Grupo de Investigación en Ciencias del Movimiento, Bioconducta y Estudio del Dolor. CSEULS. UAM. 2. Instituto de Neurociencias y Dolor Craneofacial ...
CORRELATIONS AMONG PAIN, DISABILITY AND PSYCHOSOCIAL FACTORS IN PATIENTS WITH CHRONIC MIGRAINE, OROFACIAL PAIN AND CRANIOMANDIBULAR DISORDERS Gil-Martinez A1,2,4,5, La Touche R1,2,5, Paris-Alemany A1,2,5, López-Pozo S4, López-López A3, Lara-Lara M4,5, Fernández-Carnero J1,3,5. 1. Grupo de Investigación en Ciencias del Movimiento, Bioconducta y Estudio del Dolor. CSEULS. UAM. 2. Instituto de Neurociencias y Dolor Craneofacial (INDCRAN). 3. Universidad Rey Juan Carlos. Madrid. España. (URJC). 4. Hospital Universitario La Paz. Madrid. España. (HULP). 5. Instituto de Investigación Sanitaria del Hospital Universitario La Paz. IdiPAZ.
BACKGROUND There is now growing evidence which has been related pain catastrophizing, kinesiophobia and neck disability in patients with chronic migraine (CM) and in certain types of craniomandibular dysfunction (CMD)(1,2). Furthermore it has been suggested that cervical spine may be involved in the origin and maintenance of some facial ailments, as well as CMD and headaches (3,4).
CF-‐PDI
VAS
PCS
CF-‐PDI
NDI
Chronicity
TSK-‐11
HIT-‐6
35 VAS
PCS
Pearson´s r
N
Pearson´s r
,316**
,496**
,591**
,263**
,223**
,652**
30
172
169
170
172
172
168
161
25
,316**
,488**
,533**
,368**
,473**
,438**
20 15
CF-‐PDI
N
Pearson´s r
N
169
,496**
170
,488**
170
168
168
171
170
,704**
171
170
,186*
171
168
,424**
167
160
10
,409**
∗∗
5 0
162
∗∗ MP
NDI
Pearson´s r
,591**
,533**
,704**
,375**
,383**
JP
CP
CM
CP
CM
,602**
NDI
OBJECTIVE Our purpose was to correlate neck and craniomandibular disabilities, pain catastrophizing, fear of movement, pain intensity and headache impact in subgroups of patients with CM, CMD and orofacial pain.
Chronicity
N
Pearson´s r
N
172
170
171
173
173
169
162
35
,263**
,368**
,186*
,375**
,165*
,526**
30
172
170
171
173
173
169
25
162
20
TSK-‐11
Pearson´s r
,223**
,473**
,424**
,383**
,165*
,258** 15
N
168
168
167
169
169
169
158 10
HIT-‐6
DESIGN AND METHODS A Cross-Sectional study was conducted in a sample of 173 patients divided into 4 groups differentiated with an average age of 46.61 (12.93) years. 83% of the sample was female and there was no difference between groups.
Pearson´s r
N
,652**
,438**
,409**
,602**
,526**
,258**
161
160
162
162
162
158
162
5
0
MP
JP
Fig.2. a) CM patient showed more craneofacial pain and disability than JP (p< .01) and MP groups. b)NDI had significant differences between all groups except when compared CM with CP (p> .05).
Table 1. Person´s correlations among diferent variables. ** Significa*ve correla*ons at 0,01 level (bilateral). * Significa*ve correla*ons at 0,05 level (bilateral).
CONCLUSIONS Important information is provided about the similarities and differences that exist in the characteristics of pain, psychological factors and functional disability in patients with CM, MP, JP and CP.
We have measured characteristics associated with pain, disability and psychological factors in 46 patients with orofacial myofascial pain (MP), 40 with craniomandibular joint pain (JP), 46 patients with orofacial combined pain (CP) and 41 patients with CM.
This study could facilitates the creation of new working hypothesis in the field of neck and craniomandibular pains.
To measure these variables have been used: Visual Analogue Scale (VAS), Neck Disability Index (NDI)(5), Craniofacial Pain and Disability Inventory (CF-PDI)(in press), Headache Impact Test (HIT-6)(6), Tampa Scale of Kinesiophobia in its reduced version (TSK-11)(7) and Pain Catastrophizing Scale (PCS)(8).
We suggest to consider the role played by psychological factors such as pain catastrophizing and fear of movement without losing sight disabilities of cervical and craniofacial regions. Fig.1. a) Strongest correlations of the study were found between NDI and CF-PDI in CP group, (r = 0.67, p
