Background: Knee and hip osteoarthritis (OA) among older adults account for substantial disability and extensive healthcare use. Effective pain coping strategies help to deal with OA. This study aims to determine the long-term relationship between pain coping style and the course of healthcare use in patients with knee and/or hip OA over 10 years. Methods: Baseline and 10-year follow-up data of 861 Dutch participants with early knee and/or hip OA from the Cohort Hip and Cohort Knee (CHECK) cohort were used. The amount of healthcare use (HCU) and pain coping style were measured. Generalized Estimating Equations were used, adjusted for relevant confounders. Results: At baseline, 86.5% of the patients had an active pain coping style. Having an active pain coping style was significantly (p = 0.022) associated with an increase of 16.5% (95% CI, 2.0–32.7) in the number of used healthcare services over 10 years. Conclusion: Patients with early knee and/or hip OA with an active pain coping style use significantly more different healthcare services over 10 years, as opposed to those with a passive pain coping style. Further research should focus on altered treatment (e.g., focus on self-management) in patients with an active coping style, to reduce HCU.
Migraine, tension-type headache (TTH) and headaches attributed to temporomandibular disorders (TMD) are prevalent in patients with TMD-pain. The objective was to describe the course of headache complaints as compared to the course of TMD complaints in TMD-pain patients with headache during usual care multidisciplinary treatment for TMD. This was a 12-week longitudinal observational study following adults with TMD-pain and headache during a usual-care multidisciplinary TMD-treatment. The Graded Chronic Pain Scale was used for both TMD and headache to measure pain-related disability (primary outcome measure), pain intensity, days with pain and days experiencing disability (secondary outcome measures). Stratified for the headache type, general linear modelling for repeated measures was used to analyze changes over time in the TMD complaints and the headache complaints. TMD-pain patients with migraine (n = 22) showed significant decrease of pain-related disability for both TMD and headache complaints over time. No difference in the effect over time was found between the two complaints. Patients with TMD-pain and TTH (n = 21) or headache attributed to TMD (n = 17) did not improve in disability over time. For the secondary outcome measures, the results were equivocal. In conclusion, TMD-pain patients with migraine, improvement in TMD-related disability was comparable to headache-related disability for TMD-pain patients with TTH or with headache attributed to TMD, no improvements in disability were found.
Virtual training systems provide highly realistic training environments for police. This study assesses whether a pain stimulus can enhance the training responses and sense of the presence of these systems. Police officers (n = 219) were trained either with or without a pain stimulus in a 2D simulator (VirTra V-300) and a 3D virtual reality (VR) system. Two (training simulator) × 2 (pain stimulus) ANOVAs revealed a significant interaction effect for perceived stress (p =.010, ηp2 =.039). Post-hoc pairwise comparisons showed that VR provokes significantly higher levels of perceived stress compared to VirTra when no pain stimulus is used (p =.009). With a pain stimulus, VirTra training provokes significantly higher levels of perceived stress compared to VirTra training without a pain stimulus (p <.001). Sense of presence was unaffected by the pain stimulus in both training systems. Our results indicate that VR training appears sufficiently realistic without adding a pain stimulus. Practitioner summary: Virtual police training benefits from highly realistic training environments. This study found that adding a pain stimulus heightened perceived stress in a 2D simulator, whereas it influenced neither training responses nor sense of presence in a VR system. VR training appears sufficiently realistic without adding a pain stimulus.
