Podcast
Questions and Answers
What was the primary aim of the psychological treatment sessions within the Pain Reprocessing Therapy (PRT) intervention?
What was the primary aim of the psychological treatment sessions within the Pain Reprocessing Therapy (PRT) intervention?
- To desensitize patients to pain by reinforcing the idea of peripheral tissue injury.
- To increase the severity of the reported pain by the patients.
- To directly address and heal peripheral tissue injuries through physical therapy.
- To help patients understand their pain as stemming from non-dangerous brain activity. (correct)
Which of the following best describes the study design used in the research?
Which of the following best describes the study design used in the research?
- A retrospective cohort study analyzing pre-existing patient data.
- A qualitative study based on patient interviews conducted over six months.
- An observational study tracking patients' pain levels without intervention.
- A randomized clinical trial with longitudinal fMRI and a one-year follow-up assessment. (correct)
The study included three arms, one of which was an open-label placebo. What does 'open-label' signify in this context?
The study included three arms, one of which was an open-label placebo. What does 'open-label' signify in this context?
- Only the researchers knew that the treatment was a placebo, while the participants thought they were receiving active medication.
- Both the researchers and the participants were aware that the treatment was a placebo. (correct)
- The patients were not aware that they were receiving a placebo.
- Neither the researchers nor the participants knew who was receiving the actual treatment.
Considering the results, which of the following Hedges' g values indicates the largest effect size of Pain Reprocessing Therapy (PRT) compared to the other interventions?
Considering the results, which of the following Hedges' g values indicates the largest effect size of Pain Reprocessing Therapy (PRT) compared to the other interventions?
Based on the study's methodology, what type of data was analyzed between January 2019 and August 2020?
Based on the study's methodology, what type of data was analyzed between January 2019 and August 2020?
What is a primary focus of Pain Reprocessing Therapy (PRT) in the context of chronic back pain?
What is a primary focus of Pain Reprocessing Therapy (PRT) in the context of chronic back pain?
According to the study, what percentage of chronic back pain cases are classified as primary, meaning a specific peripheral cause cannot be identified?
According to the study, what percentage of chronic back pain cases are classified as primary, meaning a specific peripheral cause cannot be identified?
Which of the following factors is identified as a maintenance factor in primary chronic back pain?
Which of the following factors is identified as a maintenance factor in primary chronic back pain?
In the study, what was the primary method used to investigate the treatment mechanisms of Pain Reprocessing Therapy (PRT)?
In the study, what was the primary method used to investigate the treatment mechanisms of Pain Reprocessing Therapy (PRT)?
What key finding regarding brain activity was observed in patients who received Pain Reprocessing Therapy (PRT) compared to those in the placebo or usual care groups?
What key finding regarding brain activity was observed in patients who received Pain Reprocessing Therapy (PRT) compared to those in the placebo or usual care groups?
What specific belief was found to mediate the treatment effects of Pain Reprocessing Therapy (PRT) on pain?
What specific belief was found to mediate the treatment effects of Pain Reprocessing Therapy (PRT) on pain?
Compared to usual care and placebo, what was the primary outcome for participants undergoing PRT at the conclusion of the treatment?
Compared to usual care and placebo, what was the primary outcome for participants undergoing PRT at the conclusion of the treatment?
Which of the following best describes the objective of the study?
Which of the following best describes the objective of the study?
Flashcards
Longitudinal Study
Longitudinal Study
A type of randomized trial that measures changes over a period of time. Includes initial and follow-up assessments.
Pain Reprocessing Therapy (PRT)
Pain Reprocessing Therapy (PRT)
Treatment where patients are helped to understand that their chronic pain is due to nondangerous brain activity rather than a tissue injury. Uses cognitive, somatic, and exposure-based techniques.
Placebo Treatment
Placebo Treatment
A substance with no therapeutic effect, administered to mimic a real treatment. Used as a control to assess the true effect of a treatment.
Usual Care
Usual Care
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Hedges' g
Hedges' g
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Primary Chronic Back Pain (CBP)
Primary Chronic Back Pain (CBP)
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Maintenance Factors in CBP
Maintenance Factors in CBP
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Goal of PRT
Goal of PRT
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Central Nervous System's role in Pain
Central Nervous System's role in Pain
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Reappraisal of Pain
Reappraisal of Pain
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Neuroplasticity Changes with PRT
Neuroplasticity Changes with PRT
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Randomized Clinical Trial
Randomized Clinical Trial
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Study Notes
- This study investigates Pain Reprocessing Therapy (PRT) as a psychological treatment for chronic back pain (CBP).
- The study examines if PRT can provide substantial and durable pain relief by shifting beliefs about the causes and threat value of pain.
Background
- CBP is a major cause of disability, and current treatments are often ineffective.
- In about 85% of CBP cases, a specific peripheral cause cannot be identified (primary CBP).
- Factors that maintain primary CBP include fear, avoidance, and the belief that pain indicates ongoing injury.
Objective
- To determine if PRT can offer substantial and lasting pain relief for primary CBP.
- To understand the mechanisms by which PRT affects pain.
Study Design
- Randomized clinical trial with longitudinal functional magnetic resonance imaging (fMRI) and 1-year follow-up.
- Conducted in a university research setting.
- Compared PRT to open-label placebo and usual care.
Interventions
- PRT group: 1 telehealth session with a physician + 8 psychological treatment sessions over 4 weeks.
- Treatment focused on reconceptualizing pain as non-dangerous brain activity rather than tissue injury.
- Used cognitive, somatic, and exposure-based techniques.
- Placebo group: Open-label subcutaneous saline injection in the back.
- Usual care group: Continued with their routine care.
Main Outcomes Measured
- One-week mean back pain intensity score (0-10) at posttreatment.
- Pain beliefs.
- fMRI measures of evoked pain and resting connectivity.
Results
- 151 adults participated
- 54% female
- mean age: 41.1 years
- mean pain duration: 10.0 years
- 4.10 pain intensity
- 23.34 disability
- Significant group differences in pain were observed post-treatment:
- PRT group: 1.18 pain score
- Placebo group: 2.84 pain score
- Usual care group: 3.13 pain score
- Hedges g effect sizes:
- -1.14 for PRT vs placebo
- -1.74 for PRT vs usual care
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Description
This study investigates Pain Reprocessing Therapy (PRT) for chronic back pain (CBP). It examines if PRT can provide pain relief by shifting beliefs about the causes and threat value of pain. The study compares PRT to placebo and usual care.
