Background & Aims

Chronic pain is one of the most common health concerns among older adults, significantly contributing to disability. The presence of psychiatric comorbidities, such as major depression, can further diminish the older individual’s ability to effectively cope with the adverse effects of untreated pain. Despite the high prevalence of this dual challenge, there is a notable lack of research on identifying suitable treatment options for older adults dealing with both major depression and chronic musculoskeletal, non-cancer pain. Given the increased risks associated with pharmacological pain management in the elderly, non-pharmacological interventions like biofeedback become pivotal. Therefore, this study aims to explore the feasibility and evaluate pain-related outcomes of a surface electromyography biofeedback (sEMG-BF) treatment protocol within an inpatient setting.

Methods

This prospective, single-center, single-arm feasibility study will take place at the Department of Psychiatry and Psychotherapy, LVR-Clinic, Heinrich Heine University, Düsseldorf, Germany. Forty inpatients aged 50 and above, diagnosed with major depression and chronic musculoskeletal pain will be enrolled and undergo 6 weekly sEMG-BF sessions. In addition to examining feasibility, the study will assess various clinical outcomes. The primary outcomes will be pain intensity and interference (evaluated using the Brief Pain Inventory). Secondary outcomes will include pain catastrophizing (Pain Catastrophizing Scale), anxiety and depression (Hospital Anxiety and Depression Scale), and acceptance of pain (Chronic Pain Acceptance Questionnaire). Further, pressure pain threshold (trapezius muscle) will be assessed using a digital pressure algometer. Clinical outcomes will be evaluated at both baseline and post-intervention. Pre-post differences will be calculated using a paired t-test.

Results

n/a

Conclusions

This planned study is novel as it will investigate the feasibility and evaluate pain-related outcomes of an sEMG-BF protocol tailored specifically for older adults with comorbid major depression and chronic non-cancer pain. The findings of this research will have the potential to establish evidence-based practices for the application of sEMG-BF in this expanding patient demographic.

References

Schwan J, Sclafani J, Tawfik VL. Chronic Pain Management in the Elderly. Anesthesiol Clin. 2019 Sep;37(3):547-560. doi: 10.1016/j.anclin.2019.04.012. Epub 2019 Jun 18. PMID: 31337484; PMCID: PMC6658091.
Edwards RR, Dworkin RH, Sullivan MD, Turk DC, Wasan AD. The Role of Psychosocial Processes in the Development and Maintenance of Chronic Pain. J Pain. 2016 Sep;17(9 Suppl):T70-92. doi: 10.1016/j.jpain.2016.01.001. PMID: 27586832; PMCID: PMC5012303.
Bair MJ, Robinson RL, Katon W, Kroenke K. Depression and Pain Comorbidity: A Literature Review. Arch Intern Med. 2003;163(20):2433–2445. doi:10.1001/archinte.163.20.2433
Lazaridou A, Paschali M, Vilsmark ES, Sadora J, Burton D, Bashara A, Edwards RR. Biofeedback EMG alternative therapy for chronic low back pain (the BEAT-pain study). Digit Health. 2023 Feb 7;9:20552076231154386. doi: 10.1177/20552076231154386. PMID: 36776410; PMCID: PMC9909059.

Presenting Author

Myrella Paschali

Poster Authors

Myrella Paschali

MD

LVR-Clinic Düsseldorf, Heinrich-Heine University Düsseldorf

Lead Author

E-mail

Topics

  • Pain in Special Populations: Elderly