ImClone Systems Incorporated (NASDAQ: IMCL), a global leader in the development and commercialization of novel antibodies to treat cancer, announced that ERBITUX® (cetuximab) has been commercially launched in Japan for use in treating patients with advanced or metastatic colorectal cancer (mCRC). The launch of ERBITUX in Japan is the result of a co-development and co-commercialization agreement between ImClone, Bristol-Myers Squibb Company and Merck KGaA, Darmstadt, Germany.

ERBITUX is the first ever epidermal growth factor receptor, or EGFR, targeted monoclonal antibody to receive marketing authorization in Japan. In July 2008, ERBITUX received marketing authorization in Japan to treat patients with EGFR-positive, curatively unresectable (inoperable), advanced or recurrent CRC, and to use in combination with irinotecan in second and further lines of mCRC. Bristol-Myers Squibb and Merck KGaA have now fully launched their respective sales force detailing activities for medical institutions in Japan to make ERBITUX available to patients with mCRC.

“We are pleased that ERBITUX is now commercially available as a treatment option for colorectal cancer patients in Japan, where this type of cancer is the second most prevalent and afflicts nearly 100,000 individuals each year,” said Joseph I. DePinto, Vice President, Commercial Operations of ImClone. “ImClone remains committed to maximizing the potential of ERBITUX as an effective therapy for cancer patients around the world.”

Under the terms of the co-development and co-commercialization agreement of ERBITUX in Japan, Merck Serono Co., Ltd. will distribute the product and record the sales for the collaboration. The terms of this agreement provide that Merck KGaA will receive 50 percent of the profit/loss from sales in Japan, and ImClone and Bristol-Myers Squibb will each receive 25 percent. The sharing of profit/loss reflects the co-exclusive rights to ERBITUX in Japan previously granted by ImClone to Merck KGaA and Bristol-Myers Squibb. In addition to its percentage of profits, ImClone will receive from Merck KGaA a 4.75 percent royalty of total net sales in Japan.

The co-development and co-commercialization agreement between ImClone, Bristol-Myers Squibb and Merck KGaA (along with the Japanese subsidiaries of Bristol-Myers Squibb and Merck LTD) is for the joint development and marketing of ERBITUX in Japan for the treatment of EGFR-expressing mCRC, as well as for the treatment of any other cancers the three companies agree to pursue.

About Colorectal Cancer

In Japan, the incidence of colorectal cancer has increased markedly during the last 50 years. Among men and women in Japan, the incidence is higher than for lung cancer (95,651 per year versus 66,453) and second to stomach cancer (95,651 per year versus 109,779). In terms of mortality, the ranking is slightly different; colorectal cancer is now the third largest cancer threat in Japan after lung and stomach cancer (38,206, 56,367 and 54,423 people per year, respectively). Approximately 25 percent of colorectal cancer patients present with metastatic disease or cancer that has spread to other organs. EGFR is expressed in 60-80 percent of colorectal cancer tumors.

About ERBITUX® (Cetuximab)

ERBITUX (cetuximab) is a monoclonal antibody (IgG1 Mab) designed to inhibit the function of a molecular structure expressed on the surface of normal and tumor cells called the epidermal growth factor receptor (EGFR, HER1, c-ErbB-1). In vitro assays and in vivo animal studies have shown that binding of ERBITUX to the EGFR blocks phosphorylation and activation of receptor-associated kinases, resulting in inhibition of cell growth, induction of apoptosis, and decreased matrix metalloproteinase and vascular endothelial growth factor production. In vitro, ERBITUX can mediate antibody-dependent cellular cytotoxicity (ADCC) against certain human tumor types. In vitro assays and in vivo animal studies have shown that ERBITUX inhibits the growth and survival of tumor cells that express the EGFR. No anti-tumor effects of ERBITUX were observed in human tumor xenografts lacking EGFR expression.

Squamous Cell Carcinoma of the Head and Neck (SCCHN)

ERBITUX, in combination with radiation therapy, is indicated for the initial treatment of locally or regionally advanced squamous cell carcinoma of the head and neck. ERBITUX, as a single agent, is indicated for the treatment of patients with recurrent or metastatic squamous cell carcinoma of the head and neck for whom prior platinum-based therapy has failed.

Colorectal Cancer

ERBITUX, as a single agent, is indicated for the treatment of EGFR-expressing metastatic colorectal cancer after failure of both irinotecan- and oxaliplatin-based regimens. ERBITUX, as a single agent, is also indicated for the treatment of EGFR-expressing metastatic colorectal cancer in patients who are intolerant to irinotecan-based regimens.

ERBITUX, in combination with irinotecan, is indicated for the treatment of EGFR-expressing metastatic colorectal carcinoma in patients who are refractory to irinotecan-based chemotherapy. The effectiveness of ERBITUX in combination with irinotecan is based on objective response rates. Currently, no data are available that demonstrate an improvement in disease-related symptoms or increased survival with ERBITUX in combination with irinotecan for the treatment of EGFR-expressing metastatic colorectal carcinoma.

For full prescribing information, including boxed WARNINGS regarding infusion reactions and cardiopulmonary arrest, visit ERBITUX.

Important Safety Information

Grade 3/4 infusion reactions occurred in approximately 3% of patients receiving ERBITUX (Cetuximab) in clinical trials, with fatal outcome reported in less than 1 in 1000. Serious infusion reactions, requiring medical intervention and immediate, permanent discontinuation of ERBITUX, included rapid onset of airway obstruction (bronchospasm, stridor, hoarseness), hypotension, loss of consciousness, and/or cardiac arrest. Most reactions (90%) were associated with the first infusion of ERBITUX despite premedication with antihistamines. Caution must be exercised with every ERBITUX infusion, as there were patients who experienced their first severe infusion reaction during later infusions. Monitor patients for 1 hour following ERBITUX infusions in a setting with resuscitation equipment and other agents necessary to treat anaphylaxis (eg, epinephrine, corticosteroids, intravenous antihistamines, bronchodilators, and oxygen). Longer observation periods may be required in patients who require treatment for infusion reactions.

Cardiopulmonary arrest and/or sudden death occurred in 4 (2%) of 208 patients with squamous cell carcinoma of the head and neck treated with radiation therapy and ERBITUX, as compared to none of 212 patients treated with radiation therapy alone. Fatal events occurred within 1 to 43 days after the last ERBITUX treatment. Carefully consider the use of ERBITUX in combination with radiation therapy in head and neck cancer patients with a history of coronary artery disease, congestive heart failure or arrhythmias in light of these risks. Closely monitor serum electrolytes including serum magnesium, potassium, and calcium during and after ERBITUX therapy.

Interstitial lung disease (ILD), which was fatal in one case, occurred in 4 of 1570 (

Students majoring in communication disorders at Baldwin-Wallace College in Berea, Ohio, are ahead of their peers nationwide who are working toward careers in speech pathology because of a one-of-a-kind program that gives the undergraduates more hands-on experience than most graduate students in the field.

The student-clinicians work at the Baldwin-Wallace Speech Clinic in one of two programs: a summer camp that runs two days a week; and a ten-month program that meets once a week during the academic year. The students interact with children who have diagnoses (sometimes multiple diagnoses) such as Autism, Rett syndrome, cerebral palsy and Down syndrome, and are considered functionally non-verbal.

Through their work, the students are achieving unparalleled successes in helping non-verbal children communicate, many for the first time. “There is nothing like this program anywhere else in the country,” said Colleen F. Visconti, chair of the communication program and director of the Speech Clinic. “We have an advantage with the energy and focus of our undergrads–students who really want to learn–being able to engage and help the children.”

The clinic started as a summer camp for Cleveland-area children in 2007 and was so successful that the longer program was added in 2009. The program was also recently expanded to include B-W students majoring in pre-physical therapy who also work with the children to help improve their motor skills. “Word is spreading,” says Visconti, “and we have already been contacted by parents from across the country expressing interest.”

Visconti and Christie Needham, Clinical Supervisor of the Speech Clinic, developed their own testing that measures changes in the children’s form of communication. They ask: Did the child look at you and get you to look at them? Are they greeting people when exiting or entering a room? Do they seem to be commenting more on activities taking place? Are their social skills improving? Are they able to identify some of their emotions and to take turns in a game without getting upset with others taking turns.

A handful of Baldwin-Wallace student clinicians, a clinical supervisor and a part-time supervisor work closely with the children, who are an average age of seven or eight.

“Our undergraduate students are getting access to these patients working with 12 different children, while in graduate school a student might work with one or two children at the most,” says Visconti. “It’s because of the way our program is set up,” she explains. “Our big drive is to have our students work in a clinic as an undergraduate. Our students are graduating with about 100 client contact hours, and the national average is only about 40.”

A typical session will begin with families dropping children off in the morning for greeting time and then breaking out into small groups and individual situations. “Similar to a circle time at preschool, we talk with the children a lot about feelings, when they’re happy and when they’re sad or mad, and we even talk about the weather,” says Christie Needham, Clinical Supervisor. “We then have art and game activities, a snack and a literacy project, and throughout the session the children are learning to communicate with technology or their voices, if they can.”

Some of the newest and most costly technological devices the Clinic uses are on loan from manufacturers in the industry, but they also use iPads and iTouches that the children are able to use to communicate via pictures.

“When the families start coming to the program, they’ve usually tried everything, and nothing is working and their child is still not talking,” says Needham. “We have been able to give them the opportunity to see how they’re children can succeed in communicating.” She adds: “They are also able to have a better relationship with their child, instead of frustration they’re able to start understanding their child better.

One example is a parent who always thought her child liked the color blue. Once her daughter began to communicate via pointing at pictures on a device, the mother learned that her daughter actually preferred pink and wanted a pink wheel chair and her bedroom painted pink. “Prior to the program, her mother thought she was a tomboy!” Needham says.

Visconti says that many people outside of the field would consider the children as unable to accomplish much, but that’s not the case. “We just need to find the right mode of communication for these children and it will open a whole new world for them,” she explains. Most importantly, she points out: “They will be able to communicate in a new way.”

Source: Academy Communications

The American Physical Therapy Association (APTA) has endorsed My Therapy Exercise™, a physical therapy custom exercise video program available in the iTunes App store for the iPhone/iTouch/iPad and as a software download for Mac/PC from mytherapyexercise.

Developed by APTA member Robert E. Adams, PT, My Therapy Exercise™ is a comprehensive video home exercise program featuring 170 videos of stretches, range of motion, and strengthening for each body part. The videos may be watched individually or linked to create a customizable physical therapy routine.

My Therapy Exercise™ encourages users to work with their physical therapist or other health care professional to determine exercises that are appropriate for their individual therapeutic needs. “The video presentation exercises are consistent with those used in physical therapy practices and proper use should improve patient education and help save time for physical therapists,” said APTA President R. Scott Ward, PT, PhD.

The program also contains an exercise prescription list that can be e-mailed directly from the My Therapy Exercise™ app, or printed out from the Web site for consultations with a PT or doctor. Every clip has audio voice-over instruction with professional instruction on proper set-up, alignment, and necessary precautions.

Source:

American Physical Therapy Association (APTA)

People living in the Sahelian belt of Chad are facing one of the worst nutrition crises in recent years. The international medical humanitarian organization Doctors Without Borders/MГ©decins Sans FrontiГЁres (MSF) is calling for a faster and larger deployment of humanitarian assistance to meet the needs of the most vulnerable populations, particularly children under the age of five.

Several factors, including erratic rainfall, failed harvests, soaring food prices, early depletion of food stocks, and poor access to healthcare, have contributed to increased rates of malnutrition. In the Hadjer Lamis region, recent rapid nutrition screenings show that over five percent of children less than five years of age are suffering from severe acute malnutrition and are at risk of dying. An estimated 5,000 children in Hadjer Lamis alone are in urgent need of nutritional assistance.

“We are very worried about the number of severely malnourished children that our medical teams are seeing – close to 3,000 children were admitted to our programs in the month of May,” said Dr. Benoit Kayembe, MSF emergency medical coordinator in Chad.

This current rise in malnutrition is especially alarming since it coincides with the beginning of the “hunger season.” More children are at risk of becoming severely malnourished in the coming weeks, until the next expected harvest in October.

National authorities and local and international agencies have initiated a response to the severe food security crisis. Despite these efforts, there are still many communities not receiving food and nutritional assistance. MSF calls for an accelerated and expanded emergency response in all affected areas to meet the needs of the most vulnerable, especially children under five, whose nutritional needs are especially acute.

MSF is currently implementing emergency nutrition interventions in the Hadjer Lamis, Batha, GuГ©ra, Salamat, and Quaddai regions, as well as in the capital N’Djamena. Activities include in-patient and ambulatory therapeutic feeding centers and targeted food distributions to over 60,000 children in the coming weeks.

Chad is not the only country facing a malnutrition crisis. Most countries located in the Sahel region are experiencing increasing rates of childhood malnutrition. MSF has also already begun operating emergency nutrition programs-and reinforcing existing ones-in Niger, Mali, Burkina Faso, and Sudan.

MSF recently launched “Starved for Attention,” a major, global multimedia campaign to highlight the crisis of childhood malnutrition and how increased childhood sickness and death can be prevented with effective nutrition interventions: starvedforattention

Source
Doctors Without Borders/MГ©decins Sans FrontiГЁres

Contrary to the prevailing idea that stretching enhances athletic performance, a new study by UNLV kinesiology researchers found that certain stretching may actually reduce performance by decreasing leg power.

The study, which appears in the September 2008 issue of the Journal of Strength and Conditioning Research, investigated how two typical stretching techniques for the hamstrings and quadriceps muscles in the legs affected measures of strength and power in a group of male and female athletes.

Specifically, participants were asked to perform a vertical jump and seated knee flex on three occasions after a typical duration of basic static (holding) and ballistic (bouncing) stretches, or no stretching at all. While little or no difference was found in vertical jump and leg torque, power measures for the stretching groups were significantly reduced.

“Athletes typically include static stretching as a part of the warm-up, but the evidence is clear that this practice will decrease performance in sports that require explosive movements,” said UNLV kinesiology professor and study co-author Bill Holcomb, who directs the university’s Sports Injury Research Center. “Developing flexibility is important for reducing sports injury, but the time to stretch is after, not before, performance.”

Holcomb suggests that coaches limit stretch duration as a part of the warm up in most sports and refrain from pre-activity stretching altogether for sports that are reliant on maximum power. Instead, athletes should perform a whole-body warm-up activity followed by sport specific, or dynamic, stretching.

Power, calculated using a force-measuring device during the vertical jump testing, decreased between 2.4 and 3.4 percent after ballistic and static stretching. Vertical jump is commonly used in research as a predictor of power because the process of jumping requires a person to effectively generate force with their legs at rapid speed. Also, the hamstrings and quadriceps both function as major muscles used in jumping.

While the percentage of the power decrease may not warrant a change in warm up routine for recreational athletes, it is quite significant for competitive athletes participating in activities requiring maximum power, such as track and field and football, for example.

Participating in the study with Holcomb were UNLV Department of Kinesiology and Nutrition professors Mack Rubley and Mark Guadagnoli, and graduate kinesiology student Michelle Samuel. The study appeared in the September 2008 issue of the Journal of Strength and Conditioning Research and can be found online at: nsca-jscr.

UNLV is a doctoral-degree-granting institution of 28,000 students and 3,300 faculty and staff. Founded in 1957, the university offers more than 220 undergraduate, master’s and doctoral degree programs. UNLV is located on a 350-acre campus in dynamic Southern Nevada and is classified in the category of Research Universities (high research activity) by the Carnegie Foundation for the Advancement of Teaching.

UNLV

The Cardiac Rehabilitation Program at Scott & White Healthcare in Temple has received accreditation from the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR).

Cardiac rehabilitation is a medical program designed to help patients recover following a heart attack, coronary angioplasty or cardiac surgery. The program is designed to improve a patient’s overall health through a comprehensive plan of exercise, diet and lifestyle modification. The vast majority of patients who present with heart disease do so because of a lifetime of behaviors that contribute to heart disease. In order to ensure a healthy future cardiac rehabilitation helps patients learn what they can do to help to prevent more heart disease.

“The certification of this program means that we have fulfilled all the requirements of the AACVPR, and that by doing so we are acknowledged as a high quality program,” said Keith Birkemeier, exercise physiologist and supervisor of Scott & White’s Cardiac Rehabilitation Program. “Patients and families look for programs that are considered the best, and the classification of a program as ‘certified’ helps them locate and choose a program for their care.”

James M. Schmitz, M.D., medical director of the Cardiology Clinic at the Scott & White Heart and Vascular Institute, noted that studies have found that patients who participate in cardiac rehabilitation programs have significantly improved survival. Moreover, patients who continue to attend cardiac rehabilitation not only live longer but also better lives.

Source:
Katherine Voss
Scott & White Healthcare

Researchers in London say they have found an effective two-part treatment for microtears in the hamstring: injections of the patient’s own blood and a steroid along with “dry-needling,” in which repeated needle punctures cause controlled internal bleeding in the injured area. Results of the study were presented today at the annual meeting of the Radiological Society of North America (RSNA).

“By injecting the patient’s own blood where it is needed at the site of a damaged tendon, we help the patient heal themselves,” said lead researcher Waseem A. Bashir, M.D., a radiologist at Royal National Orthopaedic Hospital and Ealing Hospital in London. “Blood contains many growth factors, and the injections have been shown to promote faster healing of certain injuries.”

Hamstring tendinopathy is a common sports injury that occurs in soccer, gymnastics, karate or any sport that requires quick acceleration. It may be caused by an improper warm-up or, in an elite athlete, as the result of repetitive strain. Unlike a torn or ruptured tendon that can be surgically repaired, the tiny microtears that characterize chronic tendinopathy are not easily diagnosed, are difficult to heal and often sideline athletes for long periods, if not permanently.

“Patients with hamstring tendinopathy will experience pain walking or climbing stairs and even while sitting or riding in a car,” Dr. Bashir said. “The condition is literally a pain in the butt.”

In the study, 42 patients with suspected hamstring microtearing underwent ultrasound and MRI to confirm the tendinopathy and then were randomly assigned to one of three treatment groups. The first group received an injection of both a long-lasting anesthetic and steroid on the surface of the tendon, as well as the dry-needling procedure at the site of microtears.

The second group received an injection of the anesthetic along with two to three milliliters of their own blood, called an autologous blood injection (ABI), and dry-needling. The third group received a local anesthetic, a steroid and ABI along with dry-needling.

“The injections were all performed with ultrasound and color Doppler, which allows us to watch in real-time where the needle is going,” Dr. Bashir said. “During the dry-needling, we can see blood flow increase in the area.”

Following their treatments, all patients in the study participated in a structured six-week physiotherapy program. The patients were then evaluated at various intervals over a one-year period to assess their levels of pain and functioning.

Patients treated solely with an injection of a steroid and dry-needling reported improved functionality for only three to 12 weeks after treatment. A year later, patients in this group reported being at pre-treatment levels of pain and functionality. Patients who received their own blood plus dry-needling reported significant improvements in functionality even one year after the treatment.

Patients who received both their own blood and a steroid along with dry-needling at the site of tendon damage experienced the most significant reduction in pain levels and the most sustained functional improvement one year following treatment.

“Ultrasound-guided ABI in the hamstring, in combination with a local steroid and dry-needling, appears to be a more clinically effective alternative to the current standard, steroid therapy,” Dr. Bashir said. “A few of our soccer-playing patients had been told their condition was untreatable and they had basically given up all hope of playing again. They were amazed to be able to play again after our treatment and physical therapy.”

He added that ABI therapy has also been an effective treatment for microtears in other tendons, including the elbow, the patellar tendon and those in the rotator cuff within the shoulder.

Dr. Bashir’s coauthor is David A. Connell, M.D.

Source:

Radiological Society of North America

MIT researchers are developing a new kind of autonomous wheelchair that can learn all about the locations in a given building, and then take its occupant to a given place in response to a verbal command.

Just by saying “take me to the cafeteria” or “go to my room,” the wheelchair user would be able to avoid the need for controlling every twist and turn of the route and could simply sit back and relax as the chair moves from one place to another based on a map stored in its memory.

“It’s a system that can learn and adapt to the user,” says Nicholas Roy, assistant professor of aeronautics and astronautics and co-developer of the wheelchair. “People have different preferences and different ways of referring” to places and objects, he says, and the aim is to have each wheelchair personalized for its user and the user’s environment.

Unlike other attempts to program wheelchairs or other mobile devices, which rely on an intensive process of manually capturing a detailed map of a building, the MIT system can learn about its environment in much the same way as a person would: By being taken around once on a guided tour, with important places identified along the way. For example, as the wheelchair is pushed around a nursing home for the first time, the patient or a caregiver would say: “this is my room” or “here we are in the foyer” or “nurse’s station.”

Also collaborating on the project are Bryan Reimer, a research scientist at MIT’s AgeLab, and Seth Teller, professor of computer science and engineering and head of the Robotics, Vision, and Sensor Networks (RVSN) group at MIT’s Computer Science and Artificial Intelligence Laboratory (CSAIL). Teller says the RVSN group is developing a variety of machines, of various sizes, that can have situational awareness, that is, that can “learn these mental maps, in order to help people do what they want to do, or do it for them.” Besides the wheelchair, the devices range in scale from a location-aware cellphone all the way up to an industrial forklift that can transport large loads from place to place outdoors, autonomously.

Outdoors in the open, such systems can rely on GPS receivers to figure out where they are, but inside buildings that method usually doesn’t work, so other approaches are needed. Roy and Teller have been exploring the use of WiFi signals, as well as wide-field cameras and laser rangefinders, coupled to computer systems that can construct and localize within an internal map of the environment as they move around.

“I’m interested in having robots build and maintain a high-fidelity model of the world,” says Teller, whose central research focus is developing machines that have situational awareness.

For now, the wheelchair prototype relies on a WiFi system to make its maps and then navigate through them, which requires setting up a network of WiFi nodes around the facility in advance. After months of preliminary tests on campus, they have begun trials in a real nursing home environment with real patients, at the Boston Home in Dorchester, a facility where all of the nearly 100 patients have partial or substantial loss of muscle control and use wheelchairs.

As the research progresses, Roy says he’d like to add a collision-avoidance system using detectors to prevent the chair from bumping into other wheelchairs, walls or other obstacles. In addition,Teller says he hopes to add mechanical arms to the chairs, to aid the patients further by picking up and manipulating objects – everything from flipping a light switch to picking up a cup and bringing it to the person’s lips.
The research has been funded by Nokia and Microsoft.

By David Chandler, MIT News Office

Massachusetts Institute of Technology

A new study found
that massage therapy may have immediate benefits on pain and mood
among patients with advanced cancer. The study, sponsored by the
Institute of Medicine and the National Institutes of Health, was a
randomized trial of 380 advanced cancer patients at 15 U.S. hospices.
In the study, patients had improvement in pain and mood immediately
following treatment that was greater with massage than with simple
touch.

Pain and depressed mood are common problems for patients with
advanced cancer. While drug therapies can reduce symptoms, they don’t
always work and often have troublesome side effects. Researchers
think that massage may interrupt the cycle of distress, offering
physical and psychological benefits. Physically, massage may decrease
inflammation and edema, increase blood and lymphatic circulation, and
relax muscle spasms. Psychologically, massage may promote relaxation,
release endorphins, and create a positive experience that distracts
temporarily from pain and depression.

Researchers caution that while message may offer some immediate
relief for patients with advanced cancer, the effects do not last
over time, demonstrating the need for more effective strategies to
manage pain at the end of life.

American College of Physicians

Coping with chronic pain can affect every aspect of a person’s life and cause conflict between what their mind wants to achieve and what their body allows them to do, according to research in the December issue of the Journal of Nursing and Healthcare of Chronic Illness.

Swedish researchers carried out in-depth interviews with ten people who had experienced chronic pain for between four and 32 years and were taking part in an outpatient rehabilitation programme. Nine of the patients, who ranged from 22 to 50 with an average age of 38, were unable to work because of their pain.

“A recent research study found that chronic pain affected up to 30 per cent of adults across Europe, impacting on people’s everyday lives and in many cases their ability to work” says lead author Asa Skjutar from the Karolinska Institutet.

“Although multidisciplinary rehabilitation programmes for people with chronic pain are well established in Sweden, they don’t work for everyone. There can be a number of reasons for this, from failing to customise treatment to individual needs through to delayed intervention which makes people less amenable to change.

“What is clear is that many patients with chronic pain find that their needs are not being met by healthcare professionals. Previous research has found that patients’ beliefs play an important role in how successful any interventions are. That is why we were keen to find out how people felt chronic pain impacted on their lives.”

Three key themes emerged during the interviews:

Adapting

Patients expressed conflicts between what they wanted to do and what their body let them do and they were constantly weighing up the consequences of their actions.

One woman described how she had to set her pain aside, grit her teeth and let her mind take the lead as she got her children off to school and daycare. “Had I listened to what hurts, then I wouldn’t have done it” she said. Another patient talked about how a fishing trip satisfied his lust for adventure, even though he was aware of the increased pain that might follow.

Others, however, talked about not making definite plans to avoid the guilt of cancelling. They also said that they had no problem in accepting help or stopping what they were doing if they felt their pain levels would escalate.

“The participants had gone though rehabilitation programmes that recommend a steady and moderate level of activity, but said that they had not found the best way to manage their pain” says Asa. “They moved between the two extremes of letting their body and their mind lead and repeated this cycle so that neither dominated.”

Discovering

Patients also spoke about their need to let go of the way they used to live – including their behaviour, daily routines and independence – and find new ways to express themselves. “It’s so strange for me to say no” said one participant. “I’m not used to it. Nobody else is used to it either.” But she learnt how to say no and, although it was tough, it felt good.

Another patient talked about how he had managed to paint a wall on one side of the house, but was unable to paint the remaining walls. “I am very pleased that it looks so nice even though I know that the other ones aren’t done” he said. “Before I wouldn’t have looked at that wall, I would’ve looked at the other ones.”

“These transformations didn’t happen overnight, they happened bit by bit” says Asa. “But they made people realise that they had made the adjustments they needed to make to their lives to manage their pain.”

Engaging

People who took part in the study also realised that they needed to manage their pain in order to enjoy their lives. They initially focused their energy on work-related roles and finding a fast cure for their pain, but this often led to more pain and feelings of defeat.

Family time and friendships became very important, because social interaction could often be achieved without too much activity. “I’m seeing friends and family again, which means a lot to me” said one participant. It was also important to have a change of scene. “I went to a friend’s and played a video game and talked and just had a good time, just relaxed” said another. “It was so nice to get out and do something.”

“Doing something they enjoyed gave people energy and made them feel more optimistic and positive” says Asa.

“Understanding how people are affected by chronic pain enables healthcare professionals to give them the support they need to adapt their lives, discover a new way forward and engage with friends and family in a way that enhances their quality of life” she concludes.

“Chronic pain is a very common health problem in adults and its management affects not just people’s personal lives and relationships but their contribution to society and the economy. It is vital that we enhance our understanding of people’s needs so we can provide more effective chronic pain management services that meet people’s varied and changing needs.”

Sources: Wiley – Blackwell, AlphaGalileo Foundation.