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Pain management in rheumatoid arthritis: cognitive behavior modification and transcutaneous neural stimulation
Bruce JR, Riggin CS, Parker JC, Walker SE, Meyer AA, Wellman FE, Kunce J
Arthritis Care & Research 1988 Jun;1(2):78-84
clinical trial
3/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: No; Point estimates and variability: No. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

In order to assess the combined effects of cognitive-behavior modification (CBM) and transcutaneous neural stimulation (TNS) on patients with rheumatoid arthritis, a pilot research project was conducted. An interrupted time-series design was utilized with subjects serving as their own controls. Eight male rheumatoid arthritis patients were randomly assigned, two subjects each, to one of the following treatment conditions: (1) Cognitive Behavior Modification (CBM); (2) Transcutaneous Neural Stimulation (TNS); (3) CBM followed by a CBM/TNS combination; or (4) TNS followed by a CBM/TNS combination. The dependent measures included a visual analogue scale, grip strength, McGill Pain Questionnaire, and joint evaluations by a rheumatologist blind to the treatment conditions. Regarding self-reported pain, this study found a slight superiority for the combined TNS/CBM treatments, particularly when the TNS procedures were introduced first. Further research on strategies for maximizing nonpharmacological pain management is recommended.
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