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      Physical functioning and mindfulness skills training in chronic pain: a systematic review

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          Abstract

          Purpose

          The importance of improved physical function as a primary outcome in the treatment of chronic pain is widely accepted. There have been limited attempts to assess the effects mindfulness skills training (MST) has on objective outcomes in chronic pain care.

          Methods

          This systematic review evaluated published reports of original randomized controlled trials that described physical function outcomes after MST in the chronic pain population and met methodological quality according to a list of predefined criteria. PRISMA criteria were used to identify and select studies, and assess their eligibility for inclusion. The established guidelines for best practice of systematic reviews were followed to report the results.

          Results

          Of the 2,818 articles identified from the original search of four electronic databases, inclusionary criteria were met by 15 studies published as of August 10, 2015, totaling 1,199 patients. All included studies used self-report measures of physical function, and only two studies also employed performance-based measures of function. There were wide variations in how physical function was conceptualized and measured. Although the quality of the studies was rated as high, there was inconclusive evidence for improvement in physical function assessed by self-report due to contradiction in individual study findings and the measures used to assess function. Strong evidence for lack of improvement in physical function assessed via performance-based measures was found.

          Conclusion

          This review draws attention to the importance of having a unified approach to how physical function is conceptualized and assessed, as well as the importance of using quality performance-based measures in addition to subjective self-reports that appropriately assess the physical function construct within MSTs for chronic pain.

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          Most cited references 43

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          Design and analysis of pilot studies: recommendations for good practice.

          Pilot studies play an important role in health research, but they can be misused, mistreated and misrepresented. In this paper we focus on pilot studies that are used specifically to plan a randomized controlled trial (RCT). Citing examples from the literature, we provide a methodological framework in which to work, and discuss reasons why a pilot study might be undertaken. A well-conducted pilot study, giving a clear list of aims and objectives within a formal framework will encourage methodological rigour, ensure that the work is scientifically valid and publishable, and will lead to higher quality RCTs. It will also safeguard against pilot studies being conducted simply because of small numbers of available patients.
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            Psychological factors in chronic pain: evolution and revolution.

            Research has demonstrated the importance of psychological factors in coping, quality of life, and disability in chronic pain. Furthermore, the contributions of psychology in the effectiveness of treatment of chronic pain patients have received empirical support. The authors describe a biopsychosocial model of chronic pain and provide an update on research implicating the importance of people's appraisals of their symptoms, their ability to self-manage pain and related problems, and their fears about pain and injury that motivate efforts to avoid exacerbation of symptoms and further injury or reinjury. They provide a selected review to illustrate treatment outcome research, methodological issues, practical, and clinical issues to identify promising directions. Although there remain obstacles, there are also opportunities for psychologists to contribute to improved understanding of pain and treatment of people who suffer from chronic pain. The authors conclude by noting that pain has received a tremendous amount of attention culminating in the passage of a law by the U.S. Congress designating the period 2001-2011 as the "The Decade of Pain Control and Research."
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              Randomized Trial of a Fitbit-Based Physical Activity Intervention for Women.

              Direct-to-consumer mHealth devices are a potential asset to behavioral research but rarely tested as intervention tools. This trial examined the accelerometer-based Fitbit tracker and website as a low-touch physical activity intervention. The purpose of this study is to evaluate, within an RCT, the feasibility and preliminary efficacy of integrating the Fitbit tracker and website into a physical activity intervention for postmenopausal women.
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                Author and article information

                Journal
                J Pain Res
                J Pain Res
                Journal of Pain Research
                Journal of Pain Research
                Dove Medical Press
                1178-7090
                2019
                03 January 2019
                : 12
                : 179-189
                Affiliations
                [1 ]Department of Diagnostic Sciences, Tufts University School of Dental Medicine, Boston, MA, USA, william_c.jackson@ 123456tufts.edu
                [2 ]Department of Psychiatry, Massachusetts General Hospital, Harvard School of Medicine, MA, USA
                [3 ]Department of Clinical Health Psychology, William James College, MA, USA
                [4 ]Department of Health Sciences Library, Tufts University School of Dental Medicine, Boston, MA, USA
                [5 ]Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
                [6 ]Research and Network Development, Boston PainCare, Waltham, MA, USA
                [7 ]Department of Anesthesia, Massachusetts General Hospital, Harvard School of Medicine, MA, USA
                Author notes
                Correspondence: William Jackson, Tufts University School of Dental Medicine, Craniofacial Pain Center, 1 Kneeland Street, Boston, MA 02111, USA, Tel +1 857 891 1828, Fax +1 617 726 3441, Email william_c.jackson@ 123456tufts.edu
                [*]

                These authors contributed equally to this work

                Article
                jpr-12-179
                10.2147/JPR.S172733
                6322706
                © 2019 Jackson et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

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