Evidence map›Paper›PMID 29669091›Full record

ReviewPhysical therapy2018

A Mechanism-Based Approach to Physical Therapist Management of Pain.

Ruth L Chimenti, Laura A Frey-Law, Kathleen A Sluka

2 registry-linked trialsAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Physical therapy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 106 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
106citing papers in PubMed, 12 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03959319 nacompletednot on this mapstarted 2019, after this paper: background citation

Comparison of Movement Pattern Training and Manual Therapy for Prearthritic Hip Disorders: a Pilot Randomized Clinical Trial

TypeinterventionalSponsorWashington University School of MedicineRan2019 to 2022Enrolled33ConditionsHip-related Groin Pain, Femoroacetabular Impingement, Dysplasia Mild, Prearthritic Hip DisorderArmsMovement Pattern Training, Manual Therapy
NCT07147764 narecruitingnot on this mapstarted 2025, after this paper: background citation

Comparison of the Effect of Pain Neuroscience Education Combined With Physiotherapy, and Physiotherapy Alone in Temporomandibular Disorders

TypeinterventionalSponsorAinaz ShahediRan2025 to 2026Enrolled36ConditionsTemporomandibular Joint DisordersArmsPhysiotherapy, Pain Neuroscience Education
3 · Its place in the literature

Who cites it

106 citing papers in PubMed, 12 syntheses or guidelines pooled it.

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  16. Expectations affect pain sensitivity changes during massage.The Journal of manual & manipulative therapy · 2023
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46 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors.

Ruth L ChimentiDepartment of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, Iowa.
Laura A Frey-LawDepartment of Physical Therapy and Rehabilitation Science, University of Iowa.
Kathleen A SlukaDepartment of Physical Therapy and Rehabilitation Science, 1-242 MEB, University of Iowa, Iowa City, IA 52242 (USA).

Funding

Interdisciplinary Training Program in Pain ResearchT32NS045549 · NINDS · UNIVERSITY OF IOWA · PI KATHLEEN A SLUKA, Yuriy M Usachev · 2004 to 2026
$3.7M
Fibromyalgia Activity Study with TENS "FAST"UM1AR063381 · NIAMS · UNIVERSITY OF IOWA · PI CROFFORD, LESLIE J, SLUKA, KATHLEEN A · 2013 to 2017
$3.4M
Central Mechanisms involved in the interactions between muscle pain and exerciseR01AR061371 · NIAMS · UNIVERSITY OF IOWA · PI SLUKA, KATHLEEN A · 2012 to 2016
$2.3M
Mechanism-based treatment approach to chronic tendinopathy painR00AR071517 · NIAMS · UNIVERSITY OF IOWA · PI CHIMENTI, RUTH LOUISE PORTER · 2019 to 2021
$740k
Phenotyping Evoked Central Sensitivity to Painful StimuliR03AR065197 · NIAMS · UNIVERSITY OF IOWA · PI FREY LAW, LAURA A · 2014 to 2016
$227k
Mechanism-based treatment approach to chronic tendinopathy painK99AR071517 · NIAMS · UNIVERSITY OF IOWA · PI CHIMENTI, RUTH LOUISE PORTER · 2017 to 2018
$172k
NIAMS NIH HHS K99 AR071517NIAMS NIH HHS R00 AR071517NIAMS NIH HHS R01 AR061371NIAMS NIH HHS R03 AR065197NIAMS NIH HHS UM1 AR063381NINDS NIH HHS T32 NS045549
6 · The paper itself

Abstract

Pain reduction is a primary goal of physical therapy for patients who present with acute or persistent pain conditions. The purpose of this review is to describe a mechanism-based approach to physical therapy pain management. It is increasingly clear that patients need to be evaluated for changes in peripheral tissues and nociceptors, neuropathic pain signs and symptoms, reduced central inhibition and enhanced central excitability, psychosocial factors, and alterations of the movement system. In this Perspective, 5 categories of pain mechanisms (nociceptive, central, neuropathic, psychosocial, and movement system) are defined, and principles on how to evaluate signs and symptoms for each mechanism are provided. In addition, the underlying mechanisms targeted by common physical therapist treatments and how they affect each of the 5 categories are described. Several different mechanisms can simultaneously contribute to a patient's pain; alternatively, 1 or 2 primary mechanisms may cause a patient's pain. Further, within a single pain mechanism, there are likely many possible subgroups. For example, reduced central inhibition does not necessarily correlate with enhanced central excitability. To individualize care, common physical therapist interventions, such as education, exercise, manual therapy, and transcutaneous electrical nerve stimulation, can be used to target specific pain mechanisms. Although the evidence elucidating these pain mechanisms will continue to evolve, the approach outlined here provides a conceptual framework for applying new knowledge as advances are made.

Indexed as

Physical TherapistsPhysical Therapy ModalitiesHumansPain ManagementPain MeasurementPatient Education as TopicTranscutaneous Electric Nerve Stimulation

Identifiers

PMID29669091
PMCPMC6256939

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.