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Triebel, Jan
Publications (3 of 3) Show all publications
Bjornsdottir, S. V., Triebel, J., Arnljotsdottir, M., Tomasson, G. & Valdimarsdottir, U. A. (2018). Long-lasting improvements in health-related quality of life among women with chronic pain, following multidisciplinary rehabilitation. Disability and Rehabilitation, 40(15), 1764-1772
Open this publication in new window or tab >>Long-lasting improvements in health-related quality of life among women with chronic pain, following multidisciplinary rehabilitation
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2018 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, no 15, p. 1764-1772Article in journal (Refereed) Published
Abstract [en]

Purpose:

To determine whether observed health-related quality-of-life improvements after four-week traditional multidisciplinary pain management program and additional neuroscience education and mindfulness-based cognitive therapy for chronic pain are sustained at six-month follow-up.

Method:

This observational longitudinal follow-up study, with complete follow-up of 75 women, 61.5% of initial traditional approach group (treated 2001-2005) and 56 (62.2%) receiving the new approach (treated 2006-2009). Pain intensity and quality of life were measured at baseline and six months after interventions. Analysis of variance (ANOVA) and paired samples t-tests were used for statistical analysis.

Results:

Both groups showed sustained improvements in pain intensity (traditional approach = -10.6 [p < 0.001]; new approach = -14.5 [p < 0.001]) and quality of life (traditional approach = 6.4 [p < 0.001]; new approach = 6.9 [p < 0.001]). Sleep was not sustained among traditional approach group (change = 2.4 [p = 0.066]), whereas all other domains among both groups were sustained. Significant decline was observed from discharge to six month among both groups with the exception of the sleep domain among the traditional approach group, pain intensity among the new approach and financial status among both groups. No baseline differences were revealed between responders and nonresponders.

Conclusions:

Multidisciplinary interventions for women with chronic pain conditions improved quality of life and pain intensity with lasting improvements observed half a year after treatment completion.

Keywords
Quality of life, chronic pain, multidisciplinary rehabilitation, mindfulness, neuroscience patient education, follow-up
National Category
Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:uu:diva-355479 (URN)10.1080/09638288.2017.1312565 (DOI)000431537400004 ()28407728 (PubMedID)
Available from: 2018-06-29 Created: 2018-06-29 Last updated: 2018-06-29Bibliographically approved
Triebel, J., Snellman, G., Sandén, B., Strömqvist, F. & Robinson, Y. (2017). Women do not fare worse than men after lumbar fusion surgery: Two-year follow-up results from 4,780 prospectively collected patients in the Swedish National Spine Register with lumbar degenerative disc disease and chronic low back pain.. The spine journal, 17(5), 656-662
Open this publication in new window or tab >>Women do not fare worse than men after lumbar fusion surgery: Two-year follow-up results from 4,780 prospectively collected patients in the Swedish National Spine Register with lumbar degenerative disc disease and chronic low back pain.
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2017 (English)In: The spine journal, ISSN 1529-9430, E-ISSN 1878-1632, Vol. 17, no 5, p. 656-662Article in journal (Refereed) Published
Abstract [en]

BACKGROUND CONTEXT: Proper patient selection is of outmost importance in surgical treatment of degenerative disc disease (DDD) with chronic low back pain (CLBP). Among other factors gender was previously found to influence lumbar fusion surgery outcome.

PURPOSE: This study investigates whether gender affects clinical outcome after lumbar fusion.

STUDY DESIGN: National registry cohort study PATIENT SAMPLE: Between 2001 and 2011, 2251 men and 2521 women were followed prospectively within the Swedish National Spine Registry (SWESPINE) after lumbar fusion surgery for DDD and CLBP.

OUTCOME MEASURES: Patient-reported outcome measures (PROM) visual analogue scale (VAS) for leg and back pain, Oswestry Disability Index (ODI), quality-of-life (QoL) parameter EQ5D and labour status and pain medication were collected preoperatively, 1 and 2 years after surgery.

METHODS: Gender-differences of baseline data and PROM improvement from baseline were analysed. The effect of gender on clinically important improvement of PROM was determined in a multivariate logistic regression model. Furthermore, gender-related differences in return-to-work were investigated.

RESULTS: Preoperatively women had worse leg pain (p<0.001), back pain (p=0.002), lower QoL (p<0.001) and greater disability than men (p=0.001). Postoperatively women presented greater improvement 2 years from baseline for pain, function and QoL (all p<0.01). Women had better chances of a clinically important improvement than men for leg pain (OR=1.39, 95% C.I.: 1.19-1.61, p<0.01) and back pain (OR=1.20,95% C.I.:1.03-1.40, p=0.02) as well as ODI (OR=1.24, 95% C.I.:1.05-1.47, p=0.01), but improved at a slower pace in leg pain (p<0.001), back pain (p=0.009), and disability (p=0.008). No gender differences were found in QoL and return-to-work at 2 years postoperatively.

CONCLUSIONS: Swedish women do not have worse results than men after spinal fusion surgery. Female patients present with worse pain and function preoperatively, but improve more than men do after surgery.

National Category
Orthopaedics
Identifiers
urn:nbn:se:uu:diva-307674 (URN)10.1016/j.spinee.2016.11.001 (DOI)000401104500006 ()27845232 (PubMedID)
Funder
Swedish Society of Medicine, SLS-257511
Available from: 2016-11-18 Created: 2016-11-18 Last updated: 2018-01-13Bibliographically approved
Björnsdóttir, S. V., Arnljotsdottir, M., Tomasson, G., Triebel, J. & Valdimarsdottir, U. A. (2016). Health-related quality of life improvements among women with chronic pain: comparison of two multidisciplinary interventions. Disability and Rehabilitation, 38(9), 828-836
Open this publication in new window or tab >>Health-related quality of life improvements among women with chronic pain: comparison of two multidisciplinary interventions
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2016 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 38, no 9, p. 828-836Article in journal (Refereed) Published
Abstract [en]

Purpose: To measure the effect of 4 weeks traditional multidisciplinary pain management program (TMP) versus neuroscience education and mindfulness-based cognitive therapy (NEM) on quality of life (HRQL) among women with chronic pain. Method: This observational longitudinal cohort study conducted in an Icelandic rehabilitation centre included 122 women who received TMP, 90 receiving NEM, and 57 waiting list controls. Pain intensity (visual analogue scale) and HRQL (Icelandic Quality of Life scale) were measured before and after interventions. ANOVA and linear regression were used for comparisons. Results: Compared with controls we observed statistically significant changes in pain intensity (p < 0.001) and HRQL (p < 0.001) among women receiving both interventions, while NEM participants reported significant improvements in sleep (8.0 versus 4.4 in TMP; p = 0.008). Head to head comparison between study groups revealed that pain intensity improved more among TMP participants (21.8 versus 17.2 mm; p = 0.013 adjusted). Women with low HRQL at baseline improved more than those with higher HRQL (mean TMP = 13.4; NEM = 12.9 if HRQL <= 35 versus mean TMP = 6.6 and NEM = 7.8 if HQRL > 35). Conclusions: Our non-randomized study suggests that both NEM and TMP programs improve pain and HRQL among women with chronic pain. Sleep quality showed more improvements in NEM while pain intensity in TMP. Longer-term follow-ups are needed to address whether improvements sustain. Implications for Rehabilitation Chronic pain is a debilitating condition affecting quality of life and restricting societal participation. Intensive multidisciplinary bio-psycho-social rehabilitation is essential for this patient group. This study shows improvement in health-related quality of life and pain intensity following such rehabilitation. Emphasizing mindfulness based cognitive therapy and neuroscience patient education improves sleep to more extend than more traditional approach.

Keywords
neuroscience patient education, multidisciplinary rehabilitation, mindfulness, health-related quality of life, Chronic pain
National Category
Physiotherapy
Identifiers
urn:nbn:se:uu:diva-282454 (URN)10.3109/09638288.2015.1061609 (DOI)000370647400002 ()26122546 (PubMedID)
Available from: 2016-04-05 Created: 2016-04-05 Last updated: 2017-11-30Bibliographically approved
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