Development and Validation of a Screening Tool to Identify the Dominant Pain Mechanism in Cancer Survivors With Persistent Pain
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Cancer Survivors
- Sponsor
- Universitaire Ziekenhuizen KU Leuven
- Enrollment
- 92
- Locations
- 1
- Primary Endpoint
- Conditioned pain modulation
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
Development and internal validation of an easy-to-use tool for clinical pain assessment. The tool has to be applicable in any clinical practice and without the need for expensive and complicated hospital tools to identify the source of persistent pain after the treatment of cancer.
Detailed Description
An adequate selection of physiotherapy treatment for persistent pain after the treatment of cancer, depends highly on the mechanism of the pain. Pain can arise from a damaged nerve or tissue (skin, lymphatic system...). But when pain becomes chronic, alterations to the central nervous system can occur, as regulations of the facilitating and inhibiting mechanisms. These alterations may cause central sensitization pain. The body is now sensitized and cannot distinct harmful from harmless stimuli. Each type of pain requires a specific treatment, therefore identification of the pain mechanism is crucial. Up till now, expensive and complex tests were performed in a hospital setting to determine if a patient suffers from neuropathic, nociceptive or central sensitization pain. This study aims for developping an assessment tool that does not require expensive devices but can be easily performed by any physiotherapist, within the timeframe of a standard consultation.
Investigators
An De Groef
Principal investigator An De Groef
Universitaire Ziekenhuizen KU Leuven
Eligibility Criteria
Inclusion Criteria
- •Patient treated for primary cancer: breast, prostate, lung/bronchus, colon/rectum, gynecologic (uterus or ovary)
- •Complete remission
- •Curative treatment finished
- •Ongoing hormonal and targeted treatment permitted
- •Patient experiences pain (NRS minimum 3/10 during the past week)
Exclusion Criteria
- •Active metastasis
- •Palliative status
- •Other type of cancer than mentioned in inclusion criteria
- •Pregnancy
Outcomes
Primary Outcomes
Conditioned pain modulation
Time Frame: 10 minutes
Central sensitization pain: pain caused by changes in the central nervous system is assessed with a thermal test (2)
Temporal summation
Time Frame: 2,5 minutes
Central sensitization pain: pain caused by changes in the central nervous system is assessed with a series of touch stimuli (3)
Diffuse pain
Time Frame: 0,5 minute
Central sensitization pain: pain caused by changes in the central nervous system is assessed by painting affected areas on a body chart (4)
Joint pain
Time Frame: 30 seconds
Nociceptive pain: pain that arises from a damaged tissue is assessed by examining if several joints are sore, especially in the morning (3)
Quantitative sensory testing
Time Frame: 20 minutes
Neuropathic pain: pain that arises from a damaged nerve is assessed by measuring thermal thresholds (2)
Manual palpation
Time Frame: 3 minutes
Central sensitization pain: pain caused by changes in the central nervous system is assessed by applying pressure with manual palpation (5)
Douleur Neuropathic 4 questions (DN4) questionnaire
Time Frame: 2 minutes
Neuropathic pain: pain that arises from a damaged nerve is assessed with a questionnaire (1)
Lymphedema
Time Frame: 4 minutes
Nociceptive pain: pain that arises from a damaged tissue is assessed by examining the presence of lymphedema by measuring the circumference of the arm (2)
Active mobility
Time Frame: 2,5 minutes
Nociceptive pain: pain that arises from a damaged tissue is assessed by examining the movements the patient can perform (4)
Passive mobility
Time Frame: 3,5 minutes
Nociceptive pain: pain that arises from a damaged tissue is assessed by examining the movements the clinician can perform on the patient (5)
Strength
Time Frame: 1,5 minutes
Nociceptive pain: pain that arises from a damaged tissue is assessed by the strength the patient can perform in a specific movement (6)
Central Sensitization Inventory (CSI) questionnaire
Time Frame: 5 minutes
Central sensitization pain: pain caused by changes in the central nervous system is assessed with a questionnaire (1)
Scar tissue
Time Frame: 2 minutes
Nociceptive pain: pain that arises from a damaged tissue is assessed by examining the elasticity of the scar tissue by manual palpation of the clinician (7)
Pain mapping
Time Frame: 1 minute
Neuropathic pain: pain that arises from a damaged nerve is assessed by painting affected areas on a body chart (3)
Evaluation of skin
Time Frame: 20 seconds
Nociceptive pain: pain that arises from a damaged tissue is assessed by visual evaluation of the skin condition (1)
Axillary web syndrome
Time Frame: 2 minutes
Nociceptive pain: pain that arises from a damaged tissue is assessed by visually examining the presence of lymph cords in the axilla (8)
Secondary Outcomes
- Pain disability: Pain Disability Index(3 minutes)
- Pain intensity: Visual Analogue Scale(1 minute)
- Pain Self-efficacy and Expectations: questionnaire(5 minutes)
- Pain catastrophizing scale(6 minutes)
- Depression, anxiety and stress(7 minutes)
- Pain character: questionnaire(4 minutes)
- Pain questionnaire(30 seconds)