0000000000235279
AUTHOR
Enrique Lluch Girbés
showing 12 related works from this author
Addressing sleep problems and cognitive dysfunctions in comprehensive rehabilitation for chronic musculoskeletal pain
2015
Comment on Sleep, pain and exercise: An integrative perspective on neuroscience education: Comments on article titled "Exercise therapy for chronic musculoskeletal pain: Innovation by altering pain memories". [Man Ther. 2015] Exercise therapy for chronic musculoskeletal pain: Innovation by altering pain memories. [Man Ther. 2015]
Expanded Distribution of Pain as a Sign of Central Sensitization in Individuals With Symptomatic Knee Osteoarthritis.
2016
AbstractBackgroundExpanded distribution of pain is considered a sign of central sensitization (CS). The relationship between recording of symptoms and CS in people with knee osteoarthritis (OA) has been poorly investigated.ObjectiveThe aim of this study was to examine whether the area of pain assessed using pain drawings relates to CS and clinical symptoms in people with knee OA.DesignThis was a cross-sectional study.MethodsFifty-three people with knee OA scheduled to undergo primary total knee arthroplasty were studied. All participants completed pain drawings using a novel digital device, completed self-administration questionnaires, and were assessed by quantitative sensory testing. Pain…
Pain Neurophysiology Education and Therapeutic Exercise for Patients With Chronic Low Back Pain: A Single-Blind Randomized Controlled Trial.
2018
Abstract: Objective To assess the effect of a pain neurophysiology education (PNE) program plus therapeutic exercise (TE) for patients with chronic low back pain (CLBP). Design Single-blind randomized controlled trial. Setting Private clinic and university. Participants Patients with CLBP for ≥6 months (N=56). Interventions Participants were randomized to receive either a TE program consisting of motor control, stretching, and aerobic exercises (n=28) or the same TE program in addition to a PNE program (n=28), conducted in two 30- to 50-minute sessions in groups of 4 to 6 participants. Main Outcomes Measures The primary outcome was pain intensity rated on the numerical pain rating scale whi…
Benefits and Threats to Using Social Media for Presenting and Implementing Evidence.
2018
As a potential high-yield tool for disseminating information that can reach many people, social media is transforming how clinicians, the public, and policy makers are educated and find new knowledge associated with research-related information. Social media is available to all who access the internet, reducing selected barriers to acquiring original source documents such as journal articles or books and potentially improving implementation-the process of formulating a conclusion and moving on that decision. The use of social media for evidence dissemination/implementation of research has both benefits and threats. It is the aim of this Viewpoint to provide a balanced view of each. J Orthop…
Exercise therapy for chronic musculoskeletal pain: Innovation by altering pain memories.
2015
Even though nociceptive pathology has often long subsided, the brain of patients with chronic musculoskeletal pain has typically acquired a protective (movement-related) pain memory. Exercise therapy for patients with chronic musculoskeletal pain is often hampered by such pain memories. Here the authors explain how musculoskeletal therapists can alter pain memories in patients with chronic musculoskeletal pain, by integrating pain neuroscience education with exercise interventions. The latter includes applying graded exposure in vivo principles during exercise therapy, for targeting the brain circuitries orchestrated by the amygdala (the memory of fear centre in the brain). Before initiatin…
Pain Treatment for patients with osteoarthritis and central sensitization
2013
Osteoarthritis is one of the most frequent, disabling, and costly pathologies of modern society. Among the main aims of osteoarthritis management are pain control and functional ability improvement. The exact cause of osteoarthritis pain remains unclear. In addition to the pathological changes in articular structures, changes in central pain processing or central sensitization appear to be involved in osteoarthritis pain. The latter calls for a broader approach to the management of patients with osteoarthritis. Yet, the scientific literature offers scant information addressing the treatment of central sensitization, specifically in patients with osteoarthritis. Interventions such as cogniti…
Do sex and pain characteristics influence the effectiveness of pain neuroscience education in people scheduled for total knee arthroplasty? Secondary…
2021
Abstract Objective This explorative study investigates the moderating effect of sex and baseline pain characteristics on the effectiveness of preoperative pain neuroscience education (PNE) plus knee joint mobilization versus biomedical education plus knee joint mobilization in patients who have knee osteoarthritis and are scheduled to undergo total knee arthroplasty (TKA). Methods After baseline assessment of self-reported questionnaires (pain intensity, disability, symptoms of central sensitization and pain cognitions) and quantitative sensory testing, 44 participants with knee osteoarthritis were randomized into the PNE plus knee joint mobilization or biomedical education plus knee joint …
Endocrine response after cervical manipulation and mobilization in people with chronic mechanical neck pain: a randomized controlled trial
2019
BACKGROUND: Most of the research on the effects of spinal manipulation on endocrine function has been done on healthy subjects and has yielded contradictory results. The potential role of cervical manual therapy intervention in order to induce changes in the endocrine system has not yet been investigated. AIM: The aim of this trial is to compare the effects on salivary cortisol levels and clinical outcomes of cervical manipulation versus cervical mobilization or sham manipulation in patients with chronic mechanical neck pain. DESIGN: Randomized controlled trial. SETTING: University of Alcala de Henares: outpatient (referrals from office workers). POPULATION: A total of 83 patients with chro…
How much Is needed? Comparison of the effectiveness of different pain education dosages in patients with fibromyalgia
2019
AbstractObjectiveTo assess the effect of different dosages of pain neuroscience education (PNE) programs on central nociceptive processing in patients with fibromyalgia. Second, to compare the effects of different dosages of PNE programs on numerical pain rating scale (NPRS), disability, and psychological variables.DesignSingle-blind randomized controlled trial.SettingThree fibromyalgia centers in Spain (Valencia, Alcorcón, Alcalá de Henares).SubjectsSeventy-seven patients with fibromyalgia.MethodsParticipants were randomized to four groups of PNE: 1) high-dose PNE (N = 20), 2) low–concentrated dose PNE (N = 20), 3) diluted low-dose PNE (N = 20), and (4) control treatment (N = 17), conducte…
Applying Modern Pain Neuroscience in Clinical Practice: Criteria for the Classification of Central Sensitization Pain
2014
Background: The awareness is growing that central sensitization is of prime importance for the assessment and management of chronic pain, but its classification is challenging clinically since no gold standard method of assessment exists. Objectives: Designing the first set of classification criteria for the classification of central sensitization pain. Methods: A body of evidence from original research papers was used by 18 pain experts from 7 different countries to design the first classification criteria for central sensitization pain. Results: It is proposed that the classification of central sensitization pain entails 2 major steps: the exclusion of neuropathic pain and the differentia…
The Influence of Treatment Expectations on Clinical Outcomes and Cortisol Levels in Patients With Chronic Neck Pain: An Experimental Study
2019
Background The role of contextual factors like pre‐existing treatment expectations has been established. However, the effect of verbally delivered treatment expectations in patient–therapist communication has not been considered, nor has the role of cortisol changes within the placebo/nocebo response in people with chronic neck pain. Objective To examine the effect of verbally delivered treatment expectations on clinical outcomes in physical therapy practice and to determine if changes in cortisol levels are associated with changes in neck pain and disability. Methods Eighty‐three patients with chronic neck pain were randomly allocated to 3 different verbally delivered expectations (positiv…
Low Back Pain: Guidelines for the Clinical Classification of Predominant Neuropathic, Nociceptive, or Central Sensitization Pain
2015
Background: Low back pain (LBP) is a heterogeneous disorder including patients with dominant nociceptive (e.g., myofascial low back pain), neuropathic (e.g., lumbar radiculopathy), and central sensitization pain. In order to select an effective and preferably also efficient treatment in daily clinical practice, LBP patients should be classified clinically as either predominantly nociceptive, neuropathic, or central sensitization pain. Objective: To explain how clinicians can differentiate between nociceptive, neuropathic, and central sensitization pain in patients with LBP. Study Design: Narrative review and expert opinion. Setting: Universities, university hospitals and private practices. …