Behavioral and time-contingent graded exercise therapy program
Usual care
RCT
Performance of the level of daily activities, perceived recovery, shoulder pain, generic health-related quality of life, catastrophizing, coping with pain, kinesophobia, and fear-avoidance beliefs
12 W
Graded exercise therapy with focus on behavioral changes was more associated with restoring the performance of daily activities (,) and pain and catastrophizing thoughts (,) compared to usual care. Pain reduction was significantly associated with reduction of depression scores (,)
Persistent pain in the back, neck, or shoulder, or generalized pain
The Web Behavior Change Program for Activity (Web-BCPA)
Multimodal rehabilitation Synchronized treatments based on a biopsychosocial perspective of pain and with the patient in focus
RCT
Pain intensity, self-efficacy, copying, adherence, feasibility, and treatment satisfaction
4 M, 12 M
Adding a self-guided Web-based intervention with a focus on behavioral change to MMR reduced catastrophic thinking () at 12 months. However, it had no effect on pain and self-efficacy improvement. In both groups, pain was reduced and self-efficacy and coping improved
Matching treatment with psychological profile (activity training, graded exposure, and cognitive behavioral treatment)
Unmatched treatment
RCT
Perceived disability, sick leave, self-rated health status, fear and voidance, pain intensity, pain catastrophizing, depressive symptoms, anxiety, worry, and health care consumption
9 M
All participants experienced improvement in perceived disability, sick leave, fear and avoidance, pain catastrophizing, and distress (effect sizes ranging between 0.23 and 0.66), but there was no benefit to matching. Pain intensity was improved in both groups with medium effect size. There was no standard treatment control to determine if these improvements occur without specific psychological intervention
Emotional freedom technique (EFT) (exposure therapy and cognitive therapy, with acupoint stimulation)
EFT with diaphragmatic breathing and wait list
RCT
ROM, pain, and psychological conditions (anxiety and stress)
1 M
Strangely, the authors only analyzed what happened within each group, and there are no cross-group comparisons. The groups look comparable at enrollment with very slightly lower means in pain and psychological measures in the acupressure group compared to diaphragmatic breathing and wait list at one month. These differences are unlikely to be statistically significant and are small and clinically insignificant, suggesting no measurable effect of a single treatment. There was no change in shoulder motion
Neck-specified exercise with a behavioral approach: (graded exercise, education)
Neck-specified exercise without a behavioral approach or prescription of physical activity
RCT
Pain disability, pain catastrophizing, anxiety, depression, and kinesophobia
0, 3, 6, 12, 24 M
Adding a behavioral approach to neck-specific training exercises decreased general pain limitations and pain catastrophizing more than neck-specific exercise alone (at least 50% (). This method of treatment decreased pain limitations and catastrophizing in the short term, and the patients sustained this over 2 years in comparison to neck-specific exercises alone. This method also decreased kinesophobia in the first year and anxiety over 2 years
Cognitive behavioral treatment in addition to physical treatment, cognitive behavioral modification, education, and examination of the work situation
Usual care
RCT
Return to work. Work conditions, life quality, physical activity and training, pain, subjective health, psychological changes, and practical performance
0, 4, and 12 M
Adding a cognitive behavioral therapy to physical therapy helps in decreeing pain. CBT in addition to physical treatment significantly decreased the pain intensity than use of physical treatment alone ,). The intervention had no affect on return to work of the patients. However, improvement in ergonomic behavior, work potential, life quality, and physical and psychological health achieved
Individually adapted approach with a focus on physical exercise, mindfulness, and education on pain and behavior
Usual care
RCT
Fear avoidance
0, 10 W
Individually adapted physical-cognitive-mindfulness training in comparison to routine physiotherapy approaches significantly reduced work-related fear avoidance. This method could not significantly improve leisure time activity-related and fear-avoidance beliefs, by 10 weeks in comparison to the control group
Pain coping strategies: active coping (attempts to engage the physical activity in spite of the pain) and passive coping (withdrawing from activities due to pain).
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Prospective cohort
Global recovery
3, 6, and 9 M
Low level of passive coping strategy in the people with depressive symptoms causes recovery four times more quickly than those with depressive symptoms and high levels of passive coping. Active coping strategies showed no independent association with recovery
Psychological flexibility (promotion of acceptance, mindfulness, values-based action, and cognitive diffusion) and traditional pain management
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Prospective cohort
Eight measures of functioning: pain, pain-related anxiety, depression, physical disability, psychological disability, walking distance, and sit to stand
0,3 M
Pain-related outcome changes in from pre- to posttreatment are more related to psychological flexibility than traditional pain managements
Persistent shoulder or arm pain after breast cancer surgery
BrightArm Duo therapy (a robotic platform with various 3D games that address memory and cognition along with movement) for pain limitations after breast cancer surgery
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Prospective cohort
Pain and disability
8 W
Eight-week treatment with this program led to twenty percent pain reduction, with a significant 8.3-point reduction in depression severity () and increase range of motion; as there was no control group, it cannot be concluded that the improvement is merely due to virtual rehabilitation.
