Does Systematic Graded Exposure In Vivo Enhance Outcomes in Multidisciplinary Chronic Pain Management Groups?
OBJECTIVESGraded exposure in vivo (GEXP) treatment has been successfully used to reduce levels of pain-related fear and disability in some chronic pain patients, but its effectiveness has not been evaluated in general clinical settings using group-design studies. The purpose of this study was to det...
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| Veröffentlicht in: | The Clinical journal of pain 2007-05, Vol.23 (4), p.361-374 |
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| container_title | The Clinical journal of pain |
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| creator | Bliokas, Vida V Cartmill, Tania K Nagy, Barbara J |
| description | OBJECTIVESGraded exposure in vivo (GEXP) treatment has been successfully used to reduce levels of pain-related fear and disability in some chronic pain patients, but its effectiveness has not been evaluated in general clinical settings using group-design studies. The purpose of this study was to determine if the systematic incorporation of GEXP into a multidisciplinary chronic pain management group (PMG) treatment program would result in better treatment outcomes than usual PMG treatment.
METHODSOne hundred forty-three chronic pain patients who were assessed as suitable for an outpatient multidisciplinary chronic PMG program were randomly allocated to 3 experimental conditions; usual PMG, PMG incorporating systematic graded exposure, and wait-list control.
RESULTSThe clinical outcomes of the 2 treatment conditions were not significantly different, suggesting that the systematic incorporation of GEXP into a multidisciplinary PMG program did not result in better treatment outcomes than usual PMG treatment. Both group treatment programs were associated with significant treatment effects when compared with the wait-list control on measures of pain intensity, fear of movement/(re)injury, pain self-efficacy, activity level, and depression. No treatment effects were found on self-report measures of pain disability or anxiety.
DISCUSSIONThe addition of systematic graded exposure into a multidisciplinary chronic pain management program did not result in better clinical outcomes than the usual group treatment program. The validity of GEXP to the broader population of chronic pain patients warrants further investigation. |
| doi_str_mv | 10.1097/AJP.0b013e31803685dc |
| format | Article |
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METHODSOne hundred forty-three chronic pain patients who were assessed as suitable for an outpatient multidisciplinary chronic PMG program were randomly allocated to 3 experimental conditions; usual PMG, PMG incorporating systematic graded exposure, and wait-list control.
RESULTSThe clinical outcomes of the 2 treatment conditions were not significantly different, suggesting that the systematic incorporation of GEXP into a multidisciplinary PMG program did not result in better treatment outcomes than usual PMG treatment. Both group treatment programs were associated with significant treatment effects when compared with the wait-list control on measures of pain intensity, fear of movement/(re)injury, pain self-efficacy, activity level, and depression. No treatment effects were found on self-report measures of pain disability or anxiety.
DISCUSSIONThe addition of systematic graded exposure into a multidisciplinary chronic pain management program did not result in better clinical outcomes than the usual group treatment program. The validity of GEXP to the broader population of chronic pain patients warrants further investigation.</description><identifier>ISSN: 0749-8047</identifier><identifier>EISSN: 1536-5409</identifier><identifier>DOI: 10.1097/AJP.0b013e31803685dc</identifier><identifier>PMID: 17449998</identifier><identifier>CODEN: CJPAEU</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins, Inc</publisher><subject>Activities of Daily Living ; Analgesics ; Analysis of Variance ; Anxiety ; Biological and medical sciences ; Chronic Disease ; Combined Modality Therapy ; Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction ; Depression - etiology ; Desensitization, Psychologic - methods ; Disability Evaluation ; Double-Blind Method ; Fear ; Female ; Follow-Up Studies ; Fundamental and applied biological sciences. Psychology ; Humans ; Male ; Medical sciences ; Nervous system (semeiology, syndromes) ; Neurology ; Neuropharmacology ; Pain - psychology ; Pain - rehabilitation ; Pain Clinics ; Pain Measurement - methods ; Pharmacology. Drug treatments ; Retrospective Studies ; Somesthesis and somesthetic pathways (proprioception, exteroception, nociception); interoception; electrolocation. Sensory receptors ; Treatment Outcome ; Vertebrates: nervous system and sense organs</subject><ispartof>The Clinical journal of pain, 2007-05, Vol.23 (4), p.361-374</ispartof><rights>2007 Lippincott Williams & Wilkins, Inc.</rights><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4051-d962d80944673b0a5253c4689ad954f95c146a89d3a70f6d02d7530be9dc65de3</citedby><cites>FETCH-LOGICAL-c4051-d962d80944673b0a5253c4689ad954f95c146a89d3a70f6d02d7530be9dc65de3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18700622$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17449998$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bliokas, Vida V</creatorcontrib><creatorcontrib>Cartmill, Tania K</creatorcontrib><creatorcontrib>Nagy, Barbara J</creatorcontrib><title>Does Systematic Graded Exposure In Vivo Enhance Outcomes in Multidisciplinary Chronic Pain Management Groups?</title><title>The Clinical journal of pain</title><addtitle>Clin J Pain</addtitle><description>OBJECTIVESGraded exposure in vivo (GEXP) treatment has been successfully used to reduce levels of pain-related fear and disability in some chronic pain patients, but its effectiveness has not been evaluated in general clinical settings using group-design studies. The purpose of this study was to determine if the systematic incorporation of GEXP into a multidisciplinary chronic pain management group (PMG) treatment program would result in better treatment outcomes than usual PMG treatment.
METHODSOne hundred forty-three chronic pain patients who were assessed as suitable for an outpatient multidisciplinary chronic PMG program were randomly allocated to 3 experimental conditions; usual PMG, PMG incorporating systematic graded exposure, and wait-list control.
RESULTSThe clinical outcomes of the 2 treatment conditions were not significantly different, suggesting that the systematic incorporation of GEXP into a multidisciplinary PMG program did not result in better treatment outcomes than usual PMG treatment. Both group treatment programs were associated with significant treatment effects when compared with the wait-list control on measures of pain intensity, fear of movement/(re)injury, pain self-efficacy, activity level, and depression. No treatment effects were found on self-report measures of pain disability or anxiety.
DISCUSSIONThe addition of systematic graded exposure into a multidisciplinary chronic pain management program did not result in better clinical outcomes than the usual group treatment program. The validity of GEXP to the broader population of chronic pain patients warrants further investigation.</description><subject>Activities of Daily Living</subject><subject>Analgesics</subject><subject>Analysis of Variance</subject><subject>Anxiety</subject><subject>Biological and medical sciences</subject><subject>Chronic Disease</subject><subject>Combined Modality Therapy</subject><subject>Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction</subject><subject>Depression - etiology</subject><subject>Desensitization, Psychologic - methods</subject><subject>Disability Evaluation</subject><subject>Double-Blind Method</subject><subject>Fear</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Neuropharmacology</subject><subject>Pain - psychology</subject><subject>Pain - rehabilitation</subject><subject>Pain Clinics</subject><subject>Pain Measurement - methods</subject><subject>Pharmacology. Drug treatments</subject><subject>Retrospective Studies</subject><subject>Somesthesis and somesthetic pathways (proprioception, exteroception, nociception); interoception; electrolocation. Sensory receptors</subject><subject>Treatment Outcome</subject><subject>Vertebrates: nervous system and sense organs</subject><issn>0749-8047</issn><issn>1536-5409</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkF9rFDEUxYModq1-A5F5sW9TbybJJHmSsq610tKCf15DNrnjjmYmYzLT2m9vShcWGgjhkt85995DyFsKpxS0_HD29eYUtkAZMqqAtUp494ysqGBtLTjo52QFkutaAZdH5FXOvwGoaBS8JEdUcq61VisyfIqYq2_3ecbBzr2rzpP16KvNvynmJWF1MVY_-9tYbcadHR1W18vs4lA0_VhdLWHufZ9dP4V-tOm-Wu9SHIvLjX34tqP9hQOOc3GNy5Q_viYvOhsyvtm_x-TH58339Zf68vr8Yn12WTsOgtZet41XoDlvJduCFY1gjrdKW68F77RwlLdWac-shK710HgpGGxRe9cKj-yYnDz6Tin-XTDPZihTYgh2xLhkI6H04YwWkD-CLsWcE3ZmSv1QNjEUzEPMpsRsnsZcZO_2_st2QH8Q7XMtwPs9YLOzoUsluz4fOCUB2qY59L-LYcaU_4TlDpPZoQ3zzkA5jQBVNwASRKnqcill_wFog5ZB</recordid><startdate>200705</startdate><enddate>200705</enddate><creator>Bliokas, Vida V</creator><creator>Cartmill, Tania K</creator><creator>Nagy, Barbara J</creator><general>Lippincott Williams & Wilkins, Inc</general><general>Lippincott Williams and Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200705</creationdate><title>Does Systematic Graded Exposure In Vivo Enhance Outcomes in Multidisciplinary Chronic Pain Management Groups?</title><author>Bliokas, Vida V ; Cartmill, Tania K ; Nagy, Barbara J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4051-d962d80944673b0a5253c4689ad954f95c146a89d3a70f6d02d7530be9dc65de3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Activities of Daily Living</topic><topic>Analgesics</topic><topic>Analysis of Variance</topic><topic>Anxiety</topic><topic>Biological and medical sciences</topic><topic>Chronic Disease</topic><topic>Combined Modality Therapy</topic><topic>Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction</topic><topic>Depression - etiology</topic><topic>Desensitization, Psychologic - methods</topic><topic>Disability Evaluation</topic><topic>Double-Blind Method</topic><topic>Fear</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Neuropharmacology</topic><topic>Pain - psychology</topic><topic>Pain - rehabilitation</topic><topic>Pain Clinics</topic><topic>Pain Measurement - methods</topic><topic>Pharmacology. Drug treatments</topic><topic>Retrospective Studies</topic><topic>Somesthesis and somesthetic pathways (proprioception, exteroception, nociception); interoception; electrolocation. Sensory receptors</topic><topic>Treatment Outcome</topic><topic>Vertebrates: nervous system and sense organs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bliokas, Vida V</creatorcontrib><creatorcontrib>Cartmill, Tania K</creatorcontrib><creatorcontrib>Nagy, Barbara J</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Clinical journal of pain</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bliokas, Vida V</au><au>Cartmill, Tania K</au><au>Nagy, Barbara J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does Systematic Graded Exposure In Vivo Enhance Outcomes in Multidisciplinary Chronic Pain Management Groups?</atitle><jtitle>The Clinical journal of pain</jtitle><addtitle>Clin J Pain</addtitle><date>2007-05</date><risdate>2007</risdate><volume>23</volume><issue>4</issue><spage>361</spage><epage>374</epage><pages>361-374</pages><issn>0749-8047</issn><eissn>1536-5409</eissn><coden>CJPAEU</coden><abstract>OBJECTIVESGraded exposure in vivo (GEXP) treatment has been successfully used to reduce levels of pain-related fear and disability in some chronic pain patients, but its effectiveness has not been evaluated in general clinical settings using group-design studies. The purpose of this study was to determine if the systematic incorporation of GEXP into a multidisciplinary chronic pain management group (PMG) treatment program would result in better treatment outcomes than usual PMG treatment.
METHODSOne hundred forty-three chronic pain patients who were assessed as suitable for an outpatient multidisciplinary chronic PMG program were randomly allocated to 3 experimental conditions; usual PMG, PMG incorporating systematic graded exposure, and wait-list control.
RESULTSThe clinical outcomes of the 2 treatment conditions were not significantly different, suggesting that the systematic incorporation of GEXP into a multidisciplinary PMG program did not result in better treatment outcomes than usual PMG treatment. Both group treatment programs were associated with significant treatment effects when compared with the wait-list control on measures of pain intensity, fear of movement/(re)injury, pain self-efficacy, activity level, and depression. No treatment effects were found on self-report measures of pain disability or anxiety.
DISCUSSIONThe addition of systematic graded exposure into a multidisciplinary chronic pain management program did not result in better clinical outcomes than the usual group treatment program. The validity of GEXP to the broader population of chronic pain patients warrants further investigation.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>17449998</pmid><doi>10.1097/AJP.0b013e31803685dc</doi><tpages>14</tpages></addata></record> |
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| subjects | Activities of Daily Living Analgesics Analysis of Variance Anxiety Biological and medical sciences Chronic Disease Combined Modality Therapy Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction Depression - etiology Desensitization, Psychologic - methods Disability Evaluation Double-Blind Method Fear Female Follow-Up Studies Fundamental and applied biological sciences. Psychology Humans Male Medical sciences Nervous system (semeiology, syndromes) Neurology Neuropharmacology Pain - psychology Pain - rehabilitation Pain Clinics Pain Measurement - methods Pharmacology. Drug treatments Retrospective Studies Somesthesis and somesthetic pathways (proprioception, exteroception, nociception) interoception electrolocation. Sensory receptors Treatment Outcome Vertebrates: nervous system and sense organs |
| title | Does Systematic Graded Exposure In Vivo Enhance Outcomes in Multidisciplinary Chronic Pain Management Groups? |
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