Chronic Pain Clinical Trial
— PHYSIO_ENDOMOfficial title:
Effect of a Therapeutic-educational Physiotherapy Program on Pain and the Physical-functional Sphere in Women With Endometriosis and Its Impact on Quality of Life
This is a randomized clinical trial that will be carried out in women with endometriosis divided into two groups: the experimental group (EG) that will receive therapeutic-educational physiotherapy, which will combine therapeutic exercise with a pain education program, and the control group (CG) who will receive the pain education program. The participants will be evaluated at three moments: before starting the study (T1), after the 8-week treatment program (T2) and after another 8 weeks of follow-up in which they will be encouraged to continue with the treatment (T3). The initial assessment will include a medical and physiotherapy history, and at T1, T2 and T3 the following will be assessed: pain, abdominopelvic mobility, muscle status, functionality, sexual function, quality of life, stress and biomarkers of chronic inflammation.
Status | Recruiting |
Enrollment | 62 |
Est. completion date | December 22, 2026 |
Est. primary completion date | May 30, 2024 |
Accepts healthy volunteers | No |
Gender | Female |
Age group | 18 Years to 45 Years |
Eligibility | Inclusion Criteria: - Diagnosis of endometriosis made by imaging techniques (MRI or ultrasound) or by surgery. - A period of 3 months or more since the last surgery if they have undergone surgery. - Who are receiving hormone treatment and have their disease under control. - Persistent pelvic pain for at least 3 months. - With pain and hypertonus in the pelvic musculature, myofascial syndrome, vestibulodynia or pudendal neuropathy. - Consent to participate in the study - Capable of carrying out the follow-up of the study until the final visit. - Who have audiovisual resources and the internet at their disposal. Exclusion Criteria: - Women in the menopausal phase - Women undergoing fertility treatment or planning to undergo fertility treatment in the next 3 months. - Pregnant women. - Women undergoing physiotherapy treatment or who have undergone physiotherapy treatment in the last 3 months. - Having suffered a fracture in the last 3 months in the lower limb that limits their functional capacity. - Cognitive illness that prevents correct comprehension of the exercises. - Musculoskeletal pathology or neuropathy in acute phase. - Having suffered or suffering from a neoplastic disease. - Untreated endometriosis - Acquired genital abnormalities of the pelvis or pelvic floor. - Women in a situation of litigation or economic compensation, or pending the granting of a degree of disability. - Severe mental illness (schizophrenia, borderline personality disorder, etc.) |
Country | Name | City | State |
---|---|---|---|
Spain | Hospital Universitari i Politècnic La Fe, | Valencia |
Lead Sponsor | Collaborator |
---|---|
University of Valencia | Hospital Universitario La Fe, Instituto de Investigacion Sanitaria La Fe |
Spain,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Musculoskeletal pain - Pressure pain threshold | Pressure pain threshold measured in rectus abdominis and lumbar muscles | 3 assessent times: T1(pre-intervention), T2 (after 8 weeks intervention), T3 (after 16 weeks intervention) | |
Primary | Musculoskeletal pain - quantitative Sensory Testing | Quantitative sensory testing is a non-invasive technique used to assess and quantify sensory functions by determining sensation and pain thresholds using pressure. | 3 assessent times: T1(pre-intervention), T2 (after 8 weeks intervention), T3 (after 16 weeks intervention) | |
Primary | Musculoskeletal pain - pain drawing | Identification of pain areas through a pain map: this consists of a human figure on a two-dimensional plane on which the patient can express the representation of the pain areas on a schematic of the body surface. | 3 assessent times: T1(pre-intervention), T2 (after 8 weeks intervention), T3 (after 16 weeks intervention) | |
Primary | Musculoskeletal pain - Central Sensitisation Inventory | Central Sensitisation Inventory: is a self-report instrument that indirectly assesses somatic and emotional symptoms that have been found to be associated with Central Sensitisation. | 3 assessent times: T1(pre-intervention), T2 (after 8 weeks intervention), T3 (after 16 weeks intervention) | |
Secondary | Physical-Funcionality - Hand grip Strength | Hand grip strength will be measured by the handgrip strength technique using a Jamar Plus+ digital hand dynamometer. | 3 assessent times: T1(pre-intervention), T2 (after 8 weeks intervention), T3 (after 16 weeks intervention) | |
Secondary | Physical-Funcionality - functional performance | To assess functional performance patients will be instructed to cross their arms over their chest and complete as many standing cycles as possible in 30 s (30 second- Sit to stand). | 3 assessent times: T1(pre-intervention), T2 (after 8 weeks intervention), T3 (after 16 weeks intervention) | |
Secondary | Physical-Funcionality- Pelvic floor Dynamometry | Dynamometry of the pelvic floor muscles: measurement of basal tone (g) and tone at maximum contraction (Phenix Liberty Dynamometer). | 3 assessent times: T1(pre-intervention), T2 (after 8 weeks intervention), T3 (after 16 weeks intervention) | |
Secondary | Physical-Funcionality - Body composition | Body composition (% fat, % water, % muscle): record body composition (skeletal muscle mass and % body fat) with a bioimpedance scale (DC-430MA, Tanita Corporation of America, Inc, Arlignton Heights, IL, USA). | 3 assessent times: T1(pre-intervention), T2 (after 8 weeks intervention), T3 (after 16 weeks intervention) | |
Secondary | Physical-Funcionality - Motor control | Determine motor control: clinical test of lumpopelvic and thoracolumbar dissociation will be used. | assessent times: T1(pre-intervention), T2 (after 8 weeks intervention), T3 (after 16 weeks intervention) | |
Secondary | Physical-Funcionality - Lumbar spine flexibility | Lumbar spine flexibility: It will be measured with the Schöber test | assessent times: T1(pre-intervention), T2 (after 8 weeks intervention), T3 (after 16 weeks intervention) | |
Secondary | Physical-Funcionality - Catastrophyzing | Catastrophyzing: to assess catastrophic thinking related to pain the Pain Catastrophyzing Scale (PCS) will be used | assessent times: T1(pre-intervention), T2 (after 8 weeks intervention), T3 (after 16 weeks intervention) | |
Secondary | Physical-Funcionality - Kinesophobia | Kinesophobia: it will be assessed with the Tampa Scale for Kinesophobia-11 (TSK-11), which consists of 11 items. | assessent times: T1(pre-intervention), T2 (after 8 weeks intervention), T3 (after 16 weeks intervention) | |
Secondary | Quality of Life - Endometriosis | Quality of life will be assessed using the Spanish version of the Endometriosis Health Profile-30 (EHP-30). | assessent times: T1(pre-intervention), T2 (after 8 weeks intervention), T3 (after 16 weeks intervention) | |
Secondary | Quality of Life - Gastrointestinal | Quality of life at the gastrointestinal level will be assessed using the Gastrointestinal Quality of Life Index, which addresses 5 domains (digestive symptoms, physical state, emotions, social dysfunction and effects of medical treatment). | assessent times: T1(pre-intervention), T2 (after 8 weeks intervention), T3 (after 16 weeks intervention) | |
Secondary | Quality of Life - Sexual Function | the abbreviated Index of Female Sexual Function (IFSF-6) will be used. It is a multidimensional self-reported instrument for the evaluation of female sexual function | assessent times: T1(pre-intervention), T2 (after 8 weeks intervention), T3 (after 16 weeks intervention) | |
Secondary | Quality of Life - Stress | Stress using the Perceived stress scale (PSQ). | assessent times: T1(pre-intervention), T2 (after 8 weeks intervention), T3 (after 16 weeks intervention) | |
Secondary | Biomarkers - Inflamation | Plasma markers of chronic inflammation and intestinal permeability will be assessed including a multiplex array of inflammation markers, and as specific markers of chronic inflammation associated with intestinal permeability, zonulin, C-reactive protein, Binding Protein , and bactericidal/permeability-increasing protein will be assessed. | assessent times: T1(pre-intervention), T2 (after 8 weeks intervention), T3 (after 16 weeks intervention) | |
Secondary | Patient's satisfaction | Satisfaction with the treatment received will be assessed using the Satisfaction with Treatment Received Scale (CRES-4). | assessent times: T2 (after 8 weeks intervention), T3 (after 16 weeks intervention) | |
Secondary | Patient's perception of change | Patient's Perception of change after the treatment will be measured by patients' global impression of change (PGIC) in a quantitative and qualitative way. | assessent times: T2 (after 8 weeks intervention), T3 (after 16 weeks intervention) | |
Secondary | APP usability | A questionnaire on the usability of the application will be used. System Usability Scale. | assessent times: T2 (after 8 weeks intervention), T3 (after 16 weeks intervention) | |
Secondary | Adherence to treatment | Adherence to treatment: in the experimental group it will be measured through the records made in the application https://fisiotrack.com/, in the control group it will be measured through an ad hoc activity diary that will be provided to them. | assessent times: T2 (after 8 weeks intervention), T3 (after 16 weeks intervention) |
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