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CURRENT ISSUEEUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

A Journal on Physical Medicine and Rehabilitation after Pathological Events


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063

 

European Journal of Physical and Rehabilitation Medicine 2014 October;50(5):567-77

 REVIEW ARTICLES

Alternative approach: a systematic review of non-pharmacological non-spastic and non-trigeminal pain management in multiple sclerosis

Jawahar R. 1, Oh U. 2, Yang S. 1, Lapane K. L. 3

1 Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, USA;
2 Department of Neurology, Virginia Commonwealth University, Richmond, VA, USA;
3 Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA

The aim of this paper was to evaluate non-pharmacological strategies for the reduction of non-spastic and non-trigeminal pain in patients with multiple sclerosis (MS) by conducting a systematic review. Experimental studies published after 1965 were chosen for review by searching electronic databases (e.g. PubMed, Cumulative Index to Nursing and Allied Health Literature, Science Citation Index Expanded, Conference Proceedings Citation Index- Science, and clinicaltrials.gov) and bibliographies/citations of previously published reviews. Studies were included if all participants were adults clinically diagnosed with MS, study sample was not restricted to participants with spasticity or trigeminal neuralgia, and participant-reported pain was a primary or secondary outcome measured with a previously validated tool. Records were screened and methodological qualities of included studies were assessed independently by two reviewers under the supervision of another reviewer. Pain scores were recorded as mean differences between or within groups weighted by the inverse of the pooled standard deviation (Cohen’s d). A total of 13 studies which met the inclusion and exclusion criteria were identified for review; interventions included education, electrical stimulation, and physical therapies. Meta-analyses were not performed due to few trials identified per treatment within these classes. Pain relief was reported compared to placebo for two trials in transcutaneous electrical nerve stimulation (TENS) with effect sizes of -3.37 and -3.32, respectively. Inconclusive pain relief was reported for other education and physical therapies. TENS may be effective in reducing central neuropathic pain in MS. More trials with rigorous design and reporting are needed to determine effective treatments for specific pain types presenting in people living with MS.

language: English


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