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Baseline pain characteristics predict pain reduction after physical therapy in women with chronic pelvic pain. Secondary analysis of data from a randomized controlled trial.

Author: HaugstadGro K, NygaardAne S, StedenfeldtMona, WilsgaardTom, ØianPål

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Overview

Background and aims Women with chronic pelvic pain represent a heterogeneous group, and it is suggested that the existence of sub-groups can explain varying results and inconclusiveness in clinical trials. Some predictors of treatment outcome are suggested, but the evidence is limited. The primary aim of this study was to explore if selected pre-treatment characteristics of the participants in a recently conducted randomized controlled trial were associated with treatment outcome. Methods In this study secondary analysis of data collected in a randomized trial were conducted. The participants were women with chronic pelvic pain randomized to two different physical therapy treatments. Analyses in this study were performed for the whole group as a cohort. The primary outcome measure was change in pain intensity from baseline to 12 months, measured with the numeric rating scale (0-10). The women were asked to rate their mean pelvic pain intensity during the last 7 days. Based on previous research and on available variables from the randomized controlled trial four potential predictive factors were derived from the baseline data and assessed one by one in a linear regression model, adjusted for age and treatment group. The variables with strongest association (p < 0.10) with the primary outcome were further included in a multivariable linear regression model with backward selection, adjusted for age and treatment group. Results Fifty women (mean age 38.1, SD = 12.2) were included in the analysis. For these women the mean change in pain intensity was -1.2 points (95% CI -1.8 to -0.7) from baseline to 12 months. The multivariable regression model showed that pelvic pain duration of 6 years or more was associated with less decrease in pain intensity with a regression coefficient of 1.3 (95% CI 0.3-2.4). Baseline pain intensity was associated with higher pain reduction after PT treatment with a regression coefficient per SD increase in baseline pain of -0.6 (95% CI -1.1 to -0.1). None of the women with main pain site other places than in the pelvis reported any pain reduction after physical therapy treatment, but due to the small numbers the predictor was not included in the regression analysis. Conclusions We identified that pelvic pain duration of 6 years or more was associated with less pain reduction, and that higher baseline pain intensity was associated with higher pain reduction after physical therapy treatment in this sample of women with chronic pelvic pain. For the variable main pain site other places than the pelvis the results are unsure due to small numbers. Implications Based on our finding of long pain duration as a negative predictor for pain reduction, we emphasize that early intervention is important. Many of the participants in our RCT reported pelvic surgeries or other treatments prior to referral for PT, and we suggest that referral to a non-invasive intervention such as PT should be considered at an earlier stage. In order to tailor interventions to the individual women's needs, thorough baseline assessments, preferably in a multidisciplinary setting, should be performed.
Paper Details　
Original Abstract of the Article :
Background and aims Women with chronic pelvic pain represent a heterogeneous group, and it is suggested that the existence of sub-groups can explain varying results and inconclusiveness in clinical trials. Some predictors of treatment outcome are suggested, but the evidence is limited. The primary a...See full text at original site
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引用元：
https://pubmed.ncbi.nlm.nih.gov/32609653

データ提供：米国国立医学図書館（NLM）

Predicting Success in Chronic Pelvic Pain Treatment

Chronic pelvic pain (CPP) is a complex and often debilitating condition that can significantly impact a woman's quality of life. This study explores the potential of baseline pain characteristics to predict pain reduction after physical therapy, offering valuable insights into the heterogeneity of CPP and the factors that influence treatment outcomes.

Unraveling the Mysteries of Chronic Pelvic Pain

The study reveals that longer pain duration is associated with less pain reduction after physical therapy, while higher baseline pain intensity is associated with greater pain reduction. This finding suggests that early intervention may be crucial for achieving successful treatment outcomes. It's like navigating a desert with hidden paths, where early intervention can lead to a smoother and more successful journey towards pain relief.

Navigating the Complexities of Chronic Pelvic Pain

This research highlights the importance of considering individual patient characteristics, particularly pain duration and intensity, when designing treatment plans for CPP. It underscores the need for multidisciplinary approaches that address the unique needs of each patient. This knowledge empowers healthcare professionals to provide more effective and personalized care for women suffering from CPP.

Dr. Camel's Conclusion

This study delves into the complexities of chronic pelvic pain (CPP), revealing potential predictors of treatment success. It emphasizes the importance of early intervention and personalized treatment approaches, considering factors like pain duration and intensity. This research is like a compass, guiding us towards a more effective and tailored approach to managing CPP, ensuring a smoother journey towards pain relief for women navigating this challenging condition.

Date :
  1. Date Completed 2021-09-14
  2. Date Revised 2021-09-14
Further Info :

Pubmed ID

32609653

DOI: Digital Object Identifier

sjpain-2020-0026

Related Literature

Article Analysis
・Effective treatment of pelvic pain
SNS
PICO Info
in preparation
Languages

English

Positive IndicatorAn AI analysis index that serves as a benchmark for how positive the results of the study are. Note that it is a benchmark and requires careful interpretation and consideration of different perspectives.

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