(1) Background: Chronic pain in children remains an under-researched area, especially compared to acute pain. This systematic review aims to evaluate the effectiveness of non-pharmacological interventions in the management of pediatric chronic pain and their impact on the well-being of both children and their families. Given the growing interest in integrative treatments to reduce reliance on pharmacological solutions, this review addresses the need for alternative therapeutic approaches. (2) Methods: A systematic review was conducted following the PRISMA guidelines, covering studies published between 2019 and 2024 from PubMed, Cochrane Library, Web of Science, and Scopus. Eligible studies included children aged 2 to 18 years with chronic pain who received non-pharmacological interventions. Data were extracted on intervention types, participant characteristics, and outcomes. The risk of bias was assessed using RoB2 for randomized trials and ROBINS-I for non-randomized studies. (3) Results: A total of 11 studies involving 1739 children were included, assessing interventions such as cognitive behavioral therapy, personalized psychosocial follow-up programs, hypnotherapy, music therapy, and digital tools. The results demonstrated significant reductions in pain severity, improvements in emotional and physical well-being, and high patient satisfaction. However, the generalizability of findings was limited by the small sample sizes and variability in study designs. (4) Conclusions: Non-pharmacological interventions appear effective in managing pediatric chronic pain, offering improvements in pain reduction and quality of life. Further research is needed to optimize these approaches and confirm their long-term benefits across diverse populations. These interventions represent promising alternatives or complements to pharmacological treatments in pediatric pain management.
This study aimed to determine the effectiveness of therapeutic exercise plus patient therapeutic education on perceived fatigue, functional capacity and pain in breast cancer survivors with cancer-related fatigue. A randomised, single-blind, clinical trial was conducted with a total of 80 breast cancer survivors who presented cancer-related fatigue. Women were randomised into a supervised therapeutic exercise group (STE-G) (n = 40) or an unsupervised exercise group (UE-G) (n = 40). Both interventions included patient therapeutic education and were delivered in three sessions per week over eight weeks. The main outcome was perceived fatigue as assessed by the Spanish version of the Functional Assessment of Chronic Illness Therapy-Fatigue subscale (FACIT-F). Other evaluated outcomes were pain measured on a visual analogue scale, and distance measured using the 6-Minute Walk Test. Data were collected at baseline, immediately post-intervention, and at three and six months after baseline. Significantly greater improvements across all variables were observed in the STE-G throughout the entire follow-up period with the exception of pain. Conclusions: A supervised therapeutic exercise program plus patient therapeutic education significantly reduce perceived fatigue and increase functional capacity in breast cancer survivors suffering from cancer-related fatigue compared to an unsupervised physical exercise program based on individual preferences with patient therapeutic education.
1 December 2015 in Journal of Chiropractic Medicine
The purpose of this study was to evaluate the feasibility of the methods proposed to conduct a full randomized clinical trial to assess the effectiveness of mobilization with movement on shoulder functionality in older adults with shoulder dysfunction. A pilot, randomized, single-blinded clinical trial was carried out with 44 older adults (83.9±8.2 years) with shoulder dysfunction in 3 nursing homes in Toledo, Spain. Participants were recruited through information sessions and were randomly allocated into 2 groups. The control group (n = 22) intervention consisted of a physical therapy standard protocol proposed by the Spanish Rheumatology Society. Techniques based on Mulligan's concepts of mobilization with movement were added to the standard protocol for the experimental group (n = 22) intervention. Interventions took place 3 times a week for 2 consecutive weeks and were performed by 2 experienced therapists. Main outcomes were recruitment rates, participation and adherence to interventions, assessment procedures, and the implementation of mobilization with movement. Clinical outcomes were shoulder functionality, active glenohumeral range of motion, and pain intensity. Data were collected at baseline, after each group intervention, and at 1 and 3 months after finishing interventions. All the participants accepted to be randomized. Participation rates were 97.7% for the experimental group and 95.5% for the control group. The analysis of variance did not show any statistically significant difference between treatment groups for any of the variables (all P values for the group effect were greater than .36) or a change of the difference between groups over time (all P values for the time-treatment interactions were greater than .3). The research methods tested in this pilot study offer a suitable foundation to conduct a full clinical trial.
The objective of this study was to evaluate the content, quality, and readability of websites containing information on dyspareunia, vaginismus, and vulvodynia in Spanish. Web pages were retrieved entering the terms “dyspareunia”, “vaginismus”, and “vulvodynia” in Google, Yahoo!, and Bing search engines. Two researchers employed the DISCERN and Bermúdez-Tamayo questionnaires to analyze the content and quality of the websites, and the INFLESZ scale to evaluate their readability. IBM SPSS® version 25 statistical software was employed for data analysis. The internet search yielded 262 websites, 91 of which were included after applying the selection criteria. Websites with information on dyspareunia obtained median scores of 24 (30–21) in the DISCERN, 38 (41.0–35.5) in the Bermúdez-Tamayo, and 55.3 (57.2–50.9) in the INFLESZ tools. The results for websites on vaginismus revealed median scores of 23.5 (30–20) in the DISCERN, 37 (42–35) in the Bermúdez-Tamayo, and 52.9 (55.6–46.4) in the INFLESZ. Finally, the median scores for vulvodynia sites was 25.5 (30–20) in the DISCERN, 38 (43–33.7) in the Bermúdez-Tamayo, and 54.2 (57.3–47.2) in the INFLESZ. These outcomes indicate that the quality of information in these websites is very low, while the overall quality of the web pages is moderate. Sites on vaginismus and vulvodynia were “somewhat difficult” to read, while readability was “normal” for websites on dyspareunia. Healthcare professionals should be aware of the shortcomings of these websites and address them through therapeutic education with resources containing updated, quality information. This raises the need for health professionals to generate these resources themselves or for experts and/or scientific societies in the field to check the quality and timeliness of the contents, regardless of whether or not the websites are endorsed with quality seals.
To examine the feasibility of a home-based hybrid Bimanual-Intensive-Therapy combined with modified Constraint-Induced-Movement-Therapy (h-BITmCI) in children with spastic unilateral cerebral palsy...