A description of the development of an innovative multi-component [LC] treatment program based on central sensitization, 2024, Munipalli+

SNT Gatchaman

SNT Gatchaman

Senior Member (Voting Rights)
Staff member
A description of the development of an innovative multi-component long COVID treatment program based on central sensitization with preliminary patient satisfaction data
Munipalli; Smith; Baird; Dobrowolski; Allman; Thomas; Bruce

OBJECTIVES
Estimates of the prevalence of Long COVID in the United States or worldwide are imprecise, but millions of people are thought to be affected. No effective treatment exists for the often devastating symptoms of Long COVID. Central Sensitization has been postulated as a causal/explanatory mechanism for developing Long COVID. No treatment to date has targeted Central Sensitization. The present cross-sectional study describes the first 140 patients treated in a multi-component treatment program that targets Central Sensitization to reduce symptom burden, improve functioning, and lower the psychological distress observed in these patients.

METHODS
140 patients diagnosed with Long COVID after an extensive medical evaluation were assessed for function, depression, and pain catastrophizing using questionnaires and patient satisfaction measures after completion of a 16-h Cognitive Behavioral Therapy treatment program focused on Central Sensitization.

RESULTS
Upon admission, patients diagnosed with Long COVID were significantly impaired in their ability to function due to their symptoms. Further, 70% of the patients were depressed. Pain catastrophizing was observed in up to 20% of patients.

CONCLUSIONS
Patient satisfaction measures were high for the sample at the end of the treatment program suggesting that a multicomponent treatment program targeting Central Sensitization is acceptable to patients. Further research is needed to explore the effectiveness and durability of this treatment approach.

Link (Journal of Psychosomatic Research)
 
Mayo Clinic, Uni North Florida (and The Stables of King Augeas I guess)

The program is a 16-h group-based multi-component class that targets the symptoms of Central Sensitization experienced by patients with Long COVID. Topics covered include the pathophysiology of Long COVID and Central Sensitization, and lifestyle management focusing on Cognitive Behavioral strategies that decrease symptoms, improve functioning, and reduce psychological distress.
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Good to know I still have a lifestyle. I thought I'd lost that when I suddenly became devastatingly sick and disabled 4 years ago.

Strategies taught include relaxation practices, graded exercise, sleep hygiene, moderation, activity pacing, and healthy nutrition to combat fatigue. Relaxation practices that assist with self-regulation include deep diaphragmic breathing, mindfulness sensory exploration practice, passive muscle relaxation, progressive muscle relaxation, imagery/visualization, meditation, yoga, and tai chi. Returning to day-to-day movement through graded exercise includes three components: stretching daily, strengthening twice a week, and building up to 30 min of moderate aerobic conditioning.
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Graded exercise and activity pacing. Impressive.

Sleep Hygiene focuses on creating a bedtime routine, maintaining consistent wake time and bedtime, having no screen time before bed, regular exercise, no naps, a cool, dark, and quiet sleep environment, and no clock watching. Moderation and activity pacing by changing positions throughout the day, prioritizing takes, delegation, and alternating between physical and non-physical activities every 45 min – 1 h.
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Don't watch those clocks kids. You wouldn't want to know you're awake in the middle of the night.

Healthy nutrition to address fatigue includes eating several small meals throughout the day, limiting caffeine to 1–2 cups before noon, and drinking more water. Stress management and the importance of social support and decreasing social isolation were reviewed. Stress reduction strategies include prioritizing self-care, simplifying the schedule, improving sleep, exercising, delegating, having fun, relaxing, and spending time with positive, supportive people.
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Was this written by the marketing department of the Sirius Cybernetics Corporation?

Mood and anxiety were also addressed through strategies for targeting maladaptive cognition, such as pain catastrophizing. Patients developed a plan that incorporates consistent implementation of these Cognitive Behavioral strategies daily to develop new habits and ways of thinking. Family members are encouraged to attend to improve patient support as they build this plan to manage their symptoms better.
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(whispers: "blink twice slowly")

The program was developed in a joint effort between the Division of General Internal Medicine Post-acute Sequelae of COVID-19 (PASC) clinic and the Department of Psychiatry and Psychology at an extensive tertiary medical practice. The program design was modeled after the medical practice’s Fibromyalgia Treatment Program that focuses on Cognitive Behavioral strategies to decrease Central Sensitization. A health psychologist and Licensed Clinical Social Workers facilitated all program components. The information and strategies taught in the program are also incorporated into a format that can be shared with the patient’s primary medical provider to help build additional support for using these tools going forward.
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Well done Mayo Clinic. You've cracked it, finally. I don't know what it was but this iteration is definitely the one that works.
 
So a mishmash of all the old stuff, with bias and woo turned all the way to 11, is presented as innovative. The same old stuff that has never worked, but has been suggested to work for decades. Somehow you can publish a paper presenting this as innovative. Ah well.

But even more bizarre, with 150 participants this was obviously meant to be a full scale trial. Definitely expensive. But in conclusion they present it as merely acceptable, asking for a larger trial, and the published paper is merely a "we're describing what we did". Obviously because it didn't work, as otherwise this is what they would have claimed.

All passive language that pretends that people's very biased opinions is just stuff they found on the ground, to their total surprise:
Central Sensitization has been identified as a primary hypothesis and proposed underlying explanatory mechanism for the development of the persistent symptoms observed in patients with Long COVID, similar to patients with Fibromyalgia, Chronic Fatigue, and other post-viral syndromes such as Epstein-Barr or West Nile Virus [11,[15], [16], [17]]. In a recent study, up to 70% of Long COVID patients had symptoms of Central Sensitization [11].
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"Has been identified as a primary hypothesis" literally means nothing and is completely circular. It's not even the academic version of "some people are saying", it's literally some people are saying. The people saying so being them. Which they are saying so right here.
A treatment model that utilizes cognitive behavioral strategies known to be effective in the treatment of Central Sensitization was developed and provided in an intensive 2-day format
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There is so much lying and nonsense in this small sentence. Even the "known to be effective" is impressive in that it's all literally suggestions made decades ago that have never panned out and they can't ever accept that. But here they are again, innovating by developing the same thing. And providing it. And that's the conclusion. It was developed. And provided. Now give them money. Somehow.

The level of incompetence is just so extreme. Even by the standards of some small mafia-run city government this is extreme, because there are basic things you can't just fail at running a small city government, even a corrupt one, without being thrown out with torches and pitchforks.
 
SNT Gatchaman said:
A description of the development of an innovative multi-component long COVID treatment program based on central sensitization with preliminary patient satisfaction data
Munipalli; Smith; Baird; Dobrowolski; Allman; Thomas; Bruce

OBJECTIVES
Estimates of the prevalence of Long COVID in the United States or worldwide are imprecise, but millions of people are thought to be affected. No effective treatment exists for the often devastating symptoms of Long COVID. Central Sensitization has been postulated as a causal/explanatory mechanism for developing Long COVID. No treatment to date has targeted Central Sensitization. The present cross-sectional study describes the first 140 patients treated in a multi-component treatment program that targets Central Sensitization to reduce symptom burden, improve functioning, and lower the psychological distress observed in these patients.

METHODS
140 patients diagnosed with Long COVID after an extensive medical evaluation were assessed for function, depression, and pain catastrophizing using questionnaires and patient satisfaction measures after completion of a 16-h Cognitive Behavioral Therapy treatment program focused on Central Sensitization.

RESULTS
Upon admission, patients diagnosed with Long COVID were significantly impaired in their ability to function due to their symptoms. Further, 70% of the patients were depressed. Pain catastrophizing was observed in up to 20% of patients.

CONCLUSIONS
Patient satisfaction measures were high for the sample at the end of the treatment program suggesting that a multicomponent treatment program targeting Central Sensitization is acceptable to patients. Further research is needed to explore the effectiveness and durability of this treatment approach.

Link (Journal of Psychosomatic Research)
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Dear God. Is that the best the Mayo Clinic can come up with after 4 years of Long COVID. A non scientific study advancing the Central Sensitization theory that is now becoming a cult. Barbra Bruce should just stick to pain catastrophizing.
 
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