Publications by authors named "Meeus Mira"

Introduction: Rotator cuff (RC) tears are the most common and disabling musculoskeletal ailments among patients with shoulder pain. Although most individuals show improvement in function and pain following arthroscopic rotator cuff repair (ARCR), a subgroup of patients continue to suffer from persistent shoulder pain following the surgical procedure. Identifying these factors is important in planning preoperative management to improve patient outcomes.

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Objective: To examine (a) the association between metabolic factors and chronic musculoskeletal pain (CMP), (b) metabolic predictors of CMP 10 years later, and (c) the association and evolution of metabolic factors across different CMP trajectory groups.

Design: Data from the longitudinal Doetinchem Cohort Study were used. We used round 4 (2003-2007), with 4519 participants aged 36-75 years, as the baseline for the present study, with follow-up measurements in round 5 (2008-2012), and 6 (2013-2017), including self-reported pain and metabolic factors, which were measured either via self-report or physical assessment.

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Background: Pain is the leading cause of disability and reduced quality of life worldwide. Despite the increasing burden for patients and healthcare systems, pain research remains underfunded and under focused. Having stakeholders identify and prioritize areas that need urgent attention in the field will help focus funding topics, reduce 'research waste', improve the effectiveness of pain research and therapy and promote the uptake of research evidence.

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The aim of this study is to investigate the effect of induced excitation of the bottom-up pathways at the lateral elbow muscles on local muscle fatigue in the neck region in healthy participants. Eligible participants (n:55) were randomly allocated to an intervention group (n:28) or a control group (n:27). The fatigue of bilateral neck flexor(sternocleidomastoid) and extensor (upper trapezius) muscles was evaluated using surface electromyography, at baseline and immediately post-intervention during a neck flexor and extensor endurance test respectively.

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Conditioned pain modulation (CPM) is a psychophysical experimental measure of endogenous pain inhibition in humans. Within this paradigm, one noxious stimulus, the conditioning stimulus (CS), reduces the pain perception from another heterotopic noxious stimulus, the test stimulus (TS). Cognitive processes are known to influence pain perception and might impact the underlying mechanisms of CPM.

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Advancements in clinical science have shown the necessity for a paradigm shift away from a biomedical toward a biopsychosocial approach. Yet, the translation from clinical science into clinical practice is challenging. The aim of this study was to assess the short-term and mid-term changes in pain knowledge and attitudes and guideline-adherent recommendations of healthcare professionals (HCP) by means of an interdisciplinary training program (ITP) about chronic pain.

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Background: Previous research showed chronic post-total knee arthroplasty (TKA) pain in 20% of people with knee osteoarthritis (KOA). Various preoperative biopsychosocial-related factors have been described, but phenotyping people with KOA awaiting TKA based on these factors is still lacking. This could be relevant to understanding differences in TKA surgery responses.

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Persistent breast cancer treatment-related pain affects up to 40% of patients, decreasing their quality of life (QoL). While current research typically utilizes correlation and regression analysis to identify biopsychosocial phenotypes contributing to this pain, this study employs cluster analysis to identify qualitatively different phenotypes based on somatosensory and psychosocial characteristics both before and one week post-breast cancer surgery. Further, it investigates how these phenotypes are related to pain intensity one year post-surgery and examines the evolution of phenotype membership from pre- to post-surgery.

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Chronic low back pain (CLBP) is one of the most common chronic musculoskeletal disorders worldwide. Guidelines recommend exercise therapy (ET) in CLBP management, but more research is needed to investigate specific ET modalities and their underlying mechanisms. The primary goal of this study is to evaluate the short-term and long-term effectiveness of a time-contingent individualised high-intensity training (HIT) protocol on disability compared with a time-contingent moderate-intensity training (MIT) as used in usual care, in persons with severely disabling CLBP.

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Article Synopsis
  • Insomnia is common in patients with chronic spinal pain, and addressing it could enhance treatment results.
  • A clinical trial compared the effectiveness of cognitive behavioral therapy for insomnia (CBTi) combined with best-evidence pain management (BEPM) against BEPM alone in patients with both insomnia and spinal pain.
  • The trial involved 123 participants, and results showed that those receiving CBTi-BEPM experienced a significant reduction in pain intensity over 12 months compared to those who received BEPM only.
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Article Synopsis
  • * Five key prognostic factors emerged: better symptom reduction expectations, increased neuropathic pain scores, and perceptions of injury consequences influenced shoulder function and quality of life outcomes.
  • * Findings suggest that improving patients' mental states and sleep patterns before surgery could help identify those at higher risk for unsatisfactory recovery.
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Even in healthy populations, conditioned pain modulation (CPM) magnitude varies. This may be accounted for by (non-)modifiable factors, including physical activity (PA). Yet, little research has thoroughly examined PA and its relation with CPM magnitude in a representative sample.

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Objectives: This study aimed to apply the International Association for the Study of Pain (IASP) grading system for identifying nociplastic pain in knee osteoarthritis (KOA) awaiting total knee arthroplasty (TKA) and propose criteria to fine-tune decision-making. In addition, the study aimed to characterize a "probable" versus "no or possible" nociplastic pain mechanism using biopsychosocial variables and compare both groups in their 1-year post-TKA response.

Methods: A secondary analysis of baseline data of a longitudinal prospective study involving 197 patients with KOA awaiting total TKA in Belgium and the Netherlands was performed.

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Objective: This study explores the association between obesity, diabetes, and somatosensory functioning in patients with knee osteoarthritis (OA), aiming to understand how metabolic conditions are related to pain mechanisms in this patient population. We hypothesized that higher body mass index (BMI), fat mass, and glycated hemoglobin levels (HbA1c) are associated with signs of altered somatosensory functioning.

Methods: A cross-sectional analysis was conducted as part of a larger multicentre prospective cohort study.

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Background: the pathogenesis of frozen shoulder (FS) is thought to be one of inflammation and fibrosis possibly influenced by hyperglycemia. Biomechanical changes of the shoulder joint in terms of muscle strength, scapular kinematics and proprioception might occur in FS.

Objectives: to compare muscle strength, scapular kinematics, proprioception, and blood glucose levels within patients with FS and to asymptomatic individuals.

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Purpose: The aim of this study was to identify preoperative predictors for 1-year posttotal knee arthroplasty (TKA) pain and pre- to post-TKA pain difference in knee osteoarthritis (KOA) patients.

Methods: From March 2018 to July 2023, this prospective longitudinal cohort study enrolled KOA patients awaiting TKA from four hospitals in Belgium and the Netherlands. Different biopsychosocial predictors were assessed preoperatively by questionnaires and physical examinations (input variables).

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Background: There is clear evidence demonstrating the benefits of physical activity (PA) on pain and overall health, however, PA is challenging for many individuals living with chronic pain. Even non-exercise specialists can (cost) effectively promote PA, but many health professionals report a number of barriers in providing guidance on PA, suggesting that it is not consistently promoted. This expert position paper summarizes the evidence and provides five recommendations for health professionals to assess, advise and support individuals living with any chronic pain condition with a long life expectancy in adopting and sustaining physically active lifestyles.

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The objective of this study is to determine whether the change in pain intensity over time differs between somatosensory functioning evolution profiles in knee osteoarthritis (KOA) patients undergoing total knee arthroplasty (TKA). This longitudinal prospective cohort study, conducted between March 2018 and July 2023, included KOA patients undergoing TKA in four hospitals in Belgium and the Netherlands. The evolution of the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscale pain over time (baseline, 3 months, and 1 year post-TKA scores) was the outcome variable.

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Article Synopsis
  • - This study investigates how nonspecific chronic spinal pain (nCSP) and insomnia symptoms are related, focusing on their connections, strengths, and how they influence each other.
  • - Using baseline data from a randomized controlled trial involving 123 patients with nCSP and insomnia, researchers employed a detailed statistical model to analyze symptom interconnections.
  • - The findings indicate a weak direct link between pain and sleep, but suggest that anxiety and depression may mediate the relationship, with fatigue and feeling slowed down identified as key results of the interaction.
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Background: Many applied postgraduate pain training programs are monodisciplinary, whereas interdisciplinary training programs potentially improve interdisciplinary collaboration, which is favourable for managing patients with chronic pain. However, limited research exists on the development and impact of interdisciplinary training programs, particularly in the context of chronic pain.

Methods: This study aimed to describe the development and implementation of an interdisciplinary training program regarding the management of patients with chronic pain, which is part of a type 1 hybrid effectiveness-implementation study.

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Background: Studies on the concurrent validity of clinically applicable testing protocols for conditioned pain modulation (CPM) and temporal summation of pain (TSP) in breast cancer survivors (BCS) with persistent pain are lacking.

Objectives: This study investigated the concurrent validity of two bedside protocols for CPM and TSP in comparison to a respective reference protocol. The participants' preferences for bedside CPM and TSP protocols were assessed.

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Objective: Specific neck exercises are recommended in the rehabilitation of chronic nonspecific neck pain (CNNP). They are unfortunately often accompanied by acute pain flare-ups. Global exercises might be a beneficial addition, as they activate endogenous analgesia without overloading painful structures.

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Context: The prevalence of persistent pain among breast cancer survivors (BCS) is high, and it is unclear what distinguishes those with persistent pain from those without. Research suggests that differences in somatosensory function evaluated by quantitative sensory testing (QST) may be responsible.

Objectives: This study aimed to describe somatosensory profiles in terms of hyper- and hypoesthesia in BCS with and without persistent pain using reference data from healthy controls.

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Background: Chronic cancer-related pain remains underdiagnosed and undertreated, although it affects 40% of cancer survivors. Recent insights suggest that cytokine signaling between immune, neuro, and glial cells contributes to chronic pain.

Objectives: This study systematically reviewed cytokine levels and their relation to chronic cancer-related pain and, additionally, investigated differences in cytokine levels between cancer survivors with and without chronic pain.

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Gray matter (GM) changes are often observed in people with chronic spinal pain, including those with chronic whiplash-associated disorders (CWAD). These GM adaptations may be reversed with treatment, at least partially. Pain neuroscience education combined with exercise (PNE+Exercise) is an effective treatment, but its neural underlying mechanisms still remain unexplored in CWAD.

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