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| Name | Class |
|---|---|
| Fund for Scientific Research, Flanders, Belgium | OTHER |
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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.
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.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Diagnostic test ("PainsCan") for the identification of the dominant pain mechanisms in cancer survivers with persistent pain | Diagnostic Test | Easy-to-use screening tool to identify the dominant pain mechanism by using quick clinical tests and compare their accuracy and validity with complicated reference tests. |
| Measure | Description | Time Frame |
|---|---|---|
| Douleur Neuropathic 4 questions (DN4) questionnaire | Neuropathic pain: pain that arises from a damaged nerve is assessed with a questionnaire (1) | 2 minutes |
| Quantitative sensory testing | Neuropathic pain: pain that arises from a damaged nerve is assessed by measuring thermal thresholds (2) | 20 minutes |
| Pain mapping | Neuropathic pain: pain that arises from a damaged nerve is assessed by painting affected areas on a body chart (3) | 1 minute |
| Central Sensitization Inventory (CSI) questionnaire | Central sensitization pain: pain caused by changes in the central nervous system is assessed with a questionnaire (1) | 5 minutes |
| Conditioned pain modulation | Central sensitization pain: pain caused by changes in the central nervous system is assessed with a thermal test (2) | 10 minutes |
| Temporal summation | Central sensitization pain: pain caused by changes in the central nervous system is assessed with a series of touch stimuli (3) | 2,5 minutes |
| Diffuse pain | Central sensitization pain: pain caused by changes in the central nervous system is assessed by painting affected areas on a body chart (4) | 0,5 minute |
| Measure | Description | Time Frame |
|---|---|---|
| Pain catastrophizing scale | Pain catastrophizing scale | 6 minutes |
| Depression, anxiety and stress | Depression Anxiety and Stress Scale (DASS-21) |
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Inclusion Criteria:
Exclusion Criteria:
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Cancer patients older than 18, in complete remission, who experience pain scored with a minimum of 3/10 (0 being no pain at all and 10 being the worst pain imaginable). The patients do not have metastasis and are not in a palliative status, nor are they pregnant or diagnosed with a cancer type other than breast, prostate, lung/bronchus, colon/rectum or gynecologic cancer.
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| Name | Affiliation | Role |
|---|---|---|
| Nele Devoogdt, Prof. | UZ Leuven | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital Leuven | Leuven | 3000 | Belgium |
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| ID | Term |
|---|---|
| D000072716 | Cancer Pain |
| D010146 | Pain |
| D009369 | Neoplasms |
| D059350 | Chronic Pain |
| ID | Term |
|---|---|
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D003955 | Diagnostic Tests, Routine |
| ID | Term |
|---|---|
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
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| Manual palpation | Central sensitization pain: pain caused by changes in the central nervous system is assessed by applying pressure with manual palpation (5) | 3 minutes |
| Evaluation of skin | Nociceptive pain: pain that arises from a damaged tissue is assessed by visual evaluation of the skin condition (1) | 20 seconds |
| Lymphedema | 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) | 4 minutes |
| Joint pain | Nociceptive pain: pain that arises from a damaged tissue is assessed by examining if several joints are sore, especially in the morning (3) | 30 seconds |
| Active mobility | Nociceptive pain: pain that arises from a damaged tissue is assessed by examining the movements the patient can perform (4) | 2,5 minutes |
| Passive mobility | Nociceptive pain: pain that arises from a damaged tissue is assessed by examining the movements the clinician can perform on the patient (5) | 3,5 minutes |
| Strength | Nociceptive pain: pain that arises from a damaged tissue is assessed by the strength the patient can perform in a specific movement (6) | 1,5 minutes |
| Scar tissue | 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) | 2 minutes |
| Axillary web syndrome | Nociceptive pain: pain that arises from a damaged tissue is assessed by visually examining the presence of lymph cords in the axilla (8) | 2 minutes |
| 7 minutes |
| Pain Self-efficacy and Expectations: questionnaire | Pain self-efficacy and expectations questionnaire | 5 minutes |
| Pain character: questionnaire | McGill Pain questionnaire | 4 minutes |
| Pain disability: Pain Disability Index | Pain Disability Index | 3 minutes |
| Pain intensity: Visual Analogue Scale | Visual Analogue Scale at the moment, worst and least pain during the past week | 1 minute |
| Pain questionnaire | Brief Pain Inventory | 30 seconds |