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PLoS One. 2015 Apr 28;10(4):e0123008. doi: 10.1371/journal.pone.0123008. eCollection 2014.

Are pain-related fears mediators for reducing disability and pain in patients with complex regional pain syndrome type 1? An explorative analysis on pain exposure physical therapy.

Author information

1
Scientific Institute for Quality of Healthcare, Radboud university medical center, Nijmegen, The Netherlands.
2
Department of Anaesthesiology, Pain and Palliative Care, Radboud university medical center, Nijmegen, The Netherlands.
3
Department of Surgery, Radboud university medical center, Nijmegen, The Netherlands.
4
Department of Orthopaedics, Section Physical Therapy, Radboud university medical center, Nijmegen, The Netherlands.
5
Department of Rehabilitation, Radboud university medical center, Nijmegen, The Netherlands.
6
Department of Medical Psychology, Radboud university medical center, Nijmegen, The Netherlands.
7
Scientific Institute for Quality of Healthcare, Radboud university medical center, Nijmegen, The Netherlands; Department of Rehabilitation, Radboud university medical center, Nijmegen, The Netherlands.

Abstract

OBJECTIVE:

To investigate whether pain-related fears are mediators for reducing disability and pain in patients with Complex Regional Pain Syndrome type 1 when treating with Pain Exposure Physical Therapy.

DESIGN:

An explorative secondary analysis of a randomised controlled trial.

PARTICIPANTS:

Fifty-six patients with Complex Regional Pain Syndrome type 1.

INTERVENTIONS:

The experimental group received Pain Exposure Physical Therapy in a maximum of five treatment sessions; the control group received conventional treatment following the Dutch multidisciplinary guideline.

OUTCOME MEASURES:

Levels of disability, pain, and pain-related fears (fear-avoidance beliefs, pain catastrophizing, and kinesiophobia) were measured at baseline and after 3, 6, and 9 months follow-up.

RESULTS:

The experimental group had a significantly larger decrease in disability of 7.77 points (95% CI 1.09 to 14.45) and in pain of 1.83 points (95% CI 0.44 to 3.23) over nine months than the control group. The potential mediators pain-related fears decreased significantly in both groups, but there were no significant differences between groups, which indicated that there was no mediation.

CONCLUSION:

The reduction of pain-related fears was comparable in both groups. We found no indication that pain-related fears mediate the larger reduction of disability and pain in patients with Complex Regional Pain Syndrome type 1 treated with Pain Exposure Physical Therapy compared to conventional treatment.

TRIAL REGISTRATION:

International Clinical Trials Registry NCT00817128.

PMID:
25919011
PMCID:
PMC4412526
DOI:
10.1371/journal.pone.0123008
[Indexed for MEDLINE]
Free PMC Article

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