Hassan Jafari

Spouse‐assisted training in pain coping skills and the outcome of multidisciplinary pain management for chronic low back pain treatment: A 1‐year randomized controlled trial

This study examined the comparative efficacy of three interventions: a spouse‐assisted coping skills training protocol for patients undergoing a multidisciplinary pain management programme (SA‐MPMP), conventional patient‐oriented multidisciplinary pain management programme (P‐MPMP) and standard medical care (SMC). Thirty‐six chronic low back pain (CLBP) patients and their spouses were randomly assigned to one of the three conditions. The SA‐MPMP condition consisted of seven, weekly, 2‐h, group sessions of training in dyadic pain coping and couple skills, delivered by a clinical psychologist with support of a multidisciplinary team of specialists, to patients together with their spouses. P‐MPMP consisted of the SA‐MPMP training delivered to the patient only (i.e., no spouse participation and assistance). The SMC condition entailed continuation of routine treatment, entailing medical care only. Data analysis revealed that, at the 12‐month follow‐up time point, patients receiving SA‐MPMP had significant improvements in kinesiophobia and rumination about pain compared to those receiving P‐MPMP and SMC. In patients suffering from CLBP, an intervention that combines spouse‐assisted coping skills training with a multidisciplinary pain management programme can improve fear of movement and rumination about low back pain.

Effect of functional fatigue on vertical ground reaction force among individuals with flat feet

CONTEXT Flat foot is one of the lower extremity deformities that might change kinetic variables of gait. Fatigue is one of the factors that can alter the vertical ground-reaction force (GRF). The effect of a fatiguing condition on vertical GRF has not been documented in individuals with flat feet. OBJECTIVE To examine the fatigue effect on vertical GRF in individuals with flat feet compared with a normal group during barefoot walking. DESIGN Repeated-measure ANOVA for the effects of fatigue on individuals with flat feet and normal feet. SETTING Biomechanics laboratory. PARTICIPANTS 17 subjects with flat feet and 17 normal subjects (recruited according to their arch-height ratio). MAIN OUTCOME MEASURES Three vertical GRF measures (F1, the first peak force; F2, minimum force; and F3, the second peak force) were extracted before and after a functional fatigue protocol. RESULTS No significant interaction between fatigue and group was observed for the 3 vertical GRF measures. For F2, fatigue and group effects were significant (P = .001 and P = .02, respectively). Furthermore, F2 was higher in the flat-feet group than in the normal group; F2 also increased after fatigue. For F3, only a significant fatigue effect was observed (P = .004). F3 decreased after fatigue in both groups. CONCLUSIONS In the flat-feet group, a decrease in the variation of vertical GRF might be due to more flexible foot joints. After fatigue, muscles might lose their ability to control the foot joints and cause higher F2 in the flat-feet group.