understanding the underlying mechanism of muscle changes post-stroke can improve rehabilitation programmes, further studies should focus on why these muscle strength changes occur.

Most amateur football teams do not implement essential components of neuromuscular training to prevent anterior cruciate ligament injuries and lateral ankle sprains

Abstract: Neuromuscular training (NMT) is effective at reducing football injuries. The purpose of this study was to document the use of NMT to prevent anterior cruciate ligament injuries and lateral ankle sprains in adult amateur football and to identify barriers for using NMT.A preseason and in-season online survey was completed by players and coaches of 164 football teams. The survey contained questions concerning injury history, type and frequency of NMT, and barriers when NMT was not used.A total of 2013 players (40% female) and 180 coaches (10% female) completed the preseason survey, whereas 1253 players and 140 coaches completed the in-season survey. Thirty-four percent (preseason) to 21% (in-season) of players used NMT, but only 8% (preseason) to 5% (in-season) performed adequate NMT (i.e. both balance and plyometric exercises, at least twice per week). In the subpopulation of players with an injury history, 12% (preseason) and 7% (in-season) performed adequate NMT. With respect to the coaches, only 5% (preseason) and 2% (in-season) implemented adequate NMT. Most important barriers for using NMT for both players and coaches were a lack of belief in its effectiveness, a lack of knowledge, the belief that stretching is sufficient, and not feeling the need for it.Most amateur football teams do not implement essential components of NMT. The results highlight the urgent need for developing strategies to enhance the adequate use of NMT in amateur football.II.

Exoskeletons in MS rehabilitation are ready for widespread use in clinical practice: No

Abstract: David Beckwée Rehabilitation Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium/Brussels Human Robotics Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium/Frailty in Ageing Research Department, Vrije Universiteit Brussel, Brussels, Belgium/Research Group MOVANT, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium Multiple Sclerosis Journal

PSiM IV – Pain Practice

Abstract: PSiM IV – Pain Practice Investigating shortterm habituation to pain with FMRI – A protocol integrating selfreport, block and trialbytrial analyses MM van der Miesen; AL Kaas; CJ Vossen; EA Joosten; DEJ Linden; JC Peters Department of Anesthesiology and Pain Management, School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands; Department of Cognitive Neuroscience, Maastricht University, Maastricht, The Netherlands; Department of Anesthesiology, Maastricht University Medical Centre, Maastricht, The Netherlands; School of Mental Health and Neuroscience, Maastricht University, Maastricht,

Perceived injustice in cancer survivors: an exploration and a population-specific cut-off score

Abstract: Background: In the survival stage after cancer, fatigue and pain are the most occurring side effects. Both impact cancer survivors’ daily life and quality of life. New insights recently showed that perceived injustice might play a substantial role in these side effects. Up to now, less is known about perceived injustice in cancer survivors. Furthermore, no cancer survivors’ specific cut-off is available, making further research difficult.

The effect of behavioral graded activity on physical activity level, health-related quality of life, and symptom management in cancer patients and survivors: systematic review and meta-analysis

Abstract: Background: In past years, behavioral graded activity (BGA) has demonstrated positive effects on debilitating symptoms, physical functioning, and pain in chronic pain populations, and appears foremost in cognitive behavioral therapy or other psychological informed practices (PIP). Up to now, no systematic review has been published about the effect of BGA on different biopsychosocial outcomes within cancer populations. Therefore, this systematic review and meta-analysis determined the effectiveness of PIP with BGA compared to (1) waitlists (WL), (2) usual care (UC), (3) PIP alone, or (4) BGA alone in cancer patients and survivors (CPaS). Material and methods: PubMed, Web of Science, and Embase were systematically screened for randomized controlled trials encompassing BGA (e.g., graded activity, graded exercise, operant conditioning) and PIP (e.g., acceptance commitment therapy, behavior strategies, cognition therapy, cognitive behavioral therapy) in CPaS. Effect sizes were inventoried for outcomes regarding physical activity, quality of life (QoL), and debilitating symptoms. The quality of the evidence was classified by the GRADE approach. Subgroup analyses were undertaken based on the methodological quality and quality of the given BGA to reduce heterogeneity (I2 > 50%). Results: Thirty-three studies were found eligible (n = 4,330). Significant effects of PIP+BGA comparing to WL were found for anxiety (SMD:−1.29 [−1.71;−0.86], I2 = 0%), fatigue (SMD:−0.86[−1.18;−0.54], I2 = 61%), depression (SMD:−0.79[−1.10;−0.48], I2 = 0%), functional impairment (SMD:−0.72[−0.95;−0.50], I2 = 0%), psychological distress (SMD:−0.58 [−0.82;−0.34], I2 = 51%), physical activity (self-reported SMD:−0.58[−0.84; −0.32], I2 = 47% and objectively measured SMD:−0.51[−0.90;−0.13], I2 = 0%), QoL (SMD:−0.38[−0.68;−0.09], I2 = 51%), social impairment (SMD: −0.33[−0.58;−0.08], I2 = 0%) and only the psychological distress (SMD: −0.89[−1.76;−0.02], I2 = 82%) remained significantly after 1 to 3 months. When comparing PIP+BGA to UC, significant effects were found for anxiety (SMD:−0.47[−0.88;−0.06], I2 = 83%), depression (SMD:−0.46[−0.84; −0.09], I2 = 82%), fatigue (SMD:−0.35[−0.51;−0.20], I2 = 48%), and physical activity (SMD:−0.26[−0.41;−0.11], I2 = 44%). After 1 to 3 months, anxiety (SMD:−1.54[−2.88;−0.21], I2 = 87%), depression (SMD:−1.43[−2.46; −0.39], I2 = 89%)and fatigue (SMD:−0.34[−0.58;−0.10], I2 = 47%)remained significantly. These significant effects were not observed in the meta-analyses of studies comparing PIP+BGA to BGA or PIP alone. Conclusions: PIP with BGA had a favorable effect on debilitating symptoms, physical activity, and QoL in CPaS when compared to no interventions and usual care. However, further research is needed on ‘how’ and ‘when’ BGA should be provided in cancer rehabilitation. No conflict of interest.

The effect of prehabilitation in cancer patients: systematic review and meta-analysis

Abstract: Background: Recently, prehabilitation (i.e., “a process on the cancer continuum of care that occurs between the time of cancer diagnosis and the beginning of treatment”) gained noteworthy acceptance in the field of oncology. Therefore, this systematic review with meta-analysis aimed to evaluate the effect of prehabilitation in patients with breast, colon, lung, and prostate cancer on biopsychosocial outcomes before and after cancer treatment.

Do psychological factors relate to movement-evoked pain in people with musculoskeletal pain? A systematic review and meta-analysis.

Abstract: A growing body of evidence has demonstrated the importance of implementing movement-evoked pain in conventional pain assessments, with a significant role for psychological factors being suggested. Whether or not to include these factors in the assessment of movement-evoked pain has not yet been determined. The aim of this systematic review is to explore the association between psychological factors and movement-evoked pain scores in people with musculoskeletal pain. For this systematic review with meta-analysis, four electronic databases (PubMed, Medline, WOS, and Scopus) were searched. Cross-sectional studies, longitudinal cohort studies, and randomized controlled trials investigating the association between movement-evoked pain and psychological factors in adults with musculoskeletal pain were considered. Meta-analysis was conducted for outcomes with homogeneous data from at least 2 studies. Fischer-Z transformations were used as the measure of effect. Quality of evidence was assessed using the National Institutes of Health's Quality assessment tool for observational cohort and cross-sectional studies and Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Meta-analyses and grading the quality of evidence revealed moderate evidence for a relation between movement-evoked pain and depressive symptoms (Fisher-z=0.27; 95%CI: 0.17, 0.36; 5 studies (n=440)), pain-related fear (Fisher-z=0.35; 95%CI: 0.26, 0.44; 6 studies (n=492)), and pain catastrophizing (Fisher-z=0.47; 95%CI: 0.36, 0.58; 4 studies (n=312)) in people with musculoskeletal pain. Movement-evoked pain is weakly to moderately associated to depressive symptoms, pain-related fear, and pain catastrophizing in people with musculoskeletal pain.