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Sample records for subjective pain intensity

  1. Life satisfaction in subjects with long-term musculoskeletal pain in relation to pain intensity, pain distribution and coping.

    Science.gov (United States)

    Anke, Audny; Damsgård, Elin; Røe, Cecilie

    2013-03-01

    To investigate levels of life satisfaction in subjects with long-term musculoskeletal pain in relation to pain characteristics and coping. Cross-sectional study. A total of 232 (42%) respondents answered self--report questionnaires regarding life satisfaction, self-efficacy, sense of coherence, pain distribution and pain intensity at rest and during activity. Levels of life satisfaction and scores for sense of coherence were low. Pain intensity at rest was negatively correlated with global life satisfaction. This result was also obtained in multiple regression analyses together with the coping factors. The life satisfaction domains activities of daily living/contacts were negatively correlated with pain intensity during activity, and the domains work/economy were negatively correlated with pain distribution. Pain was not associated with satisfaction with family life, partner relationship or sexual life. Younger age, being married/cohabitant and being female were protective for some domains. Clinically meaningful subgroups with regard to adaptation were identified by cluster analysis, and the highest level of coping was found in the adaptive cluster with high life satisfaction/low pain intensity at rest. Long-term pain is related to low levels of life satisfaction, and pain intensity and distribution influence satisfaction in different domains. Pain intensity is negatively associated with coping. The results support efforts to reduce pain, together with strengthening active coping processes and addressing individual needs.

  2. Life satisfaction in subjects with long-term musculoskeletal pain in relation to pain intensity, pain distribution and coping

    National Research Council Canada - National Science Library

    Anke, Audny; Damsgård, Elin; Røe, Cecilie

    2013-01-01

    .... Cross-sectional study. A total of 232 (42%) respondents answered self--report questionnaires regarding life satisfaction, self-efficacy, sense of coherence, pain distribution and pain intensity at rest and during activity...

  3. Relationships among head posture, pain intensity, disability and deep cervical flexor muscle performance in subjects with postural neck pain

    Directory of Open Access Journals (Sweden)

    Arun V. Subbarayalu, PhD

    2017-12-01

    Full Text Available Objectives: Information Technology (IT professionals working with computers gradually develop forward head posture and, as a result, these professionals are susceptible to several neck disorders. This study intended to reveal the relationships between pain intensity, disability, head posture and deep cervical flexor (DCF muscle performance in patients with postural neck pain. Methods: A cross-sectional study was conducted on 84 IT professionals who were diagnosed with postural neck pain. The participants were recruited with a random sampling approach. A Visual Analogue Scale (VAS, the Northwick Park Neck Pain Questionnaire (NPQ, the Modified Head Posture Spinal Curvature Instrument (MHPSCI, and the Stabilizer Pressure Biofeedback Unit were used to measure neck pain intensity, neck disability, head posture, and DCF muscle performance, respectively. Results: The Pearson correlation coefficient revealed a significantly strong positive relationship between the VAS and the NPQ (r = 0.734. The cranio-vertebral (CV angle was found to have a significantly negative correlation with the VAS (r = −0.536 and a weak negative correlation with the NPQ (r = −0.389. Conclusion: This study concluded that a smaller CV angle corresponded to greater neck pain intensity and disability. Furthermore, there is no significant relationship between CV angle and DCF muscle performance, indicating that head posture re-education through postural correction exercises would not completely correct the motor control deficits in DCF muscles. In addition, a suitable exercise regimen that exclusively targets the deep cervical flexor muscle to improve its endurance is warranted. Keywords: Craniovertebral angle, Disability deep cervical flexors muscle performance, Head posture, Postural neck pain

  4. Influence of pain intensity, pain duration and location of pain in the ...

    African Journals Online (AJOL)

    Objective: The association of Leg length discrepancy (LLD) in subjects with chronic low back pain (LBPS) has been a debatable issue. The occurrence of LLD in LBPS and comparing with non-low back pain subjects (NLBS) and the possible influence of the site at which pain was felt, duration of low back pain and intensity ...

  5. [THE EFFECT OF THE APPLICATION OF THE KINESIOLOGY TAPING TECHNIQUE FOR MUSCLE RANGE OF MOTION OF THE LUMBAR SPINE, AND THE SUBJECTIVE PERCEPTION OF PAIN INTENSITY IN PATIENTS WITH BACK PAIN].

    Science.gov (United States)

    Garczyński, Wojciech; Lubkowska, Anna; Dobek, Aleksandra; Andryszczyk, Marek

    2014-01-01

    In an era of ubiquitous computing, a considerable part of the population, regardless of age group, spend more time in a sitting position. Long-term, static loading of the spine increases muscle tension, leading to the occurrence of pain. Physiotherapy is recommended as primary and secondary prevention of spinal pain symptoms. The Kinesiology Taping Method is one of the many special methods of physiotherapy which is used during the episodes of back pain in the lumbosacral region. This method consists in sticking on a special tape, which is made of stretch cotton similar to human skin, using a variety of techniques for patch application. The present study evaluated the effect of the application of the Kinesiology Taping technique for muscle mobility in the lumbar spine and the subjective perception of pain intensity. The study group consisted of 100 patients (89 women and 11 men) who experienced pain in the lumbar spine. To assess the mobility of the lumbar spine the Schober test was used. The subjective sensation of pain was assessed using the VAS (visual analogue scale). Measurements were taken four times: before gluing applications, immediately after taping, 7 days after application of the patch, and immediately after its removal. In response to the use of therapy, an increase of mobility of the lumbar spine in flexion front and back, and reduced pain was shown. Application of the muscle kinesiology taping technique is an effective method in reducing pain and increasing mobility of the lumbar spine.

  6. Validity of four pain intensity rating scales.

    Science.gov (United States)

    Ferreira-Valente, Maria Alexandra; Pais-Ribeiro, José Luís; Jensen, Mark P

    2011-10-01

    The Visual Analogue Scale (VAS), Numerical Rating Scale (NRS), Verbal Rating Scale (VRS), and the Faces Pain Scale-Revised (FPS-R) are among the most commonly used measures of pain intensity in clinical and research settings. Although evidence supports their validity as measures of pain intensity, few studies have compared them with respect to the critical validity criteria of responsivity, and no experiment has directly compared all 4 measures in the same study. The current study compared the relative validity of VAS, NRS, VRS, and FPS-R for detecting differences in painful stimulus intensity and differences between men and women in response to experimentally induced pain. One hundred twenty-seven subjects underwent four 20-second cold pressor trials with temperature order counterbalanced across 1°C, 3°C, 5°C, and 7°C and rated pain intensity using all 4 scales. Results showed statistically significant differences in pain intensity between temperatures for each scale, with lower temperatures resulting in higher pain intensity. The order of responsivity was as follows: NRS, VAS, VRS, and FPS-R. However, there were relatively small differences in the responsivity between scales. A statistically significant sex main effect was also found for the NRS, VRS, and FPS-R. The findings are consistent with previous studies supporting the validity of each scale. The most support emerged for the NRS as being both (1) most responsive and (2) able to detect sex differences in pain intensity. The results also provide support for the validity of the scales for use in Portuguese samples. Copyright © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  7. Automatic Pain Intensity Estimation using Heteroscedastic Conditional Ordinal Random Fields

    NARCIS (Netherlands)

    Rudovic, Ognjen; Pavlovic, Vladimir; Pantic, Maja

    Automatic pain intensity estimation from facial images is challenging mainly because of high variability in subject-specific pain expressiveness. This heterogeneity in the subjects causes their facial appearance to vary significantly when experiencing the same pain level. The standard classification

  8. Pain still hurts : pain assessment and pain management in intensive care patients

    NARCIS (Netherlands)

    S.J.G.M. Ahlers (Sabine)

    2012-01-01

    textabstractIntensive care patients are subject to many factors that may influence the patients’ state of comfort or distress. Pain is the main cause of distress experienced by many adult intensive care patients, which can be caused by different factors like underlying disease, prolonged immobility

  9. Continuous pain intensity estimation from facial expressions

    NARCIS (Netherlands)

    Kaltwang, Sebastian; Rudovic, Ognjen; Pantic, Maja

    2012-01-01

    Automatic pain recognition is an evolving research area with promising applications in health care. In this paper, we propose the first fully automatic approach to continuous pain intensity estimation from facial images. We first learn a set of independent regression functions for continuous pain

  10. Judgments about pain intensity and pain genuineness: the role of pain behavior and judgmental heuristics.

    Science.gov (United States)

    Martel, Marc O; Thibault, Pascal; Sullivan, Michael J L

    2011-04-01

    The primary objective of the present study was to examine the relative importance of pain behaviors and judgmental heuristics (eg, gender stereotypes) in observers' inferences about pain intensity and pain genuineness. Participants (n = 90) observed video depictions of chronic pain patients performing a physically challenging task and were asked to make inferences of pain intensity and pain genuineness. Analyses indicated that observers relied on judgmental heuristics and pain behaviors both when making inferences about pain intensity and when making inferences about pain genuineness. Follow-up analyses, however, revealed that judgmental heuristics (eg, gender stereotypes) were significantly less utilized when observers made inferences about pain genuineness than when observers made inferences about pain intensity. When observers made inferences about pain genuineness, analyses indicated that patients' facial pain behaviors became the most important source of information. Taken together, these findings suggest that observers who are asked to make inferences about the genuineness of others' pain are likely to reduce their reliance on judgmental heuristics in favor of more controlled and thoughtful inferential processes characterized by detailed processing of behavioral information, particularly others' facial pain behaviors. The current study provides new insights into the processes that are involved in observers' inferences about pain intensity and pain genuineness. These inferences play an important role in treatment decisions and advances in this domain could ultimately contribute to more effective management of the challenges facing patients with pain-related disorders. Copyright © 2011 American Pain Society. Published by Elsevier Inc. All rights reserved.

  11. Modeling subjective well-being in individuals with chronic pain and a physical disability: the role of pain control and pain catastrophizing.

    Science.gov (United States)

    Furrer, Angela; Michel, Gisela; Terrill, Alexandra L; Jensen, Mark P; Müller, Rachel

    2017-10-23

    To investigate the associations between subjective well-being and pain intensity, pain interference, and depression in individuals with physical disabilities. We hypothesized that (1) pain control and (2) pain catastrophizing mediate the effects of subjective well-being on pain intensity, pain interference, and depression. Analyses of cross-sectional data from 96 individuals diagnosed with spinal cord injury, multiple sclerosis, neuromuscular disease, or post-polio syndrome, with average pain intensity of ≥4 (0-10) on at least half the days in the past month. Two models tested study hypotheses using structural equation. Both models showed acceptable model fit. Pain catastrophizing significantly mediated the effect of subjective well-being on pain intensity and pain interference, but not on depression. Pain control did not significantly mediate the effect of subjective well-being on pain intensity, pain interference, or depression. Path coefficients showed significant direct effects of subjective well-being on pain control (β = 0.39), pain catastrophizing (β = -0.61), pain interference (β = -0.48; -0.42), and depression (β = -0.75; -0.78). This study supports the potential of enhancing subjective well-being and lowering pain catastrophizing for reducing pain intensity, pain interference, and depressive symptoms in individuals with chronic pain and a physical disability. The findings indicate that true experiments to test for causal associations are warranted. Implications for rehabilitation The majority of individuals with physical disabilities report having persistent moderate-to-severe pain that may negatively limit daily activities and quality of life. The present cross-sectional study indicates that individuals who reported greater subjective well-being showed significantly lower pain intensity via the mediating effect of lower pain catastrophizing. Since sample size and respective power are low, these findings should be taken as first

  12. Kinesiophobia is associated with pain intensity but not pain sensitivity before and after exercise

    DEFF Research Database (Denmark)

    Vaegter, H. B.; Madsen, A. B.; Handberg, G.

    2018-01-01

    pre-post within-subject study. SETTING: An exercise laboratory in a multidisciplinary pain clinic. PARTICIPANTS: Fifty-four patients with chronic musculoskeletal pain. INTERVENTIONS: Acute aerobic and isometric leg exercises. MAIN OUTCOME MEASURES: Clinical pain intensity (numerical rating scale......, range 0 to 10), Tampa Scale of Kinesiophobia, aerobic and isometric exercise performances (intensity and maximal voluntary contraction), and PPTs at local and remote body areas before and after exercise conditions. RESULTS: Patients with a high degree of kinesiophobia demonstrated increased pain...... differences were found in PPTs before and after exercise. CONCLUSIONS: Clinical pain intensity was significantly higher in patients with a high degree of kinesiophobia compared with patients with a low degree of kinesiophobia. Despite a difference in isometric exercise performance, the hypoalgesic responses...

  13. Effects of high intensity laser therapy on pain and function of patients with chronic back pain.

    Science.gov (United States)

    Choi, Hyeun-Woo; Lee, Jongmin; Lee, Sangyong; Choi, Jioun; Lee, Kwansub; Kim, Byung-Kon; Kim, Gook-Joo

    2017-06-01

    [Purpose] This study examined the effects of High Intensity Laser Therapy on pain and function of patients with chronic back pain. [Subjects and Methods] This study evenly divided a total of 20 patients with chronic back pain into a conservative physical therapy group that received conservative physical therapy, and a high intensity laser therapy group that received High Intensity Laser Therapy after conservative physical therapy. All patients received the therapy three times a week for four weeks. For the high intensity laser therapy group, treatment was applied to the L1-L5 and S1 regions for 10 minutes by using a high intensity laser device while vertically maintaining the separation distance from handpiece to skin at approximately 1 cm. A visual analog scale was used to measure the pain and Oswestry Disability Index was used for functional evaluation. [Results] In a within-group comparison of the conservative physical therapy and high intensity laser therapy groups, both the visual analog scale and Oswestry Disability Index significantly decreased. In a between-group comparison after treatment, the high intensity laser therapy group showed a significantly lower visual analog scale and Oswestry Disability Index than the conservative physical therapy group. [Conclusion] High Intensity Laser Therapy can be an effective nonsurgical intervention method for reducing pain and helping the performance of daily routines of patients who have chronic back pain.

  14. Unpleasant subjective emotional experiencing of pain

    Directory of Open Access Journals (Sweden)

    Nandini Vallath

    2013-01-01

    Full Text Available The field of pain medicine that once began as a supportive and compassionate care, adding value to the management of acute and chronic ailments, has now transformed into a vital and essential specialty with structured training programs and service units with professionals dedicating their careers to it. The expansion of understanding of the direct relationship of pain relief to the quality of life, uncovering of neuronal pathways, and technological advances in imaging as well as in interventional techniques have all contributed to this phenomenal growth. However, there is a growing concern whether the training programs and the specialized practitioners are gradually limiting their skilled inputs primarily within the sensory realm of the pain experience with sophisticated interventional techniques and relegating its subjective and emotional dimensions to perfunctory realms within the schema of service provision. While the specialty is still young, if we can understand the inherent aspect of these dimensions within the pain experience and acknowledge the gaps in service provision, it may be possible to champion development of truly comprehensive pain relief programs that responds effectively and ethically to a patient′s felt needs. This article attempts to position the subjectivity of pain experience in context and surface the need to design complete systems of pain relief services inclusive of this dimension. It presents authors′ review of literature on perspectives of ′unpleasant subjective emotional experiencing of the pain" to elucidate possible clinical implications based on the evidences presented on neuro-biology and neuro-psychology of the pain experience; the aim being to inspire systems of care where this dimension is sufficiently evaluated and managed.

  15. Subjective quality of life and emotional pain among subjects with ...

    African Journals Online (AJOL)

    Objective: Heart failure (HF) is a common pathology worldwide. Associated emotional pain is an important risk factor of increased morbidity and secondary psychopathology. Methods: Subjects in stable state of HF attending the cardiology clinic of Lagos University Teaching Hospital (LUTH) were recruited into the study.

  16. Assessing Pain Intensity Using Photoplethysmography Signals in Chronic Myofascial Pain Syndrome.

    Science.gov (United States)

    Ye, Jing-Jhao; Lee, Kuan-Ting; Chou, Ying-Yu; Sie, Hong-Hai; Huang, Ru-Nan; Chuang, Chiung-Cheng

    2017-05-14

    Efficacy of pain assessment is the basis for effective therapy. Clinically, assessing pain is by subjective scale, but these methods have some shortcomings. Therefore, studies have been conducted on assessment of pain using physiological signals. Photoplethysmography (PPG) signals provide much information about the cardiovascular system. PPG-derived parameters (PPG parameters) reflect nociceptive stimulation, and obtain an approximation of the R-R interval from the PPG period. The aim of this study was to evaluate PPG signals for assessment of pain intensity in chronic myofascial pain syndrome (MPS) patients. This study recruited 37 patients with chronic MPS; all of them were treated with electrotherapy and thermotherapy. The difference between pre- and post-therapy PPG parameters, and the correlation between pulse rate variability (PRV) and heart rate variability (HRV) were determined. We also obtained patients' pain intensity scores by visual analog scale, visual rating scale, and Wong-Banker face pain rating scale. Photoplethysmography and PRV/HRV parameters showed significant differences between pre- and post-treatment. The variation trend of PRV was similar with HRV in heart rate, R-R interval, low frequency, high frequency, and LF/HF; in addition, a high correlation between the parameters was observed either in pre- or post-therapy. PPG parameters indicated increased sympathetic tone. The results of the study indicated that PRV substituted for HRV in assessment of pain intensity in chronic MPS reflected parasympathetic nervous tone increase, and PPG parameters might reflect stress stimulation on skin. © 2017 World Institute of Pain.

  17. Pain Catastrophizing and Its Relationship with Health Outcomes: Does Pain Intensity Matter?

    Directory of Open Access Journals (Sweden)

    Carlos Suso-Ribera

    2017-01-01

    Full Text Available Pain catastrophizing is known to contribute to physical and mental functioning, even when controlling for the effect of pain intensity. However, research has yet to explore whether the strength of the relationship between pain catastrophizing and pain-related outcomes varies across pain intensity levels (i.e., moderation. If this was the case, it would have important implications for existing models of pain and current interventions. The present investigation explored whether pain intensity moderates the relationship between pain catastrophizing and pain-related outcomes. Participants were 254 patients (62% women with heterogeneous chronic pain. Patients completed a measure of pain intensity, pain interference, pain catastrophizing, and physical and mental health. Pain intensity moderated the relationship between pain catastrophizing and pain interference and between pain catastrophizing and physical health status. Specifically, the strength of the correlation between pain catastrophizing and these outcomes decreased considerably as pain intensity increased. In contrast, pain intensity did not moderate the relationship between pain catastrophizing and mental health. Study findings provide a new insight into the role of pain intensity (i.e., moderator in the relationship between pain catastrophizing and various pain-related outcomes, which might help develop existent models of pain. Clinical implications are discussed in the context of personalized therapy.

  18. The contribution of previous episodes of pain, pain intensity, physical impairment, and pain-related fear to disability in patients with chronic mechanical neck pain.

    Science.gov (United States)

    Saavedra-Hernández, Manuel; Castro-Sánchez, Adelaida M; Cuesta-Vargas, Antonio I; Cleland, Joshua A; Fernández-de-las-Peñas, César; Arroyo-Morales, Manuel

    2012-12-01

    The influence of physical and psychosocial variables on self-rated disability in patients with chronic mechanical neck pain has not been fully determined. This study examined the relationship of pain, physical impairment, and pain-related fear to disability in individuals with chronic mechanical neck pain. A cross-sectional study was conducted. Ninety-seven (n = 97) subjects (28 men, 69 women; mean age, 39.3 yrs) with chronic mechanical neck pain were prospectively recruited. Demographic information, duration of pain symptoms, pain intensity, pain-related fear, and cervical range of motion were collected on all subjects. Self-reported disability was measured with the Neck Disability Index. Correlation and regression analyses were performed to determine the association among the variables and to determine the proportions of explained variance in disability. Significant positive correlations existed between disability and previous history of neck pain (r = 0.45; P pain intensity (r = 0.32, P = 0.01), and disability and kinesiophobia (r = 0.23, P = 0.02). In addition, a significant negative correlation existed between disability and cervical extension range of motion (r = -0.18, P = 0.04). Stepwise regression analyses revealed that previous neck pain episodes, intensity of neck pain, kinesiophobia, and cervical extension range of motion were significant predictors of disability (r = 0.400; r adjusted = 0.372; F = 14.64; P neck pain, pain intensity, pain-related fear, and cervical extension range of motion explained 37.2% of the variability of self-report disability. Future longitudinal studies will help to determine the clinical implications of these findings.

  19. Physiological Signal-Based Method for Measurement of Pain Intensity

    Directory of Open Access Journals (Sweden)

    Yaqi Chu

    2017-05-01

    Full Text Available The standard method for prediction of the absence and presence of pain has long been self-report. However, for patients with major cognitive or communicative impairments, it would be better if clinicians could quantify pain without having to rely on the patient's self-description. Here, we present a newly pain intensity measurement method based on multiple physiological signals, including blood volume pulse (BVP, electrocardiogram (ECG, and skin conductance level (SCL, all of which are induced by external electrical stimulation. The proposed pain prediction system consists of signal acquisition and preprocessing, feature extraction, feature selection and feature reduction, and three types of pattern classifiers. Feature extraction phase is devised to extract pain-related characteristics from short-segment signals. A hybrid procedure of genetic algorithm-based feature selection and principal component analysis-based feature reduction was established to obtain high-quality features combination with significant discriminatory information. Three types of classification algorithms—linear discriminant analysis, k-nearest neighbor algorithm, and support vector machine—are adopted during various scenarios, including multi-signal scenario, multi-subject and between-subject scenario, and multi-day scenario. The classifiers gave correct classification ratios much higher than chance probability, with the overall average accuracy of 75% above for four pain intensity. Our experimental results demonstrate that the proposed method can provide an objective and quantitative evaluation of pain intensity. The method might be used to develop a wearable device that is suitable for daily use in clinical settings.

  20. Pain intensity, disability and depression in individuals with chronic back pain

    Directory of Open Access Journals (Sweden)

    Márcia de Oliveira Sakamoto Silva Garbi

    2014-08-01

    Full Text Available OBJECTIVES: to measure the pain intensity, identify the disability and depression levels in people with chronic back pain and to correlate these variables. A cross-sectional, descriptive and exploratory study was undertaken at the Pain Treatment Clinic of the University of São Paulo at Ribeirão Preto Hospital das Clínicas, between February and June 2012, after receiving approval from the Ethics Committee at the University of São Paulo at Ribeirão Preto College of Nursing.METHOD: sixty subjects with chronic back pain participated. The instruments used were: the 11-point Numerical Category Scale, the Roland-Morris Disability Questionnaire and the Beck Depression Inventory. To analyze the data, the arithmetic means, standard deviations and Spearman's correlation coefficient were calculated.RESULTS: the findings show that the participants presented high pain, disability and depression levels. The correlation between pain intensity and disability and between pain intensity and depression was positive and weak and, between disability and depression, positive and moderate.CONCLUSION: the study variables showed moderate and weak indices and the mutual correlations were positive.

  1. Pain intensity, disability and depression in individuals with chronic back pain1

    Science.gov (United States)

    Garbi, Márcia de Oliveira Sakamoto Silva; Hortense, Priscilla; Gomez, Rodrigo Ramon Falconi; da Silva, Talita de Cássia Raminelli; Castanho, Ana Carolina Ferreira; Sousa, Fátima Aparecida Emm Faleiros

    2014-01-01

    OBJECTIVES: to measure the pain intensity, identify the disability and depression levels in people with chronic back pain and to correlate these variables. A cross-sectional, descriptive and exploratory study was undertaken at the Pain Treatment Clinic of the University of São Paulo at Ribeirão Preto Hospital das Clínicas, between February and June 2012, after receiving approval from the Ethics Committee at the University of São Paulo at Ribeirão Preto College of Nursing. METHOD: sixty subjects with chronic back pain participated. The instruments used were: the 11-point Numerical Category Scale, the Roland-Morris Disability Questionnaire and the Beck Depression Inventory. To analyze the data, the arithmetic means, standard deviations and Spearman's correlation coefficient were calculated. RESULTS: the findings show that the participants presented high pain, disability and depression levels. The correlation between pain intensity and disability and between pain intensity and depression was positive and weak and, between disability and depression, positive and moderate. CONCLUSION: the study variables showed moderate and weak indices and the mutual correlations were positive. PMID:25296139

  2. Electronic diary assessment of pain-related fear, attention to pain, and pain intensity in chronic low back pain patients.

    NARCIS (Netherlands)

    Roelofs, J.; Peters, M.L.; Patijn, J.; Schouten, E.G.; Vlaeyen, J.W.

    2004-01-01

    The present study investigated the relationships between pain-related fear, attention to pain, and pain intensity in daily life in patients with chronic low back pain. An experience sampling methodology was used in which electronic diary data were collected by means of palmtop computers from 40

  3. Low intensity laser for reducing pain from anesthetic palatal injection.

    Science.gov (United States)

    Sattayut, Sajee

    2014-12-01

    The aim of this study was to evaluate the effectiveness of pain reduction techniques for palatal injection, namely, low intensity laser therapy (LILT), topical anesthesia, pressure, and light touch. Previous evidence indicates that LILT may prevent pain from palatal injection. However, no clinical trials evaluating this clinical question have been performed. A double-blind clinical trial was conducted using 80 healthy volunteers, 18-25 years of age. The subjects were randomly allocated into four groups with 10 females and 10 males each group. Pain reduction techniques were administered at an injection point that was 10 mm from the margin of the palatal gingiva of the upper left first molar according to the following groups: (1) a 790 nm 30 mW continuous wave with a 0.13 cm2 focal spot at an applied energy of 3.6 J and fluence of 27.69 J/cm2, (2) 20% benzocaine, (3) pressure, and (4) light touch as the control. Then, 2% lidocaine with 1:100,000 epinephrine was injected using a 27-gauge needle with a pressure and volume control intraligamentary syringe. All subjects recorded pain on a 10 cm visual analog scale (VAS). The pain score in the LILT group was <50 mm. The median of pain scores of the LILT, 20% benzocaine, pressure, and light touch groups were 11, 23, 27, and 31 mm, respectively. There was no statistically significant difference in VAS among the groups, using Kruskal-Wallis test (p=0.385). No statistically significant differences in pain scores were noted among low intensity laser, 20% benzocaine, pressure, and light touch.

  4. Exposure to virtual social stimuli modulates subjective pain reports.

    Science.gov (United States)

    Vigil, Jacob M; Torres, Daniel; Wolff, Alexander; Hughes, Katy

    2014-01-01

    Contextual factors, including the gender of researchers, influence experimental and patient pain reports. It is currently not known how social stimuli influence pain percepts, nor which types of sensory modalities of communication, such as auditory, visual or olfactory cues associated with person perception and gender processing, produce these effects. To determine whether exposure to two forms of social stimuli (audio and visual) from a virtual male or female stranger modulates cold pressor task (CPT) pain reports. Participants with similar demographic characteristics conducted a CPT in solitude, without the physical presence of an experimenter or another person. During the CPT, participants were exposed to the voice and image of a virtual male or female stranger. The voices had analogous vocal prosody, provided no semantic information (spoken in a foreign language) and differed only in pitch; the images depicted a middle-age male or female health care practitioner. Male participants, but not females, showed higher CPT pain intensity when they were exposed to the female stimuli compared with the male stimuli. Follow-up analyses showed that the association between the social stimuli and variability in pain sensitivity was not moderated by individual differences in subjective (eg, self-image) or objective measurements of one's physical stature. The findings show that exposure to virtual, gender-based auditory and visual social stimuli influences exogenous pain sensitivity. Further research on how contextual factors, such as the vocal properties of health care examiners and exposure to background voices, may influence momentary pain perception is necessary for creating more standardized methods for measuring patient pain reports in clinical settings.

  5. Adult attachment, anxiety, and pain self-efficacy as predictors of pain intensity and disability.

    Science.gov (United States)

    Meredith, Pamela; Strong, Jenny; Feeney, Judith A

    2006-07-01

    Pain self-efficacy and anxiety have each been shown to contribute substantially to pain intensity and pain-related disability. Although adult attachment theory has been related separately to chronic pain, anxiety, and self-efficacy, it has not before been investigated with either pain self-efficacy or anxiety in the context of chronic pain. This study investigated the interrelations between these aspects of the chronic pain experience and their relative contributions towards pain intensity and disability. A clinical sample of 152 chronic pain patients participated in this study, completing self-report measures of attachment, self-efficacy, pain intensity, and disability, prior to attending a multidisciplinary pain clinic. Results revealed that fearful and preoccupied (anxious) attachment categories were associated with low pain self-efficacy, while high scores on the attachment dimension of comfort with closeness were linked with high pain self-efficacy, particularly for males. Insecure attachment (whether defined in terms of categories or dimensions) was related to higher levels of anxiety. Pain self-efficacy proved a stronger predictor of pain intensity than did anxiety and was a stronger predictor of disability than pain intensity or anxiety. In addition, comfort with closeness moderated the associations between pain self-efficacy and disability, pain self-efficacy and pain intensity, and anxiety and disability. Together, these findings support the value of adopting an attachment theoretical approach in the context of chronic pain. Treatment considerations and future research directions are considered.

  6. Adhesive capsulitis of the shoulder: pain intensity and distribution.

    Science.gov (United States)

    Candela, V; Giannicola, G; Passaretti, D; Venditto, T; Gumina, S

    2017-12-01

    Papers regarding adhesive capsulitis (AC) of the shoulder focused on etiology, epidemiology, diagnosis, and treatment; until now, information on shoulder pain characteristics is still scarce. Our aim was to analyze pain intensity and distribution in patients with AC. The study group was composed of 278 (133M-145F) consecutive patients with AC. After diagnosis, shoulder pain distribution was assessed through an upper limb pain map and pain intensity through a visual analog scale. Patients were distinguished on the basis of gender, age, time elapsed from onset of symptoms, and severity of functional limitation. Data were submitted to statistical analysis. Intensity of shoulder pain caused by AC was higher in females (p pain arose from more than 3 months suffered a lower intensity of shoulder pain. Furthermore, pain intensity was higher in the most severe form of AC (active forward flexion Pain was localized predominantly on the anterior aspect of the shoulder (dermatomes C5-C6) and rarely extended beyond the distal third of the arm. No differences were found in pain distribution between male and female, between patients with pain from less or more than 3 months and between different levels of AC severity (p > 0.05). Shoulder pain due to AC may be influenced by gender and severity of functional limitation. AC pain distribution principally involves anterior aspect of the shoulder with downward extension of the arm until its distal third. Level IV.

  7. The Influence of Executive Functioning on Facial and Subjective Pain Responses in Older Adults

    Science.gov (United States)

    2016-01-01

    Cognitive decline is known to reduce reliability of subjective pain reports. Although facial expressions of pain are generally considered to be less affected by this decline, empirical support for this assumption is sparse. The present study therefore examined how cognitive functioning relates to facial expressions of pain and whether cognition acts as a moderator between nociceptive intensity and facial reactivity. Facial and subjective responses of 51 elderly participants to mechanical stimulation at three intensities levels (50 kPa, 200 kPa, and 400 kPa) were assessed. Moreover, participants completed a neuropsychological examination of executive functioning (planning, cognitive inhibition, and working memory), episodic memory, and psychomotor speed. The results showed that executive functioning has a unique relationship with facial reactivity at low pain intensity levels (200 kPa). Moreover, cognitive inhibition (but not other executive functions) moderated the effect of pressure intensity on facial pain expressions, suggesting that the relationship between pressure intensity and facial reactivity was less pronounced in participants with high levels of cognitive inhibition. A similar interaction effect was found for cognitive inhibition and subjective pain report. Consequently, caution is needed when interpreting facial (as well as subjective) pain responses in individuals with a high level of cognitive inhibition. PMID:27274618

  8. Chronic Temporomandibular Disorders: disability, pain intensity and fear of movement.

    Science.gov (United States)

    Gil-Martínez, Alfonso; Grande-Alonso, Mónica; López-de-Uralde-Villanueva, Ibai; López-López, Almudena; Fernández-Carnero, Josué; La Touche, Roy

    2016-12-01

    The objective was to compare and correlate disability, pain intensity, the impact of headache on daily life and the fear of movement between subgroups of patients with chronic temporomandibular disorder (TMD). A cross-sectional study was conducted in patients diagnosed with chronic painful TMD. Patients were divided into: 1) joint pain (JP); 2) muscle pain (MP); and 3) mixed pain. The following measures were included: Craniomandibular pain and disability (Craniofacial pain and disability inventory), neck disability (Neck Dsiability Index), pain intensity (Visual Analogue Scale), impact of headache (Headache Impact Test 6) and kinesiophobia (Tampa Scale of Kinesiophobia-11). A total of 154 patients were recruited. The mixed pain group showed significant differences compared with the JP group or MP group in neck disability (p pain and disability (p pain and disability for the MP group (β = 0.62; p pain group, neck disability (β = 0.40; p pain and disability. Mixed chronic pain patients show greater craniomandibular and neck disability than patients diagnosed with chronic JP or MP. Neck disability predicted the variance of craniofacial pain and disability for patients with MP. Neck disability and kinesiophobia predicted the variance of craniofacial pain and disability for those with chronic mixed pain.

  9. Subjective intensity and pleasantness in taste

    NARCIS (Netherlands)

    Veldhuizen, M.G.

    2006-01-01

    This thesis contains studies on intensity and pleasantness in taste perception. There is a formal relationship between intensity and hedonic value of stimuli, which can be expressed in an inverted U. The fact that pleasantness depends partially on stimulus intensity poses a problem when one wants to

  10. An acceptance-based intervention for children and adolescents with cancer experiencing acute pain - a single-subject study.

    Science.gov (United States)

    Thorsell Cederberg, Jenny; Dahl, JoAnne; von Essen, Louise; Ljungman, Gustaf

    2017-01-01

    Children and adolescents with cancer report pain as one of their most recurrent and troublesome symptoms throughout the cancer trajectory. Pain evokes psychological distress, which in turn has an amplifying effect on the pain experience. Acceptance-based interventions for experimentally induced acute pain predict increased pain tolerance, decreased pain intensity and decreased discomfort of pain. The aim of this study was to preliminarily evaluate an acceptance-based intervention for children and adolescents with cancer experiencing acute pain, with regard to feasibility and effect on pain intensity and discomfort of pain. This is a single-subject study with an AB design with a nonconcurrent multiple baseline. Children and adolescents aged four to 18 years undergoing cancer treatment at the Children's University Hospital, Uppsala, Sweden, reporting sustained acute pain were offered participation. Pain intensity and discomfort of pain were measured during baseline and at post-intervention. The intervention consisted of a pain exposure exercise lasting approximately 15 minutes. Five children participated in the study. All participants completed the intervention and reported that it had helped them to cope with the pain in the moment. All participants reported decreased discomfort of pain at post-measurement, three of whom also reported decreased pain intensity. The results suggest that an acceptance-based intervention may help children and adolescents with cancer to cope with the pain that is often associated with cancer treatment in spite of pharmacological pain management. The results are tentative but promising and warrant further investigation.

  11. Happiness, Pain Intensity, Pain Interference, and Distress in Individuals with Physical Disabilities.

    Science.gov (United States)

    Müller, Rachel; Terrill, Alexandra L; Jensen, Mark P; Molton, Ivan R; Ravesloot, Craig; Ipsen, Catherine

    2015-12-01

    The aim of this study was to examine how the construct of happiness is related to pain intensity, pain interference, and distress in individuals with physical disabilities. This study involves cross-sectional analyses of 471 individuals with a variety of health conditions reporting at least mild pain. The first hypothesis that happiness mediates the relationship between pain intensity and two outcomes, pain interference and distress, was not supported. The second hypothesis was supported by a good fitting model (χ2(10) = 12.83, P = 0.23, root-mean-square error of approximation = 0.025) and indicated that pain intensity significantly mediated the effect of happiness on pain interference (indirect effect: β = -0.13, P Happiness showed a significant direct effect on pain intensity (β = -0.20, P happiness components meaning, pleasure, and engagement fitted well (χ2(4) = 9.65, P = 0.05, root-mean-square error of approximation = 0.055). Pain intensity acted as a significant mediator but only mediated the effect of meaning on pain interference (indirect effect: β = -0.07, P = 0.05) and on distress (indirect effect via pain interference: β = -0.04, P = 0.05). Only meaning (β = -0.10, P = 0.05), but neither pleasure nor engagement, had a significant direct effect on pain intensity. Participants who reported greater happiness reported lower pain interference and distress through happiness' effects on pain intensity. Experiencing meaning and purpose in life seems to be most closely (and negatively) associated with pain intensity, pain interference, and distress. Findings from this study can lay the groundwork for intervention studies to better understand how to more effectively decrease pain intensity, pain interference, and distress.

  12. Negative beliefs about low back pain are associated with persistent high intensity low back pain.

    Science.gov (United States)

    Ng, Sin Ki; Cicuttini, Flavia M; Wang, Yuanyuan; Wluka, Anita E; Fitzgibbon, Bernadette; Urquhart, Donna M

    2017-08-01

    While previous cross-sectional studies have found that negative beliefs about low back pain are associated with pain intensity, the relationship between back beliefs and persistent low back pain is not well understood. This cohort study aimed to examine the role of back beliefs in persistent low back pain in community-based individuals. A hundred and ninety-two participants from a previous musculoskeletal health study were invited to take part in a two-year follow-up study. Beliefs about back pain were assessed by the Back Beliefs Questionnaire (BBQ) at baseline and low back pain intensity was measured by the Chronic Pain Grade Questionnaire at baseline and follow-up. Of the 150 respondents (78.1%), 16 (10.7%) reported persistent high intensity low back pain, 12 (8.0%) developed high intensity low back pain, in 16 (10.7%) their high intensity low back pain resolved and 106 (70.7%) experienced no high intensity low back pain. While participants were generally positive about low back pain (BBQ mean (SD) = 30.2 (6.4)), those with persistent high intensity pain reported greater negativity (BBQ mean (SD) = 22.6 (4.9)). Negative beliefs about back pain were associated with persistent high intensity low back pain after adjusting for confounders (M (SE) = 23.5 (1.6) vs. >30.1 (1.7), p back beliefs were associated with persistent high intensity low back pain over 2 years in community-based individuals. While further longitudinal studies are required, these findings suggest that targeting beliefs in programs designed to treat and prevent persistent high intensity low back pain may be important.

  13. Pain in persons with postpolio syndrome: frequency, intensity, and impact.

    Science.gov (United States)

    Stoelb, Brenda L; Carter, Gregory T; Abresch, Richard T; Purekal, Sophia; McDonald, Craig M; Jensen, Mark P

    2008-10-01

    To describe the frequency, intensity, and impact of pain in persons with postpoliomyelitis syndrome (PPS). Retrospective, cross-sectional survey. Community-based survey. Convenience sample of people with PPS. Not applicable. Overall intensity and duration of pain, pain sites, pain interference, pain treatments, and relief provided by pain treatments. A total of 91% (n=57) of the study participants (N=63) reported pain. The most frequently reported pain sites were the shoulders, lower back, legs, and hips. Participants reported pain intensity to be the greatest in the knees, legs, wrists, lower back, and head. Pain interfered most with sleep and with activities requiring a high level of musculoskeletal involvement. Respondents also reported pain problems that were more severe than those of the general population and than those of a sample of people with multiple sclerosis. Many treatments had been tried previously for pain, but continued use of treatments was reported by relatively few participants at the time of the survey. The findings indicate that pain is a persistent and common problem in persons with PPS, highlighting the need for effective and accessible pain treatments for this population.

  14. PAIN INTENSITY AND PAIN INTERFERENCE AMONG TRAUMA PATIENTS: A LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    Deya Prastika

    2016-12-01

    Full Text Available Background: The incidence of trauma has been high and has gained attention worldwide. The energy involved in trauma results in specific tissue damage. Such tissue damage generally leads to pain. The high pain intensity possibly is consequence of trauma due to transfer energy to the body from external force and absorbed in wide area. This pain affected patients’ physical and psychological function, in which well known as pain interference. Objective: The aim of this review is to describe the pain intensity and pain interference among trauma patients. Method: A systematic search of electronic databases (CINHAL, ProQuest, Science Direct, and Google scholar was conducted for quantitative and qualitative studies measuring pain intensity and pain interference. The search limited to hospitalized trauma patients in adult age. Results: The search revealed 678 studies. A total of 10 descriptive studies examined pain intensity and pain interference and met inclusion criteria. The pain intensity and pain interference was assessed using Brief Pain Inventory (BPI. Pain intensity of hospitalized trauma patients were moderate to severe. These including 6 studies in orthopedic trauma, one study in musculoskeletal, two in studies in combinational between orthopedic and musculoskeletal, and two studies in burn injury. Moreover, the patients also reported pain was relentless & unbearable. In accordance, data showed that pain interference was moderate to severe from six studies. These studies result in vary of functional interference. However, those studies examined pain interference on sleep, enjoyment of life, mood, relationship with other, walking, general activity, and walking. Conclusion: The evidence from 10 studies included in this review indicates that hospitalized trauma patients perceived moderate to severe pain intensity and pain interference. Further research is needed to better evaluate the pain of hospitalized trauma patients.

  15. Pain-Related and Negative Semantic Priming Enhances Perceived Pain Intensity

    Directory of Open Access Journals (Sweden)

    Maria Richter

    2014-01-01

    Full Text Available BACKGROUND: Negative affective and pain-related cues, such as pictures or words, have been shown to act as primes and enhance the perceived intensity of subsequent painful events. For pain-related semantic primes, it remains unclear whether this effect depends on negative valence itself or, specifically, on the pain-relatedness of the words.

  16. The primipara respons based on individual personality type to the intensity of delivery pain

    Directory of Open Access Journals (Sweden)

    Gita N Sari

    2016-01-01

    Full Text Available Delivery period is one of periods that can cause stress to the mother and the fetus. This period is the natural common phenomenon that for some women subjectively can be considered as pain process that can cause simultaneous anxiety and pain. Psychology research has shown that pain is not only connected to physical respond, the culture that teaches and nurtures us also play important role in coping the pain. These two factors shape different personality for each individual. The objective of this study is to find out the primipara respons based on individual personality type to the intensity of delivery pain. The method of this study was analytical method with survey cross sectional approach. The data was collected prospectively from interview and questionnaire in the same time to find out the correlation between individual personality type and the intensity of delivery pain based on inclusive and exclusive period February 1st 2009 to April 30th 2009. The result with chi-square test and spearman rank test showed significant correlation between individual personality type and the intensity of delivery pain (X2= 8,571 ; p = 0,014. There is the negative correlation between extrovert individual personality and intensity of delivery pain (rs= -0,730; p <0,001, and there is the positive correlation between introvert individual personality type and intensity of delivery pain (rs = 0,726; p <0,001. Based on mann whitney, showed significant difference between extrovert personality type and introverts personality type to intensity of delivery pain (Z M-W: 3,050, p: 0,002. Based on chi-square test showed significant correlation between knowledge based on individual personality type to the intensity of delivery pain (X2= 4,418; p = 0,036 The conclusion of these study are the more extrovert individual personality type the less intense the delivery pain would be, the more introvert individual personality type then the more intense delivery pain would be. The

  17. Effects of listening to music on pain intensity and pain distress after surgery: an intervention.

    Science.gov (United States)

    Vaajoki, Anne; Pietilä, Anna-Maija; Kankkunen, Päivi; Vehviläinen-Julkunen, Katri

    2012-03-01

    To evaluate the effects of music listening on pain intensity and pain distress on the first and second postoperative days in abdominal surgery patients and the long-term effects of music on the third postoperative day. Music has been found to relieve pain intensity in surgery patients. There are only a few studies on music intervention in abdominal surgery. Music intervention studies assessing multidimensional pain such as pain intensity and pain distress are also scarce. Prospective clinical study with two parallel groups. Patients undergoing elective abdominal surgery (n = 168) were divided into either a music group (n = 83) or a control group (n = 85). Patients assessed pain intensity and pain distress in bed rest, during deep breathing and in shifting position once in the evening of the operation day and on the first and second postoperative days in the morning, at noon and in the evening. On the third postoperative day, the patients assessed their pain intensity and pain distress only once. In the music group, the patients' pain intensity and pain distress in bed rest, during deep breathing and in shifting position were significantly lower on the second postoperative day compared with control group of patients. On the third postoperative day, when long-term effects of music on pain intensity and pain distress were assessed, there were no significant differences between music and control groups. This study demonstrates that the use of music alleviates pain intensity and pain distress in bed rest, during deep breathing and in shifting position after abdominal surgery on the second postoperative day. Music intervention is safe, inexpensive and easily used to improve the healing environment for abdominal surgery patients. Music intervention should be offered as an adjunct alternative to pharmacological pain relief after abdominal surgery in nursing practice. © 2011 Blackwell Publishing Ltd.

  18. Pain Extent, Pain Intensity, and Sleep Quality in Adolescents and Young Adults.

    Science.gov (United States)

    de la Vega, Rocío; Racine, Mélanie; Sánchez-Rodríguez, Elisabet; Tomé-Pires, Catarina; Castarlenas, Elena; Jensen, Mark P; Miró, Jordi

    2016-11-01

    Pain has been shown to be associated with poor sleep quality. The aim of this study was to better understand the role that pain intensity and pain extent (number of painful areas) may play in the sleep quality of young people with acute and chronic pain. Cross-sectional survey. A convenience sample of adolescents and young adults with acute or chronic pain; 414 individuals ages 12 to 24 (44% with chronic pain). We performed a hierarchical regression analysis with sleep as the dependent variable and pain intensity, extent, age and pain chronicity as predictors. Pain extent and pain intensity made significant and independent contributions to the prediction of sleep quality (βs = 0.23 [P sleep than adolescents (β = 0.13, P Sleep quality in young people could be improved by teaching them strategies to better manage pain intensity and pain extent. Clinical trials to evaluate the efficacy of (and best timing for) pain interventions to improve sleep quality are warranted. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. The determinants of subjective emotional intensity.

    NARCIS (Netherlands)

    Frijda, N.H.; Sonnemans, J.

    1995-01-01

    Tested the hypothesis that emotional intensity is determined jointly by variables from the following 4 classes: concerns (strength and relevance), appraisal, regulation, and individual response propensities. For 6 wks, 37 college students reported an emotion every week and answered questions on a

  20. Comorbidities, intensity, frequency and duration of pain, daily functioning and health care seeking in local, regional, and widespread pain - a descriptive population-based survey (SwePain).

    Science.gov (United States)

    Grimby-Ekman, Anna; Gerdle, Björn; Björk, Jonas; Larsson, Britt

    2015-07-24

    The clinical knowledge of factors related to the spread of pain on the body has increased and understanding these factors is essential for effective pain treatment. This population-based study examines local (LP), regional (RP), and widespread pain (WSP) on the body regarding comorbidities, pain aspects, and impact of pain and elucidates how the spread of pain varies over time. A postal questionnaire that addressed pain aspects (intensity, frequency, duration and anatomical spreading on a body manikin), comorbidities and implications of pain (i.e., work situation, physical activity, consumption of health care and experience of hospitality and treatment of health care) was sent to 9000 adults living in southeastern Sweden. Of these, 4774 (53 %) completed and returned the questionnaire. After 9 weeks, a follow-up questionnaire was sent to the 2983 participants who reported pain in the first questionnaire (i.e. 62 % of 4774 subjects). Of these, 1940 completed and returned the questionnaire (i.e. 65 % of 2983 subjects). The follow-up questionnaire included the same items as the first questionnaire. This study found differences in intensity, frequency and duration of pain, comorbidities, aspects of daily functioning and health care seeking in three pain categories based on spreading of pain: LP, RP and WSP. Compared to the participants with RP and LP, the participants with WSP had lower education and worse overall health, including more frequent heart disease and hypertension. In addition, participants with WSP had more intense, frequent, and long-standing pain, required more medical consultations, and experienced more impact on work. The participants with RP constituted an intermediate group regarding frequency and intensity of pain, and impact on work. The participants with LP were the least affected group regarding these factors. A substantial transition to RP had occurred by the 9-week follow-up. This study shows an association between increased spread of pain

  1. Chronic Pain and Exercise : Studies on pain intensity, biochemistry, adherence and attitudes

    OpenAIRE

    Karlsson, Linn

    2017-01-01

    Chronic pain is common in western countries and entails considerable consequences for the afflicted individuals as well as for the society. Furthermore, chronic pain is complex including an advanced interplay between biological-, psychological- and social aspects. Treatment of chronic pain attempts to decrease pain intensity and increase physical-, psychological- and social functioning. However, the treatment of chronic pain is still not optimized. Different types of physical activity and exe...

  2. The bidirectional relationship between pain intensity and sleep disturbance/quality in patients with low back pain.

    Science.gov (United States)

    Alsaadi, Saad M; McAuley, James H; Hush, Julia M; Lo, Serigne; Bartlett, Delwyn J; Grunstein, Roland R; Maher, Chris G

    2014-09-01

    This study investigated the bidirectional relationship between the intensity of low back pain (LBP) and sleep disturbance. Further, the study aimed to determine whether any relationship is dependent on pain duration, symptoms of depression and anxiety, and the method of sleep assessment (subjective vs. objective). Eighty patients with LBP completed a sleep diary. A subgroup of 50 patients additionally wore an electronic device (Armband) to measure sleep for 7 consecutive days. Pain intensity was assessed twice daily using a sleep diary. Depression and anxiety symptoms were assessed at baseline using the Depression Anxiety Stress Scale questionnaire. Generalized estimating equations (GEE) with an exchangeable correlation structure were used to examine the relationship between day-time pain intensity and sleep. The GEE analysis showed that a night of poor sleep quality, difficulty falling sleep (assessed by the sleep diary), waking after sleep onset, and low sleep efficiency (assessed by the sleep diary and Armband) were followed by a day with higher pain intensity. Further, a day with higher pain intensity was associated with a decrease in the subsequent night's sleep quality, an increase in sleep latency (assessed by the sleep diary), waking after sleep onset (assessed by both measures), and low sleep efficiency (assessed by the Armband). The findings demonstrate that there is a bidirectional relationship between sleep and pain intensity in patients with LBP. The relationship is independent of pain duration and baseline symptoms of depression and anxiety and somewhat dependent on the method of sleep measurement (sleep diary or Armband). Future research is needed to determine whether targeting sleep improvement in patients with LBP contributes to pain reduction.

  3. Painful Memories: Reliability of Pain Intensity Recall at 3 Months in Senior Patients

    Directory of Open Access Journals (Sweden)

    Raoul Daoust

    2017-01-01

    Full Text Available Background. Validity of pain recall is questioned in research. Objective. To evaluate the reliability of pain intensity recall for seniors in an emergency department (ED. Methods. This study was part of a prospective multicenter project for seniors (≥65 years old treated in an ED for minor traumatic injury. Pain intensity (0–10 numerical rating scale was evaluated at the initial ED visit, at one week (baseline, and 3 months. At three months, patients were asked to recall the pain intensity they had at baseline. Results. 482 patients were interviewed (mean age 76.6 years, SD ± 7.3 and 72.8% were female. Intraclass correlation coefficient between pain at baseline and its recall was 0.24 (95% CI: 0.14–0.33. Senior patients tended to overestimate their pain intensity by a mean of 1.2 (95% CI: 0.9–1.5 units. A stepwise multiple regression analysis showed that the variance of baseline pain recall at 3 months was explained by pain at ED visit (11%, pain at 3 months (7%, and pain at baseline (2%. Conclusion. The accuracy of pain intensity recall after three months is poor in seniors and seems to be influenced by the pain experienced at the time of injury.

  4. Determinants of procedural pain intensity in the intensive care unit. The Europain® study

    DEFF Research Database (Denmark)

    Puntillo, Kathleen A; Max, Adeline; Timsit, Jean-Francois

    2014-01-01

    in 192 ICUs in 28 countries. MEASUREMENTS AND MAIN RESULTS: Pain intensity on a 0-10 numeric rating scale increased significantly from baseline pain during all procedures (P wound drain removal, and arterial line insertion were the three most painful procedures, with median...

  5. [Subject and pain: introduction to a philosophy of medicine].

    Science.gov (United States)

    Pérez Marc, Gonzalo

    2010-10-01

    Pain cannot be explained. It may only be understood from the most unpleasant of positions: suffering it. Thus, in the attempt to account for its multiple occurrences, meanings and mechanisms, developing a philosophy of pain appears to be essential. The approach to these issues by traditional occidental medicine has not considered the particular language in their background, which contains a double subjectivity: the subjectivity it represents itself, and that which frames the relationship between the agents where this language circulates. Articulating traditional scientific medicine with social, anthropological, and artistic disciplines would allow for a satisfactory response to this double subjectiveness, resulting in a deep change in current pain therapies.

  6. Localizing and Assessing Amputee Pain with Intense Focused Ultrasound

    Science.gov (United States)

    2016-10-01

    18–21). Moreover, we have applied it successfully to identify focal and subcutaneous sources of shoulder pain in humans (22). Finally, in...AC, Gillenwater C, Mourad PD. Intense Focused Ultrasound Stimulation of the Rotator Cuff: Evaluation of the Source of Pain in Rotator Cuff Tears and...G., Deyo R. Diagnostic evaluation of low back pain with emphasis Page 33 on imaging. Ann Intern Med. 2002;(137):586–97. 27. Chou R, Loeser JD

  7. Pain cognition versus pain intensity in patients with endometriosis: toward personalized treatment.

    Science.gov (United States)

    van Aken, Mieke A W; Oosterman, Joukje M; van Rijn, C M; Ferdek, Magdalena A; Ruigt, Gé S F; Peeters, B W M M; Braat, Didi D M; Nap, Annemiek W

    2017-10-01

    To explore how pain intensity and pain cognition are related to health-related quality of life (HRQoL) in women with endometriosis. Cross-sectional questionnaire-based survey. Multidisciplinary referral center. Women with laparoscopically and/or magnetic resonance imaging-proven endometriosis (n = 50) and healthy control women (n = 42). For HRQoL, two questionnaires: the generic Short Form Health Survey (SF-36) and the Endometriosis Health Profile 30 (EHP-30). For pain cognition, three questionnaires: the Pain Catastrophizing Scale (PCS), the Pain Vigilance and Awareness Questionnaire (PVAQ), and the Pain Anxiety Symptoms Scale (PASS). For pain intensity, the verbal Numeric Rating Scale (NRS). Association between pain intensity and pain cognition with HRQoL in women with endometriosis, and the differences in HRQoL and pain cognition between women with endometriosis and healthy controls. Health-related quality of life was statistically significantly impaired in women with endometriosis as compared with healthy control women. The variables of pain intensity and pain cognition were independent factors influencing the HRQoL of women with endometriosis. Patients with endometriosis had statistically significantly more negative pain cognition as compared with controls. They reported more pain anxiety and catastrophizing, and they were hypervigilant toward pain. Pain cognition is independently associated with the HRQoL in endometriosis patients. Clinicians should be aware of this phenomenon and may consider treating pain symptoms in a multidimensional, individualized way in which the psychological aspects are taken into account. In international guidelines on management of women with endometriosis more attention should be paid to the psychological aspects of care. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  8. Profiles of Urine Drug Test in Clinical Pain Patients vs Pain Research Study Subjects.

    Science.gov (United States)

    Lee, Cheng-ting; Vo, Trang T; Cohen, Abigail S; Ahmed, Shihab; Zhang, Yi; Mao, Jianren; Chen, Lucy

    2016-04-01

    To examine similarities and differences in urine drug test (UDT) results in clinical pain patients and pain subjects participating in pain research studies. An observational study with retrospective chart review and data analysis. We analyzed 1,874 UDT results obtained from 1) clinical pain patients (Clinical Group; n = 1,529) and 2) pain subjects consented to participate in pain research studies (Research Group; n = 345). Since several medications such as opioids used in pain management are drugs of abuse (DOA) and can result in a positive UDT, we specifically identified those cases of positive UDT due to nonprescribed DOA and designated these cases as positive UDT with DOA (PUD). We found that 1) there was a higher rate of PUD in clinical pain patients (41.3%) than in pain research study subjects (14.8%); 2) although subjects in the Research Group were informed ahead of time that UDT will be conducted as a screening test, a substantial number (14.8%) of pain research study subjects still showed PUD; 3) there were different types of DOA between clinical pain patients (cannabinoids as the top DOA) and research study subjects (cocaine as the top DOA); and 4) a common factor associated with PUD was opioid therapy in both Clinical Group and Research Group. These results support previous findings that PUD is a common finding in clinical pain patients, particularly in those prescribed opioid therapy, and we suggest that UDT be used as routine screening testing in pain research studies. © 2015 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. The role of pain behaviour and family caregiver responses in the link between pain catastrophising and pain intensity : A moderated mediation model

    NARCIS (Netherlands)

    Mohammadi, Somayyeh; Dehghani, Mohsen; Sanderman, Robbert; Hagedoorn, Mariet

    2017-01-01

    Objectives: This study investigated the mediating role of pain behaviours in the association between pain catastrophising and pain intensity and explored the moderating role of family caregivers' responses to pain in the link between pain behaviours and pain intensity. Methods: The sample consisted

  10. The role of pain behaviour and family caregiver responses in the link between pain catastrophising and pain intensity: A moderated mediation model

    NARCIS (Netherlands)

    Mohammadi, Somayyeh; Dehghani, Mohsen; Sanderman, Robbert; Hagedoorn, Mariët

    2017-01-01

    Objectives: This study investigated the mediating role of pain behaviours in the association between pain catastrophising and pain intensity and explored the moderating role of family caregivers’ responses to pain in the link between pain behaviours and pain intensity. Methods: The sample consisted

  11. A systematic comparison between subjects with no pain and pain associated with active myofascial trigger points.

    Science.gov (United States)

    Gerber, Lynn H; Sikdar, Siddhartha; Armstrong, Katee; Diao, Guoqing; Heimur, Juliana; Kopecky, John; Turo, Diego; Otto, Paul; Gebreab, Tadesse; Shah, Jay

    2013-11-01

    To determine whether standard evaluations of pain distinguish subjects with no pain from those with myofascial pain syndromes (MPS) and active myofascial trigger points (MTrPs) and to assess whether self-reports of mood, function, and health-related quality of life differ between these groups. A prospective, descriptive study. University. Adults with and without neck pain. We evaluated adults with MPS and active (painful) MTrPs and those without pain. Subjects in the "active" (A) group had at least one active MTrP with spontaneous pain that was persistent, lasted longer than 3 months, and had characteristic pain on palpation. Subjects in the "no pain" (NP) group had no spontaneous pain. However, some of these subjects had discomfort upon MTrP palpation (latent MTrP), whereas others in the NP group had no discomfort upon palpation of nodules or had no nodules. Each participant underwent range of motion measurement, a 10-point manual muscle test, and manual and algometric palpation. The latter determined the pain/pressure threshold using an algometer of 4 predetermined anatomic sites along the upper trapezius. Participants rated pain using a verbal analog scale (0-10) and completed the Brief Pain Inventory and Oswestry Disability Scale (which included a sleep subscale), the Short -Form 36 Health Survey, and the Profile of Mood States. The A group included 24 subjects (mean age 36 years; 16 women), and the NP group included 26 subjects (mean age 26 years; 12 women). Group A subjects differed from NP subjects in the number of latent MTrPs (P = .0062), asymmetrical cervical range of motion (P = .01 for side bending and P = .002 for rotation), and in all pain reports (P < .0001), algometry (P < .03), Profile of Mood States (P < .038), Short Form 36 Health Survey (P < .01), and Oswestry Disability Scale (P < .0001). A systematic musculoskeletal evaluation of people with MPS reliably distinguishes them from subjects with no pain. The 2 groups are significantly different in

  12. Pain intensity and barometric pressure closely correlate in Southern Taiwan.

    Science.gov (United States)

    Liu, Yen-Chin; Tseng, Fan-Ling; Feng, Jui-Ying; Lam, Chen-Fuh; Tsai, Yu-Chuan

    2006-09-01

    Previous reports suggest that weather changes may affect the attack and pattern of pain. However, a direct relationship between weather and pain attack is yet to be determined, especially when very limited data are currently available in the tropical or subtropical regions. We studied the patients who visited our clinic for pain management in Tainan, a city in southern Taiwan, in the space from February 2004 to December 2005. Intensity of pain measured by visual analogue scale (VAS) and the weather conditions including temperature, barometric pressure, humidity and wind speed at the time of measurement, were recorded. Our results indicate that higher scores of the VAS were associated with older age and lower barometric pressure, while the associations with temperature, humidity and wind speed were not statistically significant. Our results demonstrate a unique pattern of pain, which varies with barometric pressure, in the subtropical region and may provide reference for better pain intervention during change of weather.

  13. Abnormal white matter integrity during pain-free periovulation is associated with pain intensity in primary dysmenorrhea.

    Science.gov (United States)

    Dun, Wanghuan; Yang, Jing; Yang, Ling; Ma, Shaohui; Guo, Chenguang; Zhang, Xiaona; Zhang, Huawen; Liu, Hongjuan; Zhang, Ming

    2017-08-01

    Neuroimaging studies have preliminarily described brain structural and functional differences that consist of the pain transmission and modulation systems in primary dysmenorrhea (PDM). However, whether PDM subjects have distinctive white matter (WM) alteration during the time when there is no painful menstruation is largely unknown. If that is the case, whether such specific variability is interconnected with the dysmenorrhic symptoms is unclear. In the current study, diffusion tensor imaging (DTI) was performed on 24 PDM females and 24 healthy control subjects. Optimized tract-based spatial statistics was employed to examine the between group differences in DTI measures including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD). Visual analogue scale (VAS) was used to rate the intensity of the abdominal pain at periovulation and menstruation. In our results, PDM had lower FA coupled with higher MD and RD in widespread WM fibers including the splenium part of the corpus callosum, the posterior limb of the internal capsule, the anterior, superior and posterior corona radiata, and the posterior thalamic radiation (P < 0.05, FWE corrected). Further correlation analyses revealed close correlations between these DTI measures and VAS of the menstrual phase when the PDM showed serious abdominal pain. In the current study, we found PDM females had abnormal WM integrity involving pain transmission and modulation systems when they were at periovulation. Additionally, these WM abnormalities may closely associate with the intensity of painful menstruation. These observations complement the brain microstructural investigations for the pathophysiology of PDM.

  14. Effectiveness of low-level laser therapy on pain intensity, pressure pain threshold, and SF-MPQ indexes of women with myofascial pain.

    Science.gov (United States)

    Magri, Laís Valencise; Carvalho, Vinícius Almeida; Rodrigues, Flávia Cássia Cabral; Bataglion, César; Leite-Panissi, Christie Ramos Andrade

    2017-02-01

    Women with temporomandibular disorders (TMD) frequently report pain areas in body regions. This process is associated with central sensitization phenomena, present in chronic pain. The low-level laser therapy (LLLT) has been reported as a therapeutic option for the painful TMD treatment. The aim of this study was to analyze the effect of LLLT on pain intensity (visual analogue scale, VAS), pain sensitivity in orofacial and corporal points (pressure pain threshold, PPT), and on Short Form-McGill Pain Questionnaire (SF-MPQ) indexes of women with myofascial pain (subtype of muscle TMD). Ninety-one women (18-60 years) were included in the study, among which 61 were diagnosed with myofascial pain (Research Diagnostic Criteria for Temporomandibular Disorder-Ia and Ib) and were divided into laser (n = 31) and placebo group (n = 30), and 30 were controls. The LLLT was applied at pre-established points, twice a week, eight sessions (780 nm; masseter and anterior temporal = 5 J/cm(2), 20 mW, 10 s; TMJ area = 7.5 J/cm(2), 30 mW, 10 s). Pain intensity, pain sensitivity, and the SF-MPQ indexes were measured at the baseline, during laser sessions, and 30 days after treatment. For intra-group comparisons, the Friedman test was performed, and for inter-group, the Mann-Whitney test. Increased pain sensitivity was found in women with myofascial pain when compared to controls (p  0.05). Active laser and placebo reduced the indexes of sensory, total pain, and VAS, maintaining the results after 30 days; there was a reduction in the affective pain rating index for both groups, with no maintenance after 30 days for placebo, and the present pain intensity decreased in the laser group and did not change in the placebo after LLLT. In conclusion, the LLLT active or placebo are effective in reducing the overall subjective perception of myofascial pain (VAS and SF-MPQ indexes); however, they have no effectiveness in reducing the pain sensitivity in orofacial and

  15. Fear of pain in the context of intensive pain rehabilitation among children and adolescents with neuropathic pain: Associations with treatment response

    OpenAIRE

    Simons, Laura E.; Kaczynski, Karen J.; Conroy, Caitlin; Logan, Deirdre E

    2012-01-01

    Recent research has implicated pain-related fear in relation to functional outcomes in children with chronic pain. The current study examined fear of pain, disability, and depression within the context of an intensive pain rehabilitation program. One hundred and forty-five children and adolescents who participated in an intensive interdisciplinary pediatric pain rehabilitation day program were assessed in this study. Patients completed measures of pain intensity, pain-related fears, functiona...

  16. Intensive dynamic training for females with chronic neck/shoulder pain. A randomized controlled trial

    DEFF Research Database (Denmark)

    Randløv, A; Østergaard, Mikkel; Manniche, C

    1998-01-01

    OBJECTIVES: To compare the clinical effectiveness of an intensive three-month training programme with a less intensive programme on females suffering from chronic neck/shoulder pain. STUDY DESIGN: A prospective observer-blinded clinical trial including 12-month pretreatment follow-up. SETTING......: Patients were referred to the Departments of Rheumatology and Physical Medicine at Hvidovre Hospital by their general practitioners. Training was undertaken at a satellite clinic for physiotherapy of Hvidovre Hospital. SUBJECTS: Female patients aged 18-65 years suffering from chronic neck/shoulder pain...... for a minimum of six months. INTERVENTION: Patients were examined by a physician in order to exclude serious diseases. They were then randomized to either an intensive neck/shoulder training programme or a programme of lesser intensity but of similar duration. MAIN OUTCOME MEASURES: Scales measuring pain...

  17. An acceptance-based intervention for children and adolescents with cancer experiencing acute pain – a single-subject study

    Science.gov (United States)

    Thorsell Cederberg, Jenny; Dahl, JoAnne; von Essen, Louise; Ljungman, Gustaf

    2017-01-01

    Background Children and adolescents with cancer report pain as one of their most recurrent and troublesome symptoms throughout the cancer trajectory. Pain evokes psychological distress, which in turn has an amplifying effect on the pain experience. Acceptance-based interventions for experimentally induced acute pain predict increased pain tolerance, decreased pain intensity and decreased discomfort of pain. The aim of this study was to preliminarily evaluate an acceptance-based intervention for children and adolescents with cancer experiencing acute pain, with regard to feasibility and effect on pain intensity and discomfort of pain. Methods This is a single-subject study with an AB design with a nonconcurrent multiple baseline. Children and adolescents aged four to 18 years undergoing cancer treatment at the Children’s University Hospital, Uppsala, Sweden, reporting sustained acute pain were offered participation. Pain intensity and discomfort of pain were measured during baseline and at post-intervention. The intervention consisted of a pain exposure exercise lasting approximately 15 minutes. Results Five children participated in the study. All participants completed the intervention and reported that it had helped them to cope with the pain in the moment. All participants reported decreased discomfort of pain at post-measurement, three of whom also reported decreased pain intensity. Conclusion The results suggest that an acceptance-based intervention may help children and adolescents with cancer to cope with the pain that is often associated with cancer treatment in spite of pharmacological pain management. The results are tentative but promising and warrant further investigation. PMID:28919815

  18. [Fear and preoperative anxiety behaviour and pain intensity perceived after knee arthroscopy].

    Science.gov (United States)

    Anguita-Palacios, M Carmen; Talayero-San-Miguel, Marta; Herrero-Cereceda, Salomé; Martín-Cadenas, Mar; Pardo-Cuevas, Pilar; Gil-Martínez, Alfonso

    2016-01-01

    The aim of this study was to investigate the short-term (24hours) association between postoperative pain and preoperative psychological variables (anxiety, pain catastrophizing and kinesiophobia) in a sample of knee arthroscopy ambulatory surgery. Observational cross-sectional study, conducted with 40 adult subjects who underwent knee arthroscopy in the surgical area of Cantoblanco Hospital (Hospital Universitario La Paz) in Madrid. The fear-avoidance beliefs and anxiety were assessed using validated questionnaires of pain catastrophizing, kinesiophobia and anxiety. Pre and post-surgical pain and perceived disability were evaluated by the Verbal Numeric Scale. Mean age of the sample (22 men and 18 women) was 52.85±14.21 without significant differences between gender. No statistically significant data for the association between variables of kinesiofobia, anxiety and pain catastrophizing and the intensity of perceived pain by the postoperative knee arthroscopy patient were found. Length of surgery in our study has a correlation with the immediate post-surgical pain (r=0.468; P=.002) and there is a relationship between age and pain intensity at 24hours (r=-0.329; P=.038), and between age and perceived disability (r=-0.314; P=.049). An association between catastrophizing and kinesiophobia scales (r=0.337; P=.033) is obtained likewise. In conclusion, preoperative fear-avoidance beliefs like pain anxiety or pain catastrophizing and kinesiophobia were not associated with acute postoperative pain in our study. Analyses of secondary pain related outcomes, however, indicated that reduced time of surgery may contribute to enhance clinical postoperative pain. If confirmed and replicated in larger samples, this may potentially enable clinicians to improve postoperative pain management in future patients. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  19. Handling Ibuprofen increases pain tolerance and decreases perceived pain intensity in a cold pressor test.

    Science.gov (United States)

    Rutchick, Abraham M; Slepian, Michael L

    2013-01-01

    Pain contributes to health care costs, missed work and school, and lower quality of life. Extant research on psychological interventions for pain has focused primarily on developing skills that individuals can apply to manage their pain. Rather than examining internal factors that influence pain tolerance (e.g., pain management skills), the current work examines factors external to an individual that can increase pain tolerance. Specifically, the current study examined the nonconscious influence of exposure to meaningful objects on the perception of pain. Participants (N = 54) completed a cold pressor test, examined either ibuprofen or a control object, then completed another cold pressor test. In the second test, participants who previously examined ibuprofen reported experiencing less intense pain and tolerated immersion longer (relative to baseline) than those who examined the control object. Theoretical and applied implications of these findings are discussed.

  20. Handling Ibuprofen increases pain tolerance and decreases perceived pain intensity in a cold pressor test.

    Directory of Open Access Journals (Sweden)

    Abraham M Rutchick

    Full Text Available Pain contributes to health care costs, missed work and school, and lower quality of life. Extant research on psychological interventions for pain has focused primarily on developing skills that individuals can apply to manage their pain. Rather than examining internal factors that influence pain tolerance (e.g., pain management skills, the current work examines factors external to an individual that can increase pain tolerance. Specifically, the current study examined the nonconscious influence of exposure to meaningful objects on the perception of pain. Participants (N = 54 completed a cold pressor test, examined either ibuprofen or a control object, then completed another cold pressor test. In the second test, participants who previously examined ibuprofen reported experiencing less intense pain and tolerated immersion longer (relative to baseline than those who examined the control object. Theoretical and applied implications of these findings are discussed.

  1. Neutral lumbar spine sitting posture in pain-free subjects.

    Science.gov (United States)

    O'Sullivan, Kieran; O'Dea, Patrick; Dankaerts, Wim; O'Sullivan, Peter; Clifford, Amanda; O'Sullivan, Leonard

    2010-12-01

    Sitting is a common aggravating factor in low back pain (LBP), and re-education of sitting posture is a common aspect of LBP management. However, there is debate regarding what is an optimal sitting posture. This pilot study had 2 aims; to investigate whether pain-free subjects can be reliably positioned in a neutral sitting posture (slight lumbar lordosis and relaxed thorax); and to compare perceptions of neutral sitting posture to habitual sitting posture (HSP). The lower lumbar spine HSP of seventeen pain-free subjects was initially recorded. Subjects then assumed their own subjectively perceived ideal posture (SPIP). Finally, 2 testers independently positioned the subjects into a tester perceived neutral posture (TPNP). The inter-tester reliability of positioning in TPNP was very good (intraclass correlation coefficient (ICC) = 0.91, mean difference = 3% of range of motion). A repeated measures ANOVA revealed that HSP was significantly more flexed than both SPIP and TPNP (p 0.05). HSP was more kyphotic than all other postures. This study suggests that pain-free subjects can be reliably positioned in a neutral lumbar sitting posture. Further investigation into the role of neutral sitting posture in LBP subjects is warranted. Copyright © 2010 Elsevier Ltd. All rights reserved.

  2. Neutral lumbar spine sitting posture in pain-free subjects

    OpenAIRE

    O'Sullivan, Kieran; O'Dea, Patrick; Dankaerts, Wim; O'Sullivan, Peter; Clifford, Amanda; O'Sullivan, Leonard

    2010-01-01

    Sitting is a common aggravating factor in low back pain (LBP), and re-education of sitting posture is a common aspect of LBP management. However, there is debate regarding what is an optimal sitting posture. This pilot study had 2 aims; to investigate whether pain-free subjects can be reliably positioned in a neutral sitting posture (slight lumbar lordosis and relaxed thorax); and to compare perceptions of neutral sitting posture to habitual sitting posture (HSP). The lower lumbar spine HSP o...

  3. Panoramic findings in 34-year-old subjects with facial pain and pain-free controls.

    Science.gov (United States)

    Huumonen, S; Sipilä, K; Zitting, P; Raustia, A M

    2007-06-01

    The aim of this study was to compare panoramic radiographic findings between subjects with reported facial pain and pain-free controls in a population-based sample of 34-year olds. The study was a part of a comprehensive medical survey including subjects born in the year 1966 in Northern Finland. A sub-sample of the cohort was formed based on the question concerning facial pain. A panoramic radiograph was taken of 48 subjects with facial pain and 47 pain-free controls. Pathological findings in the dentition, jaws, maxillary sinuses and temporomandibular joints (TMJs) were compared between the groups. The majority of the subjects in both groups did not have pathological findings. Compared with controls, the subjects with facial pain did not show significantly more pathological findings in the teeth, periodontium, maxillary sinuses, TMJs or in the other areas. Radiographic panoramic findings had no association with reported facial pain in the population-based sample of young adults, and have little impact on the diagnosis of facial pain.

  4. Is improved fitness associated with reduced pain intensity in patients with low back pain?

    DEFF Research Database (Denmark)

    Maribo, Thomas; Budtz, Cecilie Rud; Krogsgaard, Lene Wulff

    2016-01-01

    Introduction: Low back pain (LBP) is a common global health problem and it causes more disability worldwide than any other disease. Despite this, knowledge concerning causes, prevention and effective treatments is lacking. It is a general assumption that LBP is associated with reduced physical...... capacity, but only few studies have examined this association. Objective: To examine the association between fitness and pain intensity in LBP-patients. Further to examine the association between clinically relevant improved fitness and clinically relevant reduced pain intensity at follow-up based...... and complete 3 months’ follow-up on fitness and pain. Clinically relevant improved fitness was defined as improved fitness ≥ 10% from baseline to follow-up. Clinically relevant change in pain intensity was defined as a reduction ≥ 30% on the Numerical Rating Scale. The association was examined by Spearman...

  5. Optimism, pain coping strategies and pain intensity among women with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Zuzanna Kwissa-Gajewska

    2014-07-01

    Full Text Available Objectives: According to the biopsychosocial model of pain, it is a multidimensional phenomenon, which comprises physiological (sensation-related factors, psychological (affective and social (socio-economic status, social support factors. Researchers have mainly focused on phenomena increasing the pain sensation; very few studies have examined psychological factors preventing pain. The aim of the research is to assess chronic pain intensity as determined by level of optimism, and to identify pain coping strategies in women with rheumatoid arthritis (RA. Material and methods : A survey was carried out among 54 women during a 7-day period of hospitalisation. The following questionnaires were used: LOT-R (optimism; Scheier, Carver and Bridges, the Coping Strategies Questionnaire (CSQ; Rosenstiel and Keefe and the 10-point visual-analogue pain scale (VAS. Results: The research findings indicate the significance of optimism in the experience of chronic pain, and in the pain coping strategies. Optimists felt a significantly lower level of pain than pessimists. Patients with positive outcome expectancies (optimists experienced less pain thanks to replacing catastrophizing (negative concentration on pain with an increased activity level. Regardless of personality traits, active coping strategies (e.g. ignoring pain sensations, coping self-statements – appraising pain as a challenge, a belief in one’s ability to manage pain resulted in a decrease in pain, whilst catastrophizing contributed to its intensification. The most common coping strategies included praying and hoping. Employment was an important demographic variable: the unemployed experienced less pain than those who worked. Conclusions : The research results indicate that optimism and pain coping strategies should be taken into account in clinical practice. Particular attention should be given to those who have negative outcome expectations, which in turn determine strong chronic pain

  6. Are pain intensity and pain related fear related to functional capacity evaluation performances of patients with chronic low back pain?

    NARCIS (Netherlands)

    Reneman, M.F.; Preuper, H.R.S.; Kleen, M.; Geertzen, J.H.B.; Dijkstra, P.U.

    Introduction: Pain related fear and pain intensity have been identified as factors negatively influencing Functional Capacity Evaluation (FCE) performances in patients with CLBP. Conflicting results have been reported in the literature. The objective of this study was to analyze the relationships

  7. Association of depression with sleep quality might be greater than that of pain intensity among outpatients with chronic low back pain.

    Science.gov (United States)

    Wang, Hsin-Yu; Fu, Tsai-Sheng; Hsu, Shih-Chieh; Hung, Ching-I

    2016-01-01

    No study to date has compared the associations of pain intensity, depression, and anxiety with insomnia among outpatients with chronic low back pain (CLBP). This study aimed to investigate this issue. A total of 225 outpatients with CLBP were enrolled from a general orthopedics clinic. The Insomnia Severity Index was used to evaluate sleep quality. Major depressive disorder (MDD) and anxiety disorders were diagnosed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision, Axis I Disorders. Two psychometric scales were used to evaluate depression and anxiety. The Visual Analog Scale was employed to assess pain intensity. Multiple linear regressions were performed to determine the association of insomnia with pain intensity, depression, and anxiety. Among the 225 subjects, 58 (25.8%) had clinical insomnia; 83 (36.9%) had severe low back pain; 49 (21.8%) had MDD, including 21 (9.3%) with a current major depressive episode (MDE); and 52 (23.1%) had anxiety disorders. More than half (56.9%) of the subjects with CLBP and clinical insomnia had MDD and/or anxiety disorders. Subjects with a current MDE or anxiety disorders had greater severities of pain and insomnia as compared with subjects without these conditions. After controlling for demographic variables, MDE was more strongly associated with insomnia than severe low back pain; moreover, the severity of depression had a greater association with insomnia than pain intensity. The association of depression with insomnia was not inferior to that of pain intensity with insomnia. Among patients with CLBP and insomnia, integration of depression and anxiety treatment into treatment of pain might help to improve sleep quality.

  8. Pain, pain intensity and pain disability in high school students are differently associated with physical activity, screening hours and sleep.

    Science.gov (United States)

    Silva, Anabela G; Sa-Couto, Pedro; Queirós, Alexandra; Neto, Maritza; Rocha, Nelson P

    2017-05-16

    Studies exploring the association between physical activity, screen time and sleep and pain usually focus on a limited number of painful body sites. Nevertheless, pain at different body sites is likely to be of different nature. Therefore, this study aims to explore and compare the association between time spent in self-reported physical activity, in screen based activities and sleeping and i) pain presence in the last 7-days for 9 different body sites; ii) pain intensity at 9 different body sites and iii) global disability. Nine hundred sixty nine students completed a questionnaire on pain, time spent in moderate and vigorous physical activity, screen based time watching TV/DVD, playing, using mobile phones and computers and sleeping hours. Univariate and multivariate associations between pain presence, pain intensity and disability and physical activity, screen based time and sleeping hours were investigated. Pain presence: sleeping remained in the multivariable model for the neck, mid back, wrists, knees and ankles/feet (OR 1.17 to 2.11); moderate physical activity remained in the multivariate model for the neck, shoulders, wrists, hips and ankles/feet (OR 1.06 to 1.08); vigorous physical activity remained in the multivariate model for mid back, knees and ankles/feet (OR 1.05 to 1.09) and screen time remained in the multivariate model for the low back (OR = 2.34. Pain intensity: screen time and moderate physical activity remained in the multivariable model for pain intensity at the neck, mid back, low back, shoulder, knees and ankles/feet (Rp(2) 0.02 to 0.04) and at the wrists (Rp(2) = 0.04), respectively. Disability showed no association with sleeping, screen time or physical activity. This study suggests both similarities and differences in the patterns of association between time spent in physical activity, sleeping and in screen based activities and pain presence at 8 different body sites. In addition, they also suggest that the factors associated

  9. Pain Intensity Recognition Rates via Biopotential Feature Patterns with Support Vector Machines.

    Science.gov (United States)

    Gruss, Sascha; Treister, Roi; Werner, Philipp; Traue, Harald C; Crawcour, Stephen; Andrade, Adriano; Walter, Steffen

    2015-01-01

    The clinically used methods of pain diagnosis do not allow for objective and robust measurement, and physicians must rely on the patient's report on the pain sensation. Verbal scales, visual analog scales (VAS) or numeric rating scales (NRS) count among the most common tools, which are restricted to patients with normal mental abilities. There also exist instruments for pain assessment in people with verbal and / or cognitive impairments and instruments for pain assessment in people who are sedated and automated ventilated. However, all these diagnostic methods either have limited reliability and validity or are very time-consuming. In contrast, biopotentials can be automatically analyzed with machine learning algorithms to provide a surrogate measure of pain intensity. In this context, we created a database of biopotentials to advance an automated pain recognition system, determine its theoretical testing quality, and optimize its performance. Eighty-five participants were subjected to painful heat stimuli (baseline, pain threshold, two intermediate thresholds, and pain tolerance threshold) under controlled conditions and the signals of electromyography, skin conductance level, and electrocardiography were collected. A total of 159 features were extracted from the mathematical groupings of amplitude, frequency, stationarity, entropy, linearity, variability, and similarity. We achieved classification rates of 90.94% for baseline vs. pain tolerance threshold and 79.29% for baseline vs. pain threshold. The most selected pain features stemmed from the amplitude and similarity group and were derived from facial electromyography. The machine learning measurement of pain in patients could provide valuable information for a clinical team and thus support the treatment assessment.

  10. Pain Intensity Recognition Rates via Biopotential Feature Patterns with Support Vector Machines.

    Directory of Open Access Journals (Sweden)

    Sascha Gruss

    Full Text Available The clinically used methods of pain diagnosis do not allow for objective and robust measurement, and physicians must rely on the patient's report on the pain sensation. Verbal scales, visual analog scales (VAS or numeric rating scales (NRS count among the most common tools, which are restricted to patients with normal mental abilities. There also exist instruments for pain assessment in people with verbal and / or cognitive impairments and instruments for pain assessment in people who are sedated and automated ventilated. However, all these diagnostic methods either have limited reliability and validity or are very time-consuming. In contrast, biopotentials can be automatically analyzed with machine learning algorithms to provide a surrogate measure of pain intensity.In this context, we created a database of biopotentials to advance an automated pain recognition system, determine its theoretical testing quality, and optimize its performance. Eighty-five participants were subjected to painful heat stimuli (baseline, pain threshold, two intermediate thresholds, and pain tolerance threshold under controlled conditions and the signals of electromyography, skin conductance level, and electrocardiography were collected. A total of 159 features were extracted from the mathematical groupings of amplitude, frequency, stationarity, entropy, linearity, variability, and similarity.We achieved classification rates of 90.94% for baseline vs. pain tolerance threshold and 79.29% for baseline vs. pain threshold. The most selected pain features stemmed from the amplitude and similarity group and were derived from facial electromyography.The machine learning measurement of pain in patients could provide valuable information for a clinical team and thus support the treatment assessment.

  11. The consequences of shoulder pain intensity on quality of life and community participation in paraplegic wheelchair users

    Directory of Open Access Journals (Sweden)

    Nulle A.

    2012-10-01

    Full Text Available Background/Objective: Shoulder overuse due weight-bearing loads – wheelchair propulsion and transfers – are supposed to cause shoulder pain in active wheelchair users. Consequently, shoulder pain has been found to have a high prevalence in the spinal cord-injured population. Severity of pain levels in individuals with spinal cord injury has been shown to impact quality of life. Aim of this study was to describe the consequences of shoulder pain intensity on quality of life, physical activity, and community activities in spinal cord-injured paraplegic wheelchair users. Materials and Methods: It was a qualitative, analytical one moment study where was involved persons after spinal cord injury below Th1 with lower paraplegia, who used manually operated wheelchairs for mobility at least 50% of the time. Main outcomes measure: SF-36textregistered Health Survey, Physical Activity Scale for Individuals With Physical Disabilities, Community Activities Checklist, Wheelchair User’s Shoulder Pain Index, Functional Independence Measure, Goniometry for shoulder joint. Results and analysis: 40 participants (9 female, 31 male after spinal cord injury (SCI, mean age – 30,8 years, one to twenty years after spinal cord injury. 20 participants had pain in shoulder, 20 participants without pain in shoulder. The intensity of shoulder pain was not related to duration of SCI or the duration of shoulder pain. Shoulder pain intensity scores were inversely related to quality of life. There was a moderate, inverse relationship between shoulder pain intensity and physical activity. There was no relationship, however, between shoulder pain intensity and community activities. The level of community activity was positively related to quality of life. Conclusions: Persons with spinal cord injury who reported lower subjective quality of life and physical activity scores experienced significantly higher levels of shoulder pain. Shoulder pain intensity did not relate to

  12. CUTANEUS STIMULATION: SLOW-STROKE BACK MASSAGE REDUCES THE INTENSITY OF OSTEOARTRITIS PAIN OF ELDERLY

    Directory of Open Access Journals (Sweden)

    Mira Triharini

    2017-04-01

    Full Text Available Introduction: Osteoarthritis disease is the result of both mechanical and biological process which lead come to unstable degradation and synthesis of condrozyte cartilage and extracellular matrix. The risk factor of this instability is aging process. The aging process stimulates osteophytes formation and degradation of cartilage, and emerged pain as primary clinical symptom. One of the non pharmacological ways to cope this pain is by applying cutaneus stimulation through slow-stroke back massage method. The objective of this study was to analyze the effect of applying cutaneus stimulation with slow-stroke back massage method to osteoarthritis’s pain intensity. Method: Pre experimental design with one group pre test-post test approach was used in this study. The subject of this study were elderly above 50 years old living in Panti Werdha Hargo Dedali Surabaya, 15 participants were involved using purpose sampling technique. This study started on January 29th until February 6th, 2010. Data were collected by interview and observation and analyzed by WIlcoxcon Signed Rank Test α = 0.05, p value <α. Result: The Result showed that the message intervention was significantly affect the elder’s level of osteoarthritis pain in Panti Werdha Hargo Dedali Surabaya (p = 0.003. Discussion: It can be concluded that gives stimulation cutaneus: slow-stroke back massage reduce osteoathritis pain intensity. Slow-stroke back massage increase level of endorphin, so that pain reduction and individual pain perception will decrease.

  13. Pain threshold, tolerance and intensity in adolescents born very preterm or with low birth weight

    NARCIS (Netherlands)

    Ganzewinkel, C.J. van; Been, J.V.; Verbeek, I.; Boelen-van der Loo, T.; Pal, S.M. van der; Kramer, P.W.; Andriessena, P.

    2017-01-01

    Background. Data on long-term consequences of neonatal pain is limited. Aim. To assess whether perinatal factors, later pain experience and pain coping strategies are associated with altered pain threshold, pain tolerance and pain intensity in adolescents born preterm. Study design. Observational,

  14. Electronic momentary assessment in chronic pain 1: psychological pain responses as predictors of pain intensity

    NARCIS (Netherlands)

    Sorbi, M.J.; Peters, M.L.; Kruise, D.A.; Maas, C.J.M.; Kerssens, J.J.; Verhaak, P.F.M.; Bensing, J.

    Objectives and Methods: Electronic momentary assessment was employed to substantiate the relevance of psychological functioning in chronic pain. More than 7100 electronic diaries from 80 patients with varying IASP classified types of chronic pain served to investigate to what extent

  15. Intensive dynamic training for females with chronic neck/shoulder pain. A randomized controlled trial

    DEFF Research Database (Denmark)

    Randløv, A; Østergaard, Mikkel; Manniche, C

    1998-01-01

    and activities of daily living (ADL) were used, and strength and endurance measurements of the cervical and shoulder muscles were carried out at baseline and completion of the study. Follow-up measurements were carried out by postal questionnaire at 6 and 12 months after inclusion, and included pain, ADL......OBJECTIVES: To compare the clinical effectiveness of an intensive three-month training programme with a less intensive programme on females suffering from chronic neck/shoulder pain. STUDY DESIGN: A prospective observer-blinded clinical trial including 12-month pretreatment follow-up. SETTING......: Patients were referred to the Departments of Rheumatology and Physical Medicine at Hvidovre Hospital by their general practitioners. Training was undertaken at a satellite clinic for physiotherapy of Hvidovre Hospital. SUBJECTS: Female patients aged 18-65 years suffering from chronic neck/shoulder pain...

  16. Support for a Common Metric for Pediatric Pain Intensity Scales

    Directory of Open Access Journals (Sweden)

    Carl L von Baeyer

    2000-01-01

    Full Text Available Institutional adoption of routine measurement of pediatric pain has been impeded partly by the profusion of different metrics (eg, 0 to 5, 0 to 6, 0 to 10, 0 to 100 for reporting pain intensity on various instruments.  The present paper discusses the importance of adopting a common metric, that is, a single numbering system on which estimates of pain intensity from various sources can be recorded. To explore both support and reservations concerning the adoption of a common metric, a survey questionnaire was sent in 1999 to an estimated 600 subscribers to the Pediatric Pain Internet Mailing List. Individuals working in pediatric institutions where children's pain is routinely measured, or where adoption of such measures is planned, were requested to respond by e-mail or mail. Responses (n=37 were from nurses (49%, physicians (24%, psychologists (7% and others/unlisted (20% on four continents. Adoption of a common metric was endorsed by 81% of respondents. Among the possible numbering systems, the 0 to 10 system was strongly favoured (70% over other options. Respondents commented that adoption of a common metric would improve communication and consistency in measurement both within and among institutions.  Some disadvantages, such as staff resistance to altering existing systems, were also suggested. The majority of respondents thought that it would be desirable to adopt a common metric. Among the possible numbering systems, the 0 to 10 system is by far the most favoured. Adopting a common 0 to 10 standard, and adapting existing tools to that metric, would be positive steps toward identifying and relieving children's pain.

  17. [Clinical assessment of pain in Spanish Neonatal Intensive Care Units].

    Science.gov (United States)

    Avila-Alvarez, Alejandro; Carbajal, Ricardo; Courtois, Emilie; Pertega-Diaz, Sonia; Anand, Kanwaljeet J S; Muñiz-Garcia, Javier

    2016-10-01

    Clinical scales are currently the best method to assess pain in the neonate, given the impossibility of self-report in this age group. A study is designed with the aim of determining the current practices as regards the clinical assessment of pain in Spanish Neonatal Units and the factors associated with the use of clinical scales. A prospective longitudinal observational study was conducted. A total of 30 Units participated and 468 neonates were included. Only 13 Units (43.3%) had pain assessment protocols. Pain was evaluated with a scale in 78 neonates (16.7%, 95% CI; 13.1-20.1) and the mean number of pain assessments per patient and per day was 2.3 (Standard Deviation; 4.8), with a median of 0.75. Of the total number of 7,189 patient-days studied, there was at least one pain assessment in 654 (9.1%). No pain assessment was performed with a clinical scale on any patient in 20 (66.7%) Units. Among those that did, a wide variation was observed in the percentage of patients in whom pain was assessed, as well as in the scales used. The CRIES (C-Crying; R-Requires increased oxygen administration; I-Increased vital signs; E-Expression; S-Sleeplessness) scale was that used in most Units. In the multivariate analysis, only invasive mechanical ventilation was associated with receiving a pain assessment with a scale (OR 1.46, P=.042). The majority of neonates admitted into Intensive Care in Spain do not receive a pain assessment. Many units still do not routinely use clinical scales, and there is a wide variation between those that do use them. These results could serve as a basis for preparing national guidelines as regards pain in the neonate. Copyright © 2015 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Helplessness and perceived pain intensity: relations to cortisol concentrations after electrocutaneous stimulation in healthy young men

    Directory of Open Access Journals (Sweden)

    Müller Matthias J

    2011-06-01

    Full Text Available Abstract Background Uncontrollable aversive events are associated with feelings of helplessness and cortisol elevation and are suitable as a model of depression. The high comorbidity of depression and pain symptoms and the importance of controllability in both conditions are clinically well-known but empirical studies are scarce. The study investigated the relationship of pain experience, helplessness, and cortisol secretion after controllable vs. uncontrollable electric skin stimulation in healthy male individuals. Methods Sixty-four male volunteers were randomly assigned to receive 30 controllable (self-administered or uncontrollable (experimenter-administered painful electric skin stimuli. Perceived pain intensity (PPI, subjective helplessness ratings, and salivary cortisol concentrations were assessed. PPI was assessed after stress exposure. For salivary cortisol concentrations and subjective helplessness ratings, areas under the response curve (AUC were calculated. Results After uncontrollable vs. controllable stress exposure significantly higher PPI ratings (P = 0.023, higher subjective helplessness AUC (P Conclusions The results confirm the impact of uncontrollability on stress responses in humans; the relationship of PPI with subjective helplessness and salivary cortisol suggests a cognitive-affective sensitization of pain perception, particularly under uncontrollable conditions.

  19. [Ziconotide: an innovative alternative for intense chronic neuropathic pain].

    Science.gov (United States)

    Valía-Vera, J C; Villanueva, V L; Asensio-Samper, J M; López-Alarcón, M D; de Andrés, J A

    Intense chronic pain is a very important health problem, as it has a high prevalence (5-10%), a multifactorial aetiology and its management is very often a very complex affair. Treatment of severe cases sometimes requires interventional approaches, such as continuous intrathecal infusion of opioids. We report the case of a 38-year-old female with intense neuropathic pain in the lower back and the lower limbs secondary to three operations on the L5-S1 lumbar segment. After implementing several different pharmacological regimes involving both oral and implanted systems (spinal cord stimulation and subarachnoid infusion pump with different pharmacological combinations) with no clinical improvement, intrathecal infusion with ziconotide was included in the protocol. Ziconotide is the first specific neuronal blocker that acts on the calcium channel by blocking the N-type voltage-dependent calcium channels. It is a new non-opioid analgesic with approved indication in the treatment of intense chronic pain, in patients who require intrathecal analgesics and are refractory to other analgesic treatments. Therefore, we shall have to consider this drug as a therapeutic alternative in patients do not experience sufficient relief with the pharmacological agents and means currently available to treat them.

  20. Intensity resolution and subjective magnitude in psychophysical scaling.

    Science.gov (United States)

    Ward, L M; Armstrong, J; Golestani, N

    1996-07-01

    Several successful theories of psychophysical judgment imply that exponents of power functions in scaling tasks should covary with measures of intensity resolution such as d' in the same tasks, whereas the prevailing metatheory of ideal psychophysical scaling asserts the independence of the two. In a direct test of this relationship, three prominent psychophysical scaling paradigms were studied: category judgment without an identification function, absolute magnitude estimation, and cross-modality matching with light intensity as the response continuum. Separate groups of subjects for each scaling paradigm made repeated judgments of the loudnesses of the pure tones that constituted each of two stimulus ensembles. The narrow- and wide-range ensembles shared six identical stimulus intensities in the middle of each set. Intensity resolution, as measured by d'-like distances, of these physically identical stimuli was significantly worse for the wide-range set for all three methods. Exponents of power functions fitted to geometric mean responses, and in magnitude estimation and cross-modality matching the geometric mean responses themselves, were also significantly smaller in the wide-range condition. The variation of power function exponents, and of psychophysical scale values, for stimulus intensities that were identical in the two stimulus sets with the intensities of other members of the ensembles is inconsistent with the metatheory on which modern psychophysical scaling practice is based, although it is consistent with other useful approaches to measurement of psychological magnitudes.

  1. On the relationship between pain intensity and postural sway in patients with non-specific neck pain

    DEFF Research Database (Denmark)

    Ruhe, Alexander; Fejer, René; Walker, Bruce

    2013-01-01

    Increased center of pressure excursions are well documented in patients with non-specific neck pain. While a linear relationship between pain intensity and postural sway has been described in low back pain patients, no such investigation has been conducted in adults with non-specific neck pain....

  2. Comparison of Subjective and Objective Physical Functions in Patients with Chronic Low Back Pain

    Directory of Open Access Journals (Sweden)

    Agwubike EO

    2011-07-01

    Full Text Available Purpose: To compare the subjective and objective physical function scores of patients with Chronic Low Back Pain (CLBP. Method: A cross- sectional survey design was used. Fifty-one patients with CLBP of mechanical origin were recruited from the physiotherapy out patient clinics of the University of Nigeria Teaching Hospital and the National Orthopedic Hospital both in Enugu, Nigeria. The box numerical scale, Roland-Morris Questionnaire (RMQ-24 and the Back Performance Scale (BPS were used to assess the present pain intensity, the subjective and objective functional status of the participants respectively. Pearson correlation was used to determine relationships. Multiple Regressions were used to determine the predictors of objective function. Alpha level was set at 0.5. Results: The mean age and Body Mass Index of the participants were 49.04 ± 14.33 years and 26.57 ± 4.29 kg/m2 respectively. The mean Pain Intensity, subjective disability (RMQ and objective disability (BPS scores were 6.33 ± 2.09, 9.76 ± 5.14 and 6.43 ± 2.9 respectively. Stepwise multiple regressions showed that when all the variables were entered only marital status was a significant predictor of objective physical function. Conclusion: There is no significant association between subjective and objective functions in patients with CLBP. However, marital status (married is a significant predictor of objective function in CLBP.

  3. Unique Contributions of Body Diagram Scores and Psychosocial Factors to Pain Intensity and Disability in Patients With Musculoskeletal Pain.

    Science.gov (United States)

    Rhon, Daniel I; Lentz, Trevor A; George, Steven Z

    2017-02-01

    Study Design Retrospective cross-sectional cohort of military patients with musculoskeletal pain. Background Body diagrams are used to document symptoms and can also serve as a proxy to assess psychological influence. However, literature to support this is conflicting. Objectives To (1) examine the unique contribution of pain and nonpain symptom distribution to magnitude of self-reported pain intensity and disability, and (2) assess the moderating influence of psychological factors and body diagram score on concurrent pain intensity and disability. Methods Pain, numbness, and tingling were denoted on a body diagram at initial evaluation. Fear-avoidance beliefs, pain catastrophizing, and region-specific self-reported disability measures were collected. The contributions of pain and nonpain symptom distribution to pain intensity and disability were assessed to determine which body diagram symptom scoring method (pain only, nonpain, or composite) was appropriate for subsequent analyses. Hierarchical linear regression analyses were then used to determine the moderating effects of the Pain Catastrophizing Scale and Fear-Avoidance Beliefs Questionnaire and the body diagram score on concurrent pain and disability. Results The Pain Catastrophizing Scale and Fear-Avoidance Beliefs Questionnaire explained between 16% and 17% of the variance in pain intensity, and 8% of variance in disability (all, Pdisability and pain intensity (all, P<.001). The Pain Catastrophizing Scale moderated the relationship between body diagram score and pain intensity. The positive relationship between composite symptom score and concurrent pain intensity is stronger for patients with low catastrophizing. Conclusion The clinical utility of body diagrams with low symptom distribution may be improved by concomitant assessment of pain catastrophizing and warrants further longitudinal investigation. Level of Evidence Symptom prevalence, level 2b. J Orthop Sports Phys Ther 2017;47(2):88-96. Epub 5 Nov

  4. Reactivity in pain-free subjects and a clinical pain population: evaluation of the Kohn Reactivity Scale-dutch Version.

    Science.gov (United States)

    Veldhuijzen, Dieuwke S; Noordermeer, Siri D S; van Wijck, Albert J M; Snijders, Tom J; Geenen, Rinie

    2013-07-01

    Patients with pain are more reactive to various types of sensations, not limited to pain alone. A potential useful instrument to assess reactivity is the Kohn Reactivity Scale (KRS). This study examines the psychometric characteristics of the KRS-Dutch version and its ability to differentiate between subjects with and without pain. Internal consistency, convergent validity, and test-retest reliability of the Dutch translation of the KRS were assessed in 321 pain-free control subjects and different subgroups of this sample. Subsequently, reactivity scores were compared between the pain-free subjects and 291 pain patients who were referred to a pain clinic for treatment. Reliability analyses indicated good internal consistency (α ≥ 0.77) and high test-retest reliability (intraclass correlation = 0.95) of the KRS in the control subjects. Validity analyses yielded positive correlations of the KRS with related constructs like pain vigilance and awareness (r = 0.37), symptom severity (r = 0.29), and the personality characteristic neuroticism (r = 0.20). Pain patients had overall significantly higher KRS scores than the pain-free subjects indicating increased reactivity, particularly for the patients with medically unexplained pain. These findings indicate that the KRS is a useful instrument to screen for reactivity in pain patients, which may be of particular relevance for those suffering from medically unexplained pain. © 2012 The Authors Pain Practice © 2012 World Institute of Pain.

  5. Fear of pain in the context of intensive pain rehabilitation among children and adolescents with neuropathic pain: associations with treatment response.

    Science.gov (United States)

    Simons, Laura E; Kaczynski, Karen J; Conroy, Caitlin; Logan, Deirdre E

    2012-12-01

    Recent research has implicated pain-related fear in relation to functional outcomes in children with chronic pain. The current study examined fear of pain, disability, and depression within the context of an intensive pain rehabilitation program. One hundred forty-five children and adolescents who participated in an intensive interdisciplinary pediatric pain rehabilitation day program were assessed in this study. Patients completed measures of pain intensity, pain-related fears, functional disability, and depressive symptoms at admission, discharge, and on average, 2 months postdischarge. After controlling for pain intensity, pain-related fear was significantly related to disability and depressive symptoms at all time points. As predicted, a decline in pain-related fear was significantly associated with a decrease in disability and depressive symptoms. Interestingly, high levels of pain-related fears at admission predicted less reduction in functional disability and depression at discharge, suggesting that high levels of pain-related fear may be a risk factor in relation to treatment outcomes. Overall, results indicate that the relationship between fear of pain and changes in disability and depressive symptoms are closely linked, with fear of pain playing an important role in treatment. This paper presents results underscoring the importance of pain-related fear in relation to treatment response for children and adolescents with chronic pain. These findings support the need to develop and implement interventions that target reductions in pain-related fear. Copyright © 2012 American Pain Society. Published by Elsevier Inc. All rights reserved.

  6. Specific and number of comorbidities are associated with increased levels of temporomandibular pain intensity and duration.

    Science.gov (United States)

    Dahan, Haissam; Shir, Yoram; Velly, Ana; Allison, Paul

    2015-01-01

    Temporomandibular pain disorder (TMD) is a common pain condition in the face. People with TMD report multiple pain comorbidities. The presence of fibromyalgia and migraine in people with TMD is associated with an increase in TMD pain intensity and duration. However, data on the relationship between increasing number of pain comorbidities and TMD pain are rare. The aims of this study were: firstly to evaluate the extent to which increasing number of comorbidities is associated with increasing TMD pain intensity and duration; and secondly to evaluate the extent to which the presence of specific comorbidities is associated with increasing TMD pain intensity and duration. The sample included 180 people seeking TMD treatment at Boston and Montreal clinics. TMD was diagnosed using the Research Diagnostic Criteria for TMD. A Numerical Pain Rating Scale assessed TMD pain intensity and participants provided their TMD pain duration in a study questionnaire. The comorbidities of migraine, chronic fatigue syndrome, irritable bowel syndrome, interstitial cystitis and restless leg syndrome were diagnosed by 5 validated diagnostic questionnaires. The associations were analyzed by linear regression, controlling for confounders. There was a positive association between the number of comorbidities present and TMD pain intensity (p comorbidities present and TMD pain duration (p pain intensity (p chronic fatigue syndrome was positively associated with TMD pain intensity (p pain duration (p pain group, whereas in the non-myofascial pain group, the relationship between number of comorbidities and TMD pain duration was the only one still present. This study shows that the number of comorbidities is positively associated with TMD pain duration and intensity. The presence of specific conditions, such as migraine and chronic fatigue syndrome, is associated with an increase in TMD intensity and duration.

  7. Decreased frontal regulation during pain anticipation in unmedicated subjects with major depressive disorder.

    Science.gov (United States)

    Strigo, I A; Matthews, S C; Simmons, A N

    2013-03-12

    Major depressive disorder (MDD) is characterized by impaired processing of negative information, possibly due to dysfunction in both, the bottom-up emotional network and top-down modulatory network. By acquiring functional magnetic resonance imaging (fMRI) on a pain-anticipation task, we tested the hypothesis that individuals with MDD would show increased negative biasing that may be associated with reduced frontal connectivity. Thirty-one (15 females) unmedicated young adults with current MDD and 22 (11 females) healthy subjects with no history of MDD were recruited. Groups did not differ significantly in age, race, level of education, marital status or gender distribution. fMRI data were collected during an event-related pain-anticipation paradigm, during which subjects were cued to anticipate painful heat stimuli of high or low intensity. All temperature stimuli were applied to each subject's left forearm. We found that relative to healthy comparison subjects, participants with MDD showed significantly stronger responses to high versus low pain anticipation within right ventral anterior insula (AI), but overlapping response within right dorsal AI, which correlated positively with the depression symptoms severity in the MDD group. Functional connectivity analyses showed increased functional connectivity between dorsal insula and posterior thalamus and decreased functional connectivity between dorsal insula and the right inferior frontal gyrus in the MDD compared with the non-MDD group. Our results demonstrate that unmedicated individuals with current MDD compared with healthy never-depressed subjects show both differential and overlapping response within AI during anticipation of pain. Furthermore, the overlapping insular response is less regulated by frontal brain systems and is more subservient to affective processing regions in the posterior thalamus in MDD. These results support and provide functional validation of the co-occurring enhanced 'bottom-up' and

  8. Patient reported outcome measures of pain intensity: Do they tell us what we need to know?

    Science.gov (United States)

    Dorfman, David; George, Mary Catherine; Robinson-Papp, Jessica; Rahman, Tanni; Tamler, Ronald; Simpson, David M

    2016-04-01

    To determine the relationship between chronic pain patients' responses to self-report measures of pain intensity, and self-reported strategies when completing such measures. Ambulatory outpatients suffering from one of the following chronic pain conditions: painful HIV neuropathy, painful diabetic neuropathy, chronic Low-Back Pain. As part of a previously reported study using qualitative methods, participants completed standard pain intensity questionnaires as well as a measure of pain related disturbances in activities of daily living. In the previous study, participants' responses during a focus group were then used to identify their strategies and beliefs about their approach to completing the questionnaires. Among the beliefs were: (1) difficulties averaging pain over different time periods (i.e., "what was your average pain during the last 24h" versus "what was your average pain during the last 2 weeks"); (2) difficulty in comparing pain from different etiologies; (3) difficulties in reporting sensations of pain in a manner unaffected by issues and situations secondary to the pain experience, such as difficulties in activities of daily living. In the present paper we use ANOVA (analysis of variance) and partial correlation to determine whether the qualitatively derived perceptions are reflected in the quantitative pain intensity scores. Participants' belief that it was difficult to "average" pain intensity over different time periods was supported. The data do not support their belief that pain intensity scores are affected by other factors: their specific pain diagnosis, and the extent to which pain interfered with their activities of daily living. (1) Patients tend to report different levels of pain intensity when asked to report their pain over different periods; (2) insofar as it can be said to exist, the relationship between measures of intensity and interference with activities of daily living is minimal; (3) participants tend to report similar levels of

  9. The effect of dry needling on the radiating pain in subjects with discogenic low-back pain: A randomized control trial.

    Science.gov (United States)

    Mahmoudzadeh, Ashraf; Rezaeian, Zahra Sadat; Karimi, Abdolkarim; Dommerholt, Jan

    2016-01-01

    Disk herniation is the most common cause of radiating low back pain (LBP) in subjects under 60 years of age. The present study aims to compare the effect of dry needling (DN) and a standard conservative approach on the pain and function in subjects with discogenic radiating LBP. Fifty-eight subjects with discogenic radicular LBP were screened and randomized into control (Standard physical therapy, n = 29) and experimental group (Standard physical therapy and DN, n = 29). Radiating pain intensity and disability were measured using visual analog scale (VAS) and Oswestry Disability indices at baseline, at the end of treatment and 2 months after the last intervention session. The changes in pain intensity and disability were studied using a 3 × 2 repeated measures analysis of variance considering time as the within-subject factor and group as the between-subject. Pain intensity and disability scores decreased significantly in both experimental and control groups (experimental group: VAS = 37.24, Oswestry Disability Index [ODI] =28.48, control group: VAS = 45.5, ODI = 32.96), following the intervention. The change continued during the follow-up period (P < 0.001 for all comparisons). Pain and disability improvement, however, were more significant in experimental group, both in post intervention (experimental group: VAS = 25.17, ODI = 22.17, control group: VAS = 42.4, ODI = 30.27) (P = 0.05 and P = 0.03, respectively) and follow-up measures (P = 0.006 and P = 0.002, respectively). Both intervention strategies seem to significantly improve pain and disability immediately following intervention, where the improvement continued during 2 months after the last active intervention. Therefore, supplementary DN application may enhance the effect of the standard intervention considerably.

  10. The effect of dry needling on the radiating pain in subjects with discogenic low-back pain: A randomized control trial

    Directory of Open Access Journals (Sweden)

    Ashraf Mahmoudzadeh

    2016-01-01

    Full Text Available Background: Disk herniation is the most common cause of radiating low back pain (LBP in subjects under 60 years of age. The present study aims to compare the effect of dry needling (DN and a standard conservative approach on the pain and function in subjects with discogenic radiating LBP. Materials and Methods: Fifty-eight subjects with discogenic radicular LBP were screened and randomized into control (Standard physical therapy, n = 29 and experimental group (Standard physical therapy and DN, n = 29. Radiating pain intensity and disability were measured using visual analog scale (VAS and Oswestry Disability indices at baseline, at the end of treatment and 2 months after the last intervention session. The changes in pain intensity and disability were studied using a 3 × 2 repeated measures analysis of variance considering time as the within-subject factor and group as the between-subject. Results: Pain intensity and disability scores decreased significantly in both experimental and control groups (experimental group: VAS = 37.24, Oswestry Disability Index [ODI] =28.48, control group: VAS = 45.5, ODI = 32.96, following the intervention. The change continued during the follow-up period (P < 0.001 for all comparisons. Pain and disability improvement, however, were more significant in experimental group, both in post intervention (experimental group: VAS = 25.17, ODI = 22.17, control group: VAS = 42.4, ODI = 30.27 (P = 0.05 and P = 0.03, respectively and follow-up measures (P = 0.006 and P = 0.002, respectively. Conclusion: Both intervention strategies seem to significantly improve pain and disability immediately following intervention, where the improvement continued during 2 months after the last active intervention. Therefore, supplementary DN application may enhance the effect of the standard intervention considerably.

  11. Patellar maltracking is prevalent among patellofemoral pain subjects with patella alta: an upright, weightbearing MRI study

    Science.gov (United States)

    Pal, Saikat; Besier, Thor F.; Beaupre, Gary S.; Fredericson, Michael; Delp, Scott L.; Gold, Garry E.

    2012-01-01

    The purpose of this study is to determine if patellar maltracking is more prevalent among patellofemoral (PF) pain subjects with patella alta compared to subjects with normal patella height. We imaged 37 PF pain and 15 pain free subjects in an open-configuration magnetic resonance imaging scanner while they stood in a weightbearing posture. We measured patella height using the Caton-Deschamps, Blackburne-Peel, Insall-Salvati, Modified Insall-Salvati, and Patellotrochlear indices, and classified the subjects into patella alta and normal patella height groups. We measured patella tilt and bisect offset from oblique-axial plane images, and classified the subjects into maltracking and normal tracking groups. Patellar maltracking was more prevalent among PF pain subjects with patella alta compared to PF pain subjects with normal patella height (two-tailed Fisher’s exact test, p patella alta were maltrackers, whereas only 16% (4/25) of PF pain subjects with normal patella height were maltrackers. Patellofemoral pain subjects classified as maltrackers displayed a greater patella height compared to the pain free and PF pain subjects classified as normal trackers (two-tailed unpaired t-tests with Bonferroni correction, p patella alta compared to subjects with normal patella height; and 2) we show greater patella height in PF pain subjects compared to pain free subjects using four indices commonly used in clinics. PMID:23165335

  12. Minocycline Does Not Decrease Intensity of Neuropathic Pain Intensity, But Does Improve Its Affective Dimension.

    Science.gov (United States)

    Sumitani, Masahiko; Ueda, Hiroshi; Hozumi, Jun; Inoue, Reo; Kogure, Takamichi; Yamada, Yoshitsugu; Kogure, Takamichi

    2016-01-01

    Recent understanding of the neuron-glia communication shed light on an important role of microglia to develop neuropathic pain The analgesic effect of minocycline on neuropathic pain is promising but it remains unclear in clinical settings. This study included 20 patients with neuropathic pain of varied etiologies. We administered 100 mg/day of minocycline for 1 week and then 200 mg/day for 3 weeks, as an open-label adjunct to conventional analgesics. An 11-point numerical rating scale. (NRS) and the short-form McGill Pain Questionnaire (SF-MPQ) were used to evaluate pain severity. The data were collected at baseline and after 4 weeks of therapy and analyzed using the Wilcoxon signed-rank test. All except two of the patients tolerated the full dose of minocycline. There was no significant improvement in the scoring of NRS (5.6 ± 1.2 at baseline vs. 5.3 ± 1.9 at 4 weeks; P =.60). The total score of the SF-MPQ decreased significantly (17.2 ± 7.4 vs. 13.9 ± 9.6; P =.02), particularly in the affective subscale (4.4 ± 2.7 vs. 3.3 ± 3.6; P =.007) but not so in the sensory subscale (12.8 ± 5.2 vs. 10.6 ± 6.2; P =.06). We conclude that minocycline failed to decrease pain intensity but succeeded in reducing the affective dimension associated with neuropathic pain.

  13. Effect of Doll Injection Display on Pain Intensity due to Intramuscular Injection in Preschool Children

    Directory of Open Access Journals (Sweden)

    H. Irani

    2016-09-01

    Full Text Available Aims: Pains caused by the invasive actions such as intramuscular injection lead to the physical and mental tensions in the children. Therefore, such pains should be given relief. One of the main priorities in the nursing is to notice methods that reduce pains due to the invasive actions in the children. The aim of this study was to investigate the effects of injection displayed on a doll on the pain intensity due to the intramuscular injection in the preschool children. Materials & Methods: In the randomized controlled clinical trial, 62 kids aged between 4 and 6 years with pharyngitis were studied in the clinic of the health network of Khalil-abad Township in 2015. The intramuscular injection of penicillin 6.3.3 was administrated for the kids. The subjects, selected by simple lottery, were divided into two groups including experimental and control groups (n=31 per group. Data was collected using a demographic characteristic collecting form and Oucher standard pain assessment tool. In experimental group, the kid watching, one intramuscular injection was displayed on a doll by a nurse; then, the kid underwent an intramuscular injection. In control group, the routine injection method was done. Data was analyzed by SPSS 19 software using Mann-Whitney, independent T, and Chi-square tests. Findings: Mean pain intensity after injection in experimental group (3.22±0.90 was significantly lower than control group (4.19±0.83; p<0.001. Conclusion: The injection displayed on a doll before the intramuscular injection might lead to pain reduction in the preschool kids.

  14. Specific and number of comorbidities are associated with increased levels of temporomandibular pain intensity and duration

    OpenAIRE

    Dahan, Haissam; Shir, Yoram; Velly, Ana; Allison, Paul

    2015-01-01

    Background Temporomandibular pain disorder (TMD) is a common pain condition in the face. People with TMD report multiple pain comorbidities. The presence of fibromyalgia and migraine in people with TMD is associated with an increase in TMD pain intensity and duration. However, data on the relationship between increasing number of pain comorbidities and TMD pain are rare. The aims of this study were: firstly to evaluate the extent to which increasing number of comorbidities is associated with ...

  15. [Pain medicine as a cross-sectional subject in German medical schools. An opportunity for general pain management].

    Science.gov (United States)

    Kopf, A; Dusch, M; Alt-Epping, B; Petzke, F; Treede, R-D

    2014-08-01

    Unrelieved pain is a substantial public health concern owing in part to deficits in clinical expertise among physicians. In most medical faculties worldwide, teaching on pain and pain management is either nonexistent or limited to a small number of students attending voluntary courses. In light of the fact that pain is the most frequent reason to seek medical advice, the lack of formal training of pain medicine is considered the leading reason for inadequate pain management. Therefore, the patients' unmet needs for adequate diagnosis and therapy call for action. Pain assessment and effective pain management should be a priority in the health care system. The limited number of pain specialists available in hospitals and primary care and CME (continuous medical education) activities focusing on pain are not sufficient to solve the problem. Every practicing physician should, therefore, have basic knowledge of the most prominent painful conditions and management strategies. To achieve this goal, pain medicine should become an integral part of the undergraduate curriculum for medical students. In Germany, pain medicine became a mandatory subject in undergraduate medical studies in 2012. The introduction of pain medicine into the undergraduate curriculum in Germany is a major challenge regarding the development and implementation processes. This article describes current instruments and implementation strategies for pain medicine as a new cross-sectional subject in Germany.

  16. Do subjects with whiplash-associated disorders respond differently in the short-term to manual therapy and exercise than those with mechanical neck pain?

    DEFF Research Database (Denmark)

    Castaldo, Matteo; Catena, Antonella; Chiarotto, Alessandro

    2017-01-01

    OBJECTIVE : To compare the short-term effects of manual therapy and exercise on pain, related disability, range of motion, and pressure pain thresholds between subjects with mechanical neck pain and whiplash-associated disorders. METHODS : Twenty-two subjects with mechanical neck pain and 28...... with whiplash-associated disorders participated. Clinical and physical outcomes including neck pain intensity, neck-related disability, and pain area, as well as cervical range of motion and pressure pain thresholds over the upper trapezius and tibialis anterior muscles, were obtained at baseline and after...... the intervention by a blinded assessor. Each subject received six sessions of manual therapy and specific neck exercises. Mixed-model repeated measures analyses of covariance (ANCOVAs) were used for the analyses. RESULTS : Subjects with whiplash-associated disorders exhibited higher neck-related disability (P = 0...

  17. Widespread pain - do pain intensity and care-seeking influence sickness absence? - A population-based cohort study

    DEFF Research Database (Denmark)

    Mose, Søren; Christiansen, David Høyrup; Jensen, Jens Christian

    2016-01-01

    pain and sickness absence has not been studied. Additionally it is unknown whether care-seeking in general practice due to musculoskeletal disorders has a positive or negative impact on future absenteeism. The purpose of this study was to examine the influence of pain intensity on the association...... the results. Similar findings were observed for sickness absence of shorter duration, although the association was weaker. Care-seeking in general practice due to musculoskeletal disorders did not overall alter the odds of later sickness absence.CONCLUSION: Pain intensity and care-seeking due......BACKGROUND: Both musculoskeletal pain-intensity in relation to a specific location (e.g. lower back or shoulder) and pain in multiple body regions have been shown to be associated with impaired function and sickness absence, but the impact of pain intensity on the association between widespread...

  18. Comparison of the effects of knee and hip and single knee muscles strengthening/ stretching exercises on pain intensity and function in athletes with patellofemoral pain syndrome

    Directory of Open Access Journals (Sweden)

    Vahid Mazloum

    2016-08-01

    Full Text Available Background: Patellofemoral pain syndrome (PFPS is a common musculoskeletal condition among athletes. The evidence emphasizes on the importance of hip musculature strengthening exercises for such patients. Objective: To investigate the effects of strengthening-stretching knee muscles exercises and hip posterolateral musculature exercises in athletes with PFPS. Methods: In this clinical trial, 28 athletes with age average of 22.7±2.4 years with PFPS were allocated into conventional knee muscles exercises (CKME (n=14 and posterolateral hip muscles exercises (PHME (n=14. The subjects of both groups performed the supervised exercise protocols in 12 sessions. The Visual Analogue Scale and 6-minute walking tests were administrated respectively to evaluate pain intensity and function. The data were analyzed using Shapiro-wilk test, Independent-sample t test, and Repeated Measure ANOVA test. Findings: Demographic, pain intensity, and physical function data were similar between groups at baseline. Both groups significantly improved in pain intensity and function following a 4-week exercise program. Additionally, the athletes in PHME group had higher level of decreased pain intensity and improved function in follow-up assessment than the subjects in CKME group. Conclusion: Using hip posterolateral musculature exercises in addition to the knee conventional exercises is more effective for athletes with PFPS.

  19. Pain Related Fear and Catastrophizing Predict Pain Intensity and Disability Independently Using an Induced Muscle Injury Model

    Science.gov (United States)

    Parr, Jeffrey J.; Borsa, Paul A.; Fillingim, Roger B.; Tillman, Mark D.; Manini, Todd M.; Gregory, Chris M.; George, Steven Z.

    2012-01-01

    Timing of assessment of psychological construct is controversial and results differ based on the model of pain induction. Previous studies have not used an exercise induced injury model to investigate timing of psychological assessment. Exercise induced injury models may be appropriate for these investigations because they approximate clinical pain conditions better than other experimental stimuli. In this study we examined the changes of psychological constructs over time and determined whether timing of assessment affected the construct’s association with reports of pain intensity and disability. One-hundred twenty-six healthy volunteers completed the Fear of Pain Questionnaire (FPQ-III), Pain Catastrophizing Scale (PCS), and Tampa Scale of Kinesiophobia (TSK) prior to inducing muscle injury to the shoulder. The PCS and TSK were measured again 48 and 96 hours post-injury induction. Pain intensity and disability were collected at 48 and 96 hours and served as dependent variables in separate regression models. Results indicated that the FPQ-III had the strongest prediction of pain intensity from baseline to 96 hours. After baseline the PCS and TSK were stronger predictors of pain intensity and disability, respectively. These data provide support for the use of psychological constructs in predicting outcomes from shoulder pain. However, they deviate from the current theoretical model indicating that fear of pain is a consequence of injury and instead suggests that fear of pain before injury may influence reports of pain intensity. Perspective The current study provides evidence that fear of pain can be assessed prior to injury. Furthermore, it supports that after injury pain catastrophizing and kinesiophobia are independently associated with pain and disability. Overall these data suggest that timing of psychological assessment may be an important consideration in clinical environments. PMID:22424914

  20. Association of depression with sleep quality might be greater than that of pain intensity among outpatients with chronic low back pain

    Directory of Open Access Journals (Sweden)

    Wang HY

    2016-08-01

    Full Text Available Hsin-Yu Wang,1,2,* Tsai-Sheng Fu,2,3,* Shih-Chieh Hsu,1,2 Ching-I Hung1,2 1Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, 2Chang Gung University College of Medicine, Taoyuan, 3Department of Orthopedics, Chang Gung Memorial Hospital at Keelung, Taiwan, Republic of China *These authors contributed equally to this work Purpose: No study to date has compared the associations of pain intensity, depression, and anxiety with insomnia among outpatients with chronic low back pain (CLBP. This study aimed to investigate this issue.Patients and methods: A total of 225 outpatients with CLBP were enrolled from a general orthopedics clinic. The Insomnia Severity Index was used to evaluate sleep quality. Major depressive disorder (MDD and anxiety disorders were diagnosed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision, Axis I Disorders. Two psychometric scales were used to evaluate depression and anxiety. The Visual Analog Scale was employed to assess pain intensity. Multiple linear regressions were performed to determine the association of insomnia with pain intensity, depression, and anxiety.Results: Among the 225 subjects, 58 (25.8% had clinical insomnia; 83 (36.9% had severe low back pain; 49 (21.8% had MDD, including 21 (9.3% with a current major depressive episode (MDE; and 52 (23.1% had anxiety disorders. More than half (56.9% of the subjects with CLBP and clinical insomnia had MDD and/or anxiety disorders. Subjects with a current MDE or anxiety disorders had greater severities of pain and insomnia as compared with subjects without these conditions. After controlling for demographic variables, MDE was more strongly associated with insomnia than severe low back pain; moreover, the severity of depression had a greater association with insomnia than pain intensity.Conclusion: The association of depression with insomnia was not inferior to that of

  1. Shock enhancement of cellular materials subjected to intensive pulse loading

    Science.gov (United States)

    Zhang, J.; Fan, J.; Wang, Z.; Zhao, L.; Li, Z.

    2017-06-01

    Cellular materials can dissipate a large amount of energy due to their considerable stress plateau, which contributes to their extensive applications in structural design for crashworthiness. However, in some experiments with specimens subjected to intense impact loads, transmitted stress enhancement has been observed, leading to severe damage to the objects protected. Transmitted stress through two-dimensional Voronoi cellular materials as a protective device is qualitatively studied in this paper. Dimensionless parameters of material properties and loading parameters are defined to give critical conditions for shock enhancement and clarify the correlation between the deformations and stress enhancement. The effect of relative density on this amplifying phenomenon is investigated as well. In addition, local strain fields are calculated by using the optimal local deformation gradient, which gives a clear presentation of deformations and possible local non-uniformity in the crushing process. This research provides valuable insight into the reliability of cellular materials as protective structures.

  2. The effects of listening to preferred music on pain intensity after open heart surgery

    OpenAIRE

    Jafari, Hedayat; Zeydi, Amir Emami; Khani, Soghra; Esmaeili, Ravanbakhsh; Soleimani, Aria

    2012-01-01

    Background: Pain is a common phenomenon after surgery. Cardiac surgeries are no exception and patients generally experience acute pain after these surgeries. Inadequate pain management after cardiac surgery predisposes patients to many complications. Therefore, the aim of this study was to determine the effects of listening to preferred music on pain intensity after open heart surgery. Materials and Methods: This study was a randomized clinical trial (RCT) conducted in open heart intensive ca...

  3. Cuff pressure pain detection is associated with both sex and physical activity level in nonathletic healthy subjects

    DEFF Research Database (Denmark)

    Lemming, Dag; Börsbo, Björn; Sjörs, Anna

    2017-01-01

    analogue scale (VAS). The pain detection threshold (PDT) was defined as when the pressure was perceived as painful, and pain tolerance (PTT) was when the subject terminated the cuff inflation. For PTT, the corresponding VAS score was recorded (VAS-PTT). The protocol was repeated with two chambers inflated......PURPOSE : The aim of this study was to evaluate pressure pain sensitivity on leg and arm in 98 healthy persons (50 women) using cuff algometry. Furthermore, associations with sex and physical activity level were investigated. METHOD:  Normal physical activity level was defined as Godin Leisure......-Time Exercise Questionnaire (GLTEQ) score ≤ 45 and high activity level as GLTEQ > 45. A pneumatic double-chamber cuff was placed around the arm or leg where a single chamber was inflated. The cuff inflation rate (1 kPa/s) was constant, and pain intensity was registered continuously on a 10 cm electronic visual...

  4. Differential changes in functional disability and pain intensity over the course of psychological treatment for children with chronic pain.

    Science.gov (United States)

    Lynch-Jordan, Anne M; Sil, Soumitri; Peugh, James; Cunningham, Natoshia; Kashikar-Zuck, Susmita; Goldschneider, Kenneth R

    2014-10-01

    Patients presenting for treatment of chronic pain often believe that pain reduction must be achieved before returning to normal functioning. However, treatment programs for chronic pain typically take a rehabilitative approach, emphasizing decreasing pain-related disability first with the expectation that pain reduction will follow. This information is routinely provided to patients, yet no studies have systematically examined the actual trajectories of pain and disability in a clinical care setting. In this study of youth with chronic pain (N=94, 8 to 18 years), it was hypothesized that 1) functional disability and pain would decrease over the course of psychological treatment for chronic pain and 2) functional disability would decrease more quickly than pain intensity. Participants received cognitive behavioral therapy (CBT) for pain management (M=5.6 sessions) plus standard medical care. The Functional Disability Inventory and a Numeric Rating Scale of average pain intensity were completed by the child at every CBT session. Hierarchical linear modeling was conducted to examine the longitudinal trajectories of disability and pain. Standardized estimates of the slopes of change were obtained to test differences in rates of change between pain and disability. Results showed an overall significant decline in functional disability over time. Although pain scores reduced slightly from pretreatment to posttreatment, the longitudinal decline over treatment was not statistically significant. As expected, the rate of change of disability was significantly more rapid than pain. Evidence for variability in treatment response was noted, suggesting the need for additional research into individual trajectories of change in pediatric pain treatment. Copyright © 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  5. Anxiety, depression and pain intensity in patients with low back pain who are admitted to acute care hospitals.

    Science.gov (United States)

    Mok, Long Chau; Lee, Iris Fung-Kam

    2008-06-01

    This study examines the relationship between anxiety, depression and pain intensity in patients with low back pain who are newly admitted to an acute care hospital setting. Previous studies have supported the idea that anxiety and depression play a significant role in chronic low back pain, but the relationship between anxiety, depression and pain intensity in patients with low back pain who are newly admitted to hospital has not been adequately explored. The study reported here was descriptive correlational in design. The sample was 102 Chinese patients with low back pain who were newly admitted to an acute care hospital in Hong Kong. Data were collected through individual interviews, using an 11-point numerical pain rating scale and the Hospital Anxiety and Depression Scale. In addition, demographic data were identified from the medical record. There were 48 male and 54 female adult participants in the study. The average anxiety and depression level of the participants was 19.46 (SD 9.02) on a scale of 0-42, which is higher than the normal level. The level of anxiety and depression was significantly positively correlated with pain intensity (r = 0.471, p anxiety and depression are not only associated with pain intensity but that they also, partly, predict pain intensity in patients with low back pain who are newly admitted to an acute care hospital. Relevance to clinical practice. The results of this study support the assessment of and intervention in anxiety and depression symptoms in the provision of pain-relief nursing treatment in patients with low back pain who are admitted to acute care hospitals.

  6. Electronic momentary assessment in chronic pain (I): pain and psychological pain responses as predictors of pain intensity.

    NARCIS (Netherlands)

    Sorbi, M.J.; Peters, M.L.; Kruise, D.A.; Maas, C.J.M.; Kerssens, J.J.; Verhaak, P.F.M.; Bensing, J.M.

    2006-01-01

    Objectives and Methods: Electronic momentary assessment was employed to substantiate the relevance of psychological functioning in chronic pain. More than 7100 electronic diaries from 80 patients with varying IASP classified types of chronic pain served to investigate to what extent fear-avoidance,

  7. Missed Opportunities for Sedation and Pain Management at a Level III Neonatal Intensive Care Unit, India

    OpenAIRE

    Kothari, Shikha Y.; Dongara, Ashish R.; Nimbalkar, Somashekhar M.; Phatak, Ajay G.; Nimbalkar, Archana S.

    2016-01-01

    Background Neonates in the neonatal intensive care unit (NICU) undergo a multitude of painful and stressful procedures during the first days of life. Stress from this pain can lead to neurodevelopmental problems that manifest in later childhood and should be prevented. Objective To determine the number of painful procedures performed per day for each neonate, to verify documentation of painful procedures performed, and to, subsequently, note missed opportunities for providing pain ...

  8. Missed Opportunities for Sedation and Pain Management at a Level III Neonatal Intensive Care Unit, India

    OpenAIRE

    Shikha Yashwant Kothari; Ashish Rajeshwar Dongara; Somashekhar Marutirao Nimbalkar; Ajay Gajanan Phatak; Archana Somashekhar Nimbalkar

    2016-01-01

    Background:Neonates in the neonatal intensive care unit (NICU) undergo a multitude of painful and stressful procedures during the first days of life. Stress from this pain can lead to neurodevelopmental problems that manifest in later childhood and should be prevented.Objective:To determine the number of painful procedures performed per day for each neonate, to verify documentation of painful procedures performed, and to, subsequently, note missed opportunities for providing pain relief to ne...

  9. Walking with a powered robotic exoskeleton: Subjective experience, spasticity and pain in spinal cord injured persons.

    Science.gov (United States)

    Stampacchia, Giulia; Rustici, Alessandro; Bigazzi, Samuele; Gerini, Adriana; Tombini, Tullia; Mazzoleni, Stefano

    2016-06-27

    Powered robotic exoskeletons represent an emerging technology for the gait training of Spinal Cord Injured (SCI) persons. The analysis of the psychological and physical impact of such technology on the patient is crucial in terms of clinical appropriateness of such rehabilitation intervention for SCI persons. To investigate the acceptability of overground robot-assisted walking and its effect on pain and spasticity. Twenty-one SCI persons participated in a walking session assisted by a powered robotic exoskeleton. Pain assessed using a Numeric Rating Scale (NRS) and muscle spasticity, assessed as subjective perception using an NRS scale and as objective assessment using the Modified Ashworth scale and the Penn scale, were evaluated before and after the walking experience. Positive and negative sensations were investigated using a questionnaire. The patient's global impression of change (PGIC) scale was administrated as well. After the walking session a significant decrease in the muscle spasticity and pain intensity was observed. The SCI persons recruited in this study reported (i) a global change after the walking session, (ii) high scores on the positive and (iii) low scores on the negative sensations, thus indicating a good acceptability of the robot-assisted walking. The overground robot-assisted walking is well accepted by SCI persons and has positive effects in terms of spasticity and pain reduction.

  10. Assessment and Treatment of Pain in Adult Intensive Care Unit Patients

    Directory of Open Access Journals (Sweden)

    Jun Mo Park

    2014-08-01

    Because pain is quite subjective, the accurate assessment of pain is very difficult in the patients with impaired communication ability. The current most valid and reliable behavioral pain scales used to assess pain in adult ICU patients are the Behavioral Pain Scale and the Critical-Care Pain Observation Tool. Once pain has been accurately assessed using these methods, various pharmacologic and non-pharmacologic therapies should be performed by the multidisciplinary care team. Accurate assessment and proper treatment of pain in adult ICU patients will improve patients outcome, which reduces the stress response and decreases the risk of post-traumatic stress disorder.

  11. Relationships between spinal mobility, physical performance tests, pain intensity and disability assessments in chronic low back pain patients.

    Science.gov (United States)

    Grönblad, M; Hurri, H; Kouri, J P

    1997-03-01

    Correlations between the Oswestry Disability Questionnaire (ODQ), the Pain Disability Index (PDI), PDI subscales PDI factor 1 (PDI 1), PDI factor 2 (PDI 2) and visual analogue scale (VAS) pain intensity on the one hand and spine range of motion measures and static and dynamic functional performance tests on the other, were studied in 52 chronic low back pain patients. Comparable groups of male and female patients were studied. A moderately significant (p < 0.01) inverse correlation was observed between the ODQ and rotation to the left even after correction for age, but not when men and women were studied separately. A significant (r = -0.480, p < 0.001) inverse correlation was observed between the repeated squatting test and pain intensity and in men both pain intensity and disability correlated (r = -0.607, p < 0.001) with this particular test. Only for the women were there moderately significant (p < 0.01) inverse correlations between disability assessments and all the physical performance tests with the exception of the static back muscle test. In the women only the isometric lifting test showed a moderately significant inverse correlation (r = -0.504, p < 0.01) with pain intensity. Such apparent gender differences in the overlap between physical performance tests and self-report disability assessments and pain intensity may be clinically relevant. The results will, however, require confirmation on larger groups of chronic low back pain patients.

  12. Methods of pain assessment in adult intensive care unit patients - Polish version of the CPOT (Critical Care Pain Observation Tool) and BPS (Behavioral Pain Scale).

    Science.gov (United States)

    Kotfis, Katarzyna; Zegan-Barańska, Małgorzata; Szydłowski, Łukasz; Żukowski, Maciej; Ely, Wes E

    2017-01-01

    Many patients treated in the intensive care unit (ICU) experience pain that is a source of suffering and leaves a longterm imprint (chronic pain, post-traumatic stress disorder). Nearly 30% of patients experience pain at rest, while the percentage increases to 50% during nursing procedures. Pain in ICU patients can be divided into four categories: continuous ICU treatment-related pain/discomfort, acute illness-related pain, intermittent procedural pain and pre-existing chronic pain present before ICU admission. As daily nursing procedures and interventions performed in the ICU may be a potential source of pain, it is crucial to use simple pain monitoring tools. The assessment of pain intensity in ICU patients remains an everyday challenge for clinicians, especially in sedated, intubated and mechanically ventilated patients. Regular assessment of pain intensity leads to improved outcome and better quality of life of patients in the ICU and after discharge from ICU. The gold standard in pain evaluation is patient self-reporting, which is not always possible. Current research shows that the two tools best validated for patients unable to self-report pain are the Behavioral Pain Scale (BPS) and the Critical Care Pain Observation Tool (CPOT). Although international guidelines recommend the use of validated tools for pain evaluation, they underline the need for translation into a given language. The authors of this publication obtained an official agreement from the authors of the two behavioral scales - CPOT and BPS - for translation into Polish. Validation of these tools in the Polish population will aid their wider use in pain assessment in ICUs in Poland.

  13. Effects of stress and relaxation on pain perception in subjects with pain-free occlusional disharmony compared with healthy controls.

    Science.gov (United States)

    Ruscheweyh, R; Becker, T; Born, Y; Çolak-Ekici, R; Marziniak, M; Evers, S; Gerlach, A L; Wolowski, A

    2015-04-01

    The significance of occlusal disharmony for the development of painful temporomandibular disorder (TMD) is controversial. The ongoing biomechanical strain caused by occlusal disharmony might lead to sensitization processes in the nociceptive system. Understanding these processes might be an important step toward understanding the possible relationship between occlusal disharmony and TMD. In this study, we therefore investigated whether subjects with occlusal disharmony (n = 22) differ from healthy controls (n = 26) in their pain perception and pain modulation by stress and relaxation. Trigeminal and extratrigeminal experimental pain perception (pinprick, heat, and pressure pain) was assessed before and after stress (mental arithmetic) and relaxation (viewing of low-arousal pictures). There were no group differences in pain perception at baseline or during the stress task. Compared with controls, the occlusal disharmony group exhibited an inadequate reduction in pain perception during relaxation, which was significant for the extratrigeminal site (P < 0.01) and reached a trend for significance at the trigeminal site (P = 0.1). These results suggest that subjects with occlusal disharmony show signs of disturbed endogenous pain inhibition during relaxation. There is evidence for the presence of sensitization of the nociceptive system in subjects with occlusal disharmony. Possibly, deficient inhibition of extratrigeminal and trigeminal pain perception by relaxation might contribute to the development of TMD or other chronic pain disorders. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Pain Assessment in INTensive care (PAINT): an observational study of physician-documented pain assessment in 45 intensive care units in the United Kingdom.

    Science.gov (United States)

    Kemp, H I; Bantel, C; Gordon, F; Brett, S J; Laycock, H C

    2017-06-01

    Pain is a common and distressing symptom experienced by intensive care patients. Assessing pain in this environment is challenging, and published guidelines have been inconsistently implemented. The Pain Assessment in INTensive care (PAINT) study aimed to evaluate the frequency and type of physician pain assessments with respect to published guidelines. This observational service evaluation considered all pain and analgesia-related entries in patients' records over a 24-h period, in 45 adult intensive care units (ICUs) in London and the South-East of England. Data were collected from 750 patients, reflecting the practice of 362 physicians. Nearly two-thirds of patients (n = 475, 64.5%, 95%CI 60.9-67.8%) received no physician-documented pain assessment during the 24-h study period. Just under one-third (n = 215, 28.6%, 95%CI 25.5-32.0%) received no nursing-documented pain assessment, and over one-fifth (n = 159, 21.2%, 95%CI 19.2-23.4)% received neither a doctor nor a nursing pain assessment. Two of the 45 ICUs used validated behavioural pain assessment tools. The likelihood of receiving a physician pain assessment was affected by the following factors: the number of nursing assessments performed; whether the patient was admitted as a surgical patient; the presence of tracheal tube or tracheostomy; and the length of stay in ICU. Physician-documented pain assessments in the majority of participating ICUs were infrequent and did not utilise recommended behavioural pain assessment tools. Further research to identify factors influencing physician pain assessment behaviour in ICU, such as human factors or cultural attitudes, is urgently needed. © 2017 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists of Great Britain and Ireland.

  15. Grading the intensity of nondental orofacial pain: identification of cutoff points for mild, moderate, and severe pain

    Directory of Open Access Journals (Sweden)

    Brailo V

    2015-02-01

    Full Text Available Vlaho Brailo,1 Joanna M Zakrzewska2 1Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia; 2Facial Pain Unit, Division of Diagnostic, Surgical and Medical Sciences, Eastman Dental Hospital, UCLH NHS Foundation Trust/University College London, London, UK Background: When assessing pain in clinical practice, clinicians often label pain as mild, moderate, and severe. However, these categories are not distinctly defined, and are often used arbitrarily. Instruments for pain assessment use more sophisticated scales, such as a 0–10 numerical rating scale, and apart from pain intensity assess pain-related interference and disability. The aim of the study was to identify cutoff points for mild, moderate, and severe nondental orofacial pain using a numerical rating scale, a pain-related interference scale, and a disability measurement. Materials and methods: A total of 245 patients referred to the Facial Pain Unit in London were included in the study. Intensity and pain-related interference were assessed by the Brief Pain Inventory. Pain-related disability was assessed by the Chronic Graded Pain Scale. Average pain intensity (0–10 was classified into nine schemes with varying cutoff points of mild, moderate, and severe pain. The scheme with the most significant intergroup difference, expressed by multivariate analysis of variance, provided the cutoffs between mild, moderate, and severe pain. Results: The combination that showed the greatest intergroup differences for all patients was scheme 47 (mild 1–4, moderate 5–7, severe 8–10. The same combination provided the greatest intergroup differences in subgroups of patients with temporomandibular disorder and chronic idiopathic facial pain, respectively. Among the trigeminal neuralgia patients alone, the combination with the highest intergroup differences was scheme 48 (mild 1–4, moderate 5–8, severe 9–10. Conclusion: The cutoff points established in

  16. Correspondence of verbal descriptor and numeric rating scales for pain intensity: an item response theory calibration.

    Science.gov (United States)

    Edelen, Maria Orlando; Saliba, Debra

    2010-07-01

    Assessing pain intensity in older adults is critical and challenging. There is debate about the most effective way to ask older adults to describe their pain severity, and clinicians vary in their preferred approaches, making comparison of pain intensity scores across settings difficult. A total of 3,676 residents from 71 community nursing homes across eight states were asked about pain presence. The 1,960 residents who reported pain within the past 5 days (53% of total, 70% female; age: M = 77.9, SD = 12.4) were included in analyses. Those who reported pain were also asked to provide a rating of pain intensity using either a verbal descriptor scale (VDS; mild, moderate, severe, and very severe and horrible), a numeric rating scale (NRS; 0 = no pain to 10 = worst pain imaginable), or both. We used item response theory (IRT) methods to identify the correspondence between the VDS and the NRS response options by estimating item parameters for these and five additional pain items. The sample reported moderate amounts of pain on average. Examination of the IRT location parameters for the pain intensity items indicated the following approximate correspondence: VDS mild approximately NRS 1-4, VDS moderate approximately NRS 5-7, VDS severe approximately NRS 8-9, and VDS very severe, horrible approximately NRS 10. This IRT calibration provides a crosswalk between the two response scales so that either can be used in practice depending on the preference of the clinician and respondent.

  17. Relationship between blood- and cerebrospinal fluid-bound neurotransmitter concentrations and conditioned pain modulation in pain-free and chronic pain subjects.

    Science.gov (United States)

    Parent, Alexandre J; Beaudet, Nicolas; Daigle, Kathya; Sabbagh, Robert; Sansoucy, Yanick; Marchand, Serge; Sarret, Philippe; Goffaux, Philippe

    2015-05-01

    Descending pain inhibition is an endogenous pain control system thought to depend partially on the activation of bulbospinal monoaminergic pathways. Deficits in descending pain inhibition have been reported in numerous human chronic pain conditions, but there is currently no consensus regarding the neurochemical correlates responsible for this deficit. The aims of this study were to 1) assess the efficacy of descending pain inhibition in pain-free and chronic pain subjects, 2) screen for changes in centrally (ie, cerebrospinal fluid) and peripherally (ie, plasma) acting monoamine concentrations, and 3) explore the relationship between descending pain inhibition and monoamine neurotransmitter concentrations. Our results clearly show a deficit in pain inhibition, along with lower plasma norepinephrine and metanephrine concentrations in chronic pain subjects, compared to pain-free subjects. No differences were found in cerebrospinal fluid neurotransmitter concentrations. Finally, our results revealed a positive relationship between blood-bound norepinephrine and metanephrine concentrations and the efficacy of descending pain inhibition. Thus, basal monoamine levels in blood were related to descending pain inhibition. This finding supports the emerging idea that individual differences in descending pain inhibition may be linked to individual differences in peripheral processes, such as monoamines release in blood, which are possibly related to cardiovascular control. This article presents psychophysical and neurochemical findings that indicate that the latent potential of descending pain inhibitory responses is associated with differential activity in peripheral processes governed by monoamine neurotransmitter release, bringing insights into the relationship between descending pain inhibition and cardiovascular control in humans. Copyright © 2015 American Pain Society. Published by Elsevier Inc. All rights reserved.

  18. Changes in pain intensity and health related quality of life with Iyengar yoga in nonspecific chronic low back pain: A randomized controlled study

    Directory of Open Access Journals (Sweden)

    Gopal S Nambi

    2014-01-01

    Full Text Available Background: Nonspecific chronic low back (nCLBP pain is prevalent among adult population and often leads to functional limitations, psychological symptoms, lower quality of life (QOL, and higher healthcare costs. The purpose of this study was to determine the efficacy of Iyengar yoga therapy on pain intensity and health related quality of life (HRQOL with nCLBP. Aim of the Study: To compare the effect of Iyengar yoga therapy and conventional exercise therapy on pain intensity and HRQOL in nonspecific chronic low back pain. Materials and Methods: Experimental study with random sampling technique. Subjects/Intervention: Sixty subjects who fulfilled the selection criteria were randomly assigned to Iyengar yoga (yoga group, n = 30 and control group (exercise group, n = 30. Participants completed low back pain evaluation form and HRQOL-4 questionnaire before their intervention and again 4 weeks and 6 month later. Yoga group underwent 29 yogic postures training and exercise group had undergone general exercise program for 4 weeks. Statistics: Repeated measures analysis of variance (ANOVA was used to analyze group differences over time, while controlling for baseline differences. Results: Patients in both groups experienced significant reduction in pain and improvement in HRQOL. In visual analogue scale (VAS yoga group showed reduction of 72.81% ( P = 0.001 as compared to exercise group 42.50% ( P = 0.001. In HRQOL, yoga group showed reduction of 86.99% ( P = 0.001 as compared to exercise group 67.66% ( P = 0.001. Conclusion: These results suggest that Iyengar yoga provides better improvement in pain reduction and improvement in HRQOL in nonspecific chronic back pain than general exercise.

  19. Knowledge and Attitudes of Nurses Regarding Pain in the Intensive ...

    African Journals Online (AJOL)

    environment alters patients' normal sensory stimuli and increases their perception of pain (Gélinas, et al., 2004) ... disturbance, delirium, and paranoia also result from unmanaged pain (Gélinas et al., 2004). Nurses' ... process to obtain medical opioids and to prescribe strong opioids for patients with severe pain is becoming ...

  20. Exposure to Virtual Social Stimuli Modulates Subjective Pain Reports

    Directory of Open Access Journals (Sweden)

    Jacob M Vigil

    2014-01-01

    Full Text Available BACKGROUND: Contextual factors, including the gender of researchers, influence experimental and patient pain reports. It is currently not known how social stimuli influence pain percepts, nor which types of sensory modalities of communication, such as auditory, visual or olfactory cues associated with person perception and gender processing, produce these effects.

  1. An analysis of the variability of breakthrough pain intensity in patients with cancer.

    Science.gov (United States)

    Burton, Allen W; Filbet, Marilène; Knight, Alastair D; Tayi, Ravi; Perelman, Michael

    2014-03-01

    The management of breakthrough pain in patients with cancer (BTPc) generally includes an initial titration of breakthrough pain medication to an effective dose, followed by the use of that dose in all subsequent episodes. This strategy presumes that an individual patient has a degree of consistency of pain during repeat episodes; however, that presumption has not been formally assessed. To examine the variation in pain intensity of BTPc episodes within individual patients and across patients. Data were pooled from 2 randomized, double-blind, crossover studies that used fentanyl pectin nasal spray (FPNS) vs comparator to relieve BTPc. Eligible patients were adults with an Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2 and adequately controlled background pain. The FPNS dose was titrated prior to a double-blind treatment consisting of 10 episodes. Pain intensity was reported on an 11-point numeric scale in which 0 = no pain and 10 = worst possible pain. Inter- and intrapatient variabilities of baseline pain intensity scores per episode were analyzed by analysis of covariance via a mixed-effect model. The influences of demographics and ECOG grade at study entry were assessed. Mean baseline pain intensity score was 7.3 (standard deviation, 1.76; range, 2-10) across 1,399 BTPc episodes in 152 patients. The interpatient variability of baseline pain intensity scores was 75.96%; intrapatient variability was 20.64%. Fixed terms for demographics and ECOG grade did not significantly influence baseline pain intensity score (≤ 5% level). This was a post hoc analysis. Baseline pain intensity scores during episodes of BTPc vary widely between patients, but vary little within individual patients; this supports the use of a consistent maintenance dosage of analgesia for BTPc, once it has been titrated to an effective dose. The study was funded by Archimedes Development Ltd.

  2. Modification of electrical pain threshold by voluntary breathing-controlled electrical stimulation (BreEStim in healthy subjects.

    Directory of Open Access Journals (Sweden)

    Shengai Li

    Full Text Available BACKGROUND: Pain has a distinct sensory and affective (i.e., unpleasantness component. BreEStim, during which electrical stimulation is delivered during voluntary breathing, has been shown to selectively reduce the affective component of post-amputation phantom pain. The objective was to examine whether BreEStim increases pain threshold such that subjects could have improved tolerance of sensation of painful stimuli. METHODS: Eleven pain-free healthy subjects (7 males, 4 females participated in the study. All subjects received BreEStim (100 stimuli and conventional electrical stimulation (EStim, 100 stimuli to two acupuncture points (Neiguan and Weiguan of the dominant hand in a random order. The two different treatments were provided at least three days apart. Painful, but tolerable electrical stimuli were delivered randomly during EStim, but were triggered by effortful inhalation during BreEStim. Measurements of tactile sensation threshold, electrical sensation and electrical pain thresholds, thermal (cold sensation, warm sensation, cold pain and heat pain thresholds were recorded from the thenar eminence of both hands. These measurements were taken pre-intervention and 10-min post-intervention. RESULTS: There was no difference in the pre-intervention baseline measurement of all thresholds between BreEStim and EStim. The electrical pain threshold significantly increased after BreEStim (27.5±6.7% for the dominant hand and 28.5±10.8% for the non-dominant hand, respectively. The electrical pain threshold significantly decreased after EStim (9.1±2.8% for the dominant hand and 10.2±4.6% for the non-dominant hand, respectively (F[1, 10] = 30.992, p = .00024. There was no statistically significant change in other thresholds after BreEStim and EStim. The intensity of electrical stimuli was progressively increased, but no difference was found between BreEStim and EStim. CONCLUSION: Voluntary breathing controlled electrical stimulation

  3. The Course of Pain Intensity in Patients Undergoing Herniated Disc Surgery: A 5-Year Longitudinal Observational Study.

    Directory of Open Access Journals (Sweden)

    Marie Dorow

    Full Text Available The aims of this study are to answer the following questions (1 How does the pain intensity of lumbar and cervical disc surgery patients change within a postoperative time frame of 5 years? (2 Which sociodemographic, medical, work-related, and psychological factors are associated with postoperative pain in lumbar and cervical disc surgery patients?The baseline survey (T0; n = 534 was conducted 3.6 days (SD 2.48 post-surgery in the form of face-to-face interviews. The follow-up interviews were conducted 3 months (T1; n = 486 patients, 9 months (T2; n = 457, 15 months (T3; n = 438, and 5 years (T4; n = 404 post-surgery. Pain intensity was measured on a numeric rating-scale (NRS 0-100. Estimated changes to and influences on postoperative pain by random effects were accounted by regression models.Average pain decreased continuously over time in patients with lumbar herniated disc (Wald Chi² = 25.97, p<0.001. In patients with cervical herniated disc a reduction of pain was observed, albeit not significant (Chi² = 7.02, p = 0.135. Two predictors were associated with postoperative pain in lumbar and cervical disc surgery patients: the subjective prognosis of gainful employment (p<0.001 and depression (p<0.001.In the majority of disc surgery patients, a long-term reduction of pain was observed. Cervical surgery patients seemed to benefit less from surgery than the lumbar surgery patients. A negative subjective prognosis of gainful employment and stronger depressive symptoms were associated with postoperative pain. The findings may promote multimodal rehabilitation concepts including psychological and work-related support.

  4. The Course of Pain Intensity in Patients Undergoing Herniated Disc Surgery: A 5-Year Longitudinal Observational Study.

    Science.gov (United States)

    Dorow, Marie; Löbner, Margrit; Stein, Janine; Pabst, Alexander; Konnopka, Alexander; Meisel, Hans J; Günther, Lutz; Meixensberger, Jürgen; Stengler, Katarina; König, Hans-Helmut; Riedel-Heller, Steffi G

    2016-01-01

    The aims of this study are to answer the following questions (1) How does the pain intensity of lumbar and cervical disc surgery patients change within a postoperative time frame of 5 years? (2) Which sociodemographic, medical, work-related, and psychological factors are associated with postoperative pain in lumbar and cervical disc surgery patients? The baseline survey (T0; n = 534) was conducted 3.6 days (SD 2.48) post-surgery in the form of face-to-face interviews. The follow-up interviews were conducted 3 months (T1; n = 486 patients), 9 months (T2; n = 457), 15 months (T3; n = 438), and 5 years (T4; n = 404) post-surgery. Pain intensity was measured on a numeric rating-scale (NRS 0-100). Estimated changes to and influences on postoperative pain by random effects were accounted by regression models. Average pain decreased continuously over time in patients with lumbar herniated disc (Wald Chi² = 25.97, pherniated disc a reduction of pain was observed, albeit not significant (Chi² = 7.02, p = 0.135). Two predictors were associated with postoperative pain in lumbar and cervical disc surgery patients: the subjective prognosis of gainful employment (pdisc surgery patients, a long-term reduction of pain was observed. Cervical surgery patients seemed to benefit less from surgery than the lumbar surgery patients. A negative subjective prognosis of gainful employment and stronger depressive symptoms were associated with postoperative pain. The findings may promote multimodal rehabilitation concepts including psychological and work-related support.

  5. Neural correlates of interindividual differences in the subjective experience of pain

    OpenAIRE

    Coghill, Robert C.; McHaffie, John G.; Yen, Ye-Fen

    2003-01-01

    Some individuals claim that they are very sensitive to pain, whereas others say that they tolerate pain well. Yet, it is difficult to determine whether such subjective reports reflect true interindividual experiential differences. Using psychophysical ratings to define pain sensitivity and functional magnetic resonance imaging to assess brain activity, we found that highly sensitive individuals exhibited more frequent and more robust pain-induced activation of the prim...

  6. Dry Needling Alters Trigger Points in the Upper Trapezius Muscle and Reduces Pain in Subjects With Chronic Myofascial Pain.

    Science.gov (United States)

    Gerber, Lynn H; Shah, Jay; Rosenberger, William; Armstrong, Kathryn; Turo, Diego; Otto, Paul; Heimur, Juliana; Thaker, Nikki; Sikdar, Siddhartha

    2015-07-01

    To determine whether dry needling of an active myofascial trigger point (MTrP) reduces pain and alters the status of the trigger point to either a non-spontaneously tender nodule or its resolution. A prospective, nonrandomized, controlled, interventional clinical study. University campus. A total of 56 subjects with neck or shoulder girdle pain of more than 3 months duration and active MTrPs were recruited from a campus-wide volunteer sample. Of these, 52 completed the study (23 male and 33 female). Their mean age was 35.8 years. Three weekly dry needling treatments of a single active MTrP. Baseline and posttreatment evaluations of pain using a verbal analogue scale, the Brief Pain Inventory, and the status of the MTrP as determined by digital palpation. Trigger points were rated as active (spontaneously painful), latent (requiring palpation to reproduce the characteristic pain), or resolved (no palpable nodule). Profile of Mood States, Oswestry Disability Index, and Short Form 36 scores, and cervical range of motion. A total of 41 subjects had a change in trigger point status from active to latent or resolved, and 11 subjects had no change (P trigger point status is associated with a statistically and clinically significant reduction in pain. Reduction of pain is associated with improved mood, function, and level of disability. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  7. A Model-Based Approach for Joint Analysis of Pain Intensity and Opioid Consumption in Postoperative Pain

    DEFF Research Database (Denmark)

    Juul, Rasmus V; Knøsgaard, Katrine R; Olesen, Anne E

    2016-01-01

    intensity and opioid consumption in a 4-h postoperative period for 44 patients undergoing percutaneous kidney stone surgery. Analysis was based on 748 Numerical Rating Scale (NRS) scores of pain intensity and 51 observed morphine and oxycodone dosing events. A joint model was developed to describe...

  8. Mode of action of cupping--local metabolism and pain thresholds in neck pain patients and healthy subjects.

    Science.gov (United States)

    Emerich, M; Braeunig, M; Clement, H W; Lüdtke, R; Huber, R

    2014-02-01

    Cupping worldwide has been part of traditional medicine systems and is in the western world used as CAM therapy mainly for treating pain syndromes. The mode of action is up to now unclear. In order to investigate its mechanism we measured in parallel metabolic changes in the tissue under the cupping glass and pressure pain thresholds. In 12 volunteers (6 healthy subjects and 6 patients with chronic neck pain) a microdialysis system was implanted subcutaneously on both sides (left and right) above the trapezius muscle. After baseline measures cupping was performed at one randomly selected side (left or right), the other side served as control. Every 20 min during baseline measures and for 280 min after cupping, microdialysis probes for detection of lactate, pyruvate, glucose and glycerin were taken. In addition, pain thresholds were measured before and after cupping with algometry. Cupping resulted in a strong increase of lactate (beginning 160 min after cupping until the end of the measurements) and the lactate/pyruvate ratio, indicating an anaerobe metabolism in the surrounding tissue. Baseline pain thresholds were non-significantly lower in neck pain patients compared to healthy controls and slightly increased immediately after cupping (pcupping in healthy subjects and on the foot in neck pain patients). After 280 min no more significant changes of pain thresholds were detected. Cupping induces >280 min lasting anaerobe metabolism in the subcutaneous tissue and increases immediate pressure pain thresholds in some areas. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Is there a relationship between pain intensity and postural sway in patients with non-specific low back pain?

    Directory of Open Access Journals (Sweden)

    Fejer René

    2011-07-01

    Full Text Available Abstract Background Increased center of pressure excursions are well documented in patients suffering from non-specific low back pain, whereby the altered postural sway includes both higher mean sway velocities and larger sway area. No investigation has been conducted to evaluate a relationship between pain intensity and postural sway in adults (aged 50 or less with non-specific low back pain. Methods Seventy-seven patients with non-specific low back pain and a matching number of healthy controls were enrolled. Center of pressure parameters were measured by three static bipedal standing tasks of 90 sec duration with eyes closed in narrow stance on a firm surface. The perceived pain intensity was assessed by a numeric rating scale (NRS-11, an equal number of patients (n = 11 was enrolled per pain score. Results Generally, our results confirmed increased postural instability in pain sufferers compared to healthy controls. In addition, regression analysis revealed a significant and linear increase in postural sway with higher pain ratings for all included COP parameters. Statistically significant changes in mean sway velocity in antero-posterior and medio-lateral direction and sway area were reached with an incremental change in NRS scores of two to three points. Conclusions COP mean velocity and sway area are closely related to self-reported pain scores. This relationship may be of clinical use as an objective monitoring tool for patients under treatment or rehabilitation.

  10. Does habituation differ in chronic low back pain subjects compared to pain-free controls? A cross-sectional pain rating ERP study reanalyzed with the ERFIA multilevel method.

    Science.gov (United States)

    Vossen, Catherine J; Vossen, Helen G M; Joosten, Engelbert A; van Os, Jim; Lousberg, Richel

    2015-05-01

    The objective of the present study was to investigate cortical differences between chronic low back pain (CLBP) subjects and pain-free controls with respect to habituation and processing of stimulus intensity. The use of a novel event-related fixed-interval areas (ERFIA) multilevel technique enables the analysis of event-related electroencephalogram (EEG) of the whole post stimulus range at a single trial level. This technique makes it possible to disentangle the cortical processes of habituation and stimulus intensity.In a cross-sectional study, 78 individuals with CLBP and 85 pain-free controls underwent a rating paradigm of 150 nonpainful and painful somatosensory electrical stimuli. For each trial, the entire epoch was partitioned into 20-ms ERFIAs, which acted as dependent variables in a multilevel analysis. The variability of each consecutive ERFIA period was modeled with a set of predictor variables, including 3 forms of habituation and stimulus intensity.Seventy-six pain-free controls and 65 CLBP subjects were eligible for analysis. CLBP subjects showed a significantly decreased linear habituation at 340 to 460 ms in the midline electrodes and C3 (Ps < .05) and had a significantly more pronounced dishabituation for the regions of 400 to 460 ms and 800 to 820 ms for all electrodes, except for T3 and T4 (Ps < .05). No significant group differences for stimulus intensity processing were observed.In this study, group differences with respect to linear habituation and dishabituation were demonstrated. By means of the ERFIA multilevel technique, habituation effects were found in a broad post stimulus range and were not solely limited to peaks. This study suggests that habituation may be a key mechanism involved in the transition process to chronic pain. Future studies with a longitudinal design are required to solve this issue.

  11. Effect of instrumental music on pain intensity in patients with loss of consciousness in intensive care unit

    Directory of Open Access Journals (Sweden)

    Yaghoubinia Fariba

    2016-02-01

    Full Text Available Background and Objective: patients with loss of consciousness experience pain concerning the invasive procedures, mechanical ventilation and physical situation of ICU. The current study was conducted to determine the effect of instrumental music on pain intensity in patients with loss of consciousness in intensive care unit. Materials and Method: In this clinical trial study, study population was the intubated patients under mechanical ventilation who hospitalized in intensive care unit in one of the hospitals in Zahedan 2015. 60 eligible patients were selected conveniently and  then were randomly allocated through permuted blocks into two music therapy and control groups of 30 persons. Intervention was carried out through playing instrumental music of Arnd Stein in 3 sessions of 30 minutes via headphone. Control group only received the routine care about pain relief. Measuring the pain was done through BPS, 5 minutes before and immediately after the music therapy. In control group, measurement was done with the same interval and frequency. Data were analyzed in SPSS 15 and using independent T-test, paired T-test, chi-square and ANCOVA. Results: Every three days after the intervention, the mean score of pain was significantly reduced in intervention group (p<0.0001, and pain relief in the first day was more than the next days of intervention and this difference was significant between the intervention and control groups (p<0.0001, while this difference was not significant in control group. Conclusion: According to results, the application of instrumental music can reduce the intensity of pain in patients with loss of consciousness. Thus, it can be used as a simple, practical and low costs method in pain relief of patients with loss of consciousness in the intensive care unit.

  12. The effect of sleep restriction on laser evoked potentials, thermal sensory and pain thresholds and suprathreshold pain in healthy subjects.

    Science.gov (United States)

    Ødegård, Siv Steinsmo; Omland, Petter Moe; Nilsen, Kristian Bernhard; Stjern, Marit; Gravdahl, Gøril Bruvik; Sand, Trond

    2015-10-01

    Sleep restriction seems to change our experience of pain and reduce laser evoked potential (LEP) amplitudes. However, although LEP-habituation abnormalities have been described in painful conditions with comorbid sleep impairment, no study has previously measured the effect of sleep restriction on LEP-habituation, pain thresholds, and suprathreshold pain. Sixteen males and seventeen females (aged 18-31years) were randomly assigned to either two nights of delayed bedtime and four hours sleep (partial sleep deprivation) or nine hours sleep. The study subjects slept at home, and the sleep was measured with actigraphy both nights and polysomnography the last night. LEP, thermal thresholds and suprathreshold pain ratings were obtained the day before and the day after intervention. The investigator was blinded. ANOVA was used to evaluate the interaction between sleep restriction and day for each pain-related variable. LEP-amplitude decreased after sleep restriction (interaction p=0.02) compared to subjects randomized to nine hours sleep. LEP-habituation was similar in both groups. Thenar cold pain threshold decreased after sleep restriction (interaction p=0.009). Supra-threshold heat pain rating increased temporarily 10s after stimulus onset after sleep restriction (interaction p=0.01), while it did not change after nine hours sleep. Sleep restriction reduced the CNS response to pain, while some of the subjective pain measures indicated hyperalgesia. Since LEP-amplitude is known to reflect both CNS-pain-specific processing and cognitive attentive processing, our results suggest that hyperalgesia after sleep restriction might partly be caused by a reduction in cortical cognitive or perceptual mechanisms, rather than sensory amplification. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  13. High frequency migraine is associated with lower acute pain sensitivity and abnormal insula activity related to migraine pain intensity, attack frequency, and pain catastrophizing

    Directory of Open Access Journals (Sweden)

    Vani A Mathur

    2016-09-01

    Full Text Available Migraine is a pain disorder associated with abnormal brain structure and function, yet the effect of migraine on acute pain processing remains unclear. It also remains unclear whether altered pain-related brain responses and related structural changes are associated with clinical migraine characteristics. Using fMRI and three levels of thermal stimuli (non-painful, mildly painful, and moderately painful, we compared whole-brain activity between 14 migraine patients and 14 matched controls. Although, there were no significant differences in pain thresholds and pre-scan pain ratings to mildly painful thermal stimuli, patients had aberrant suprathreshold nociceptive processing. Compared to controls, patients had reduced activity in pain modulatory regions including left dorsolateral prefrontal, posterior parietal, and middle temporal cortices and, at a lower-threshold, greater activation in the right mid-insula to moderate pain versus mild pain. We also found that pain-related activity in the insula was associated with clinical variables in patients, including associations between: bilateral anterior insula and pain catastrophizing (PCS; bilateral anterior insula and contralateral posterior insula and migraine pain intensity; and bilateral posterior insula and migraine frequency at a lower-threshold. PCS and migraine pain intensity were also negatively associated with activity in midline regions including posterior cingulate and medial prefrontal cortices. Diffusion tensor imaging revealed a negative correlation between fractional anisotropy (a measure of white matter integrity; FA and migraine duration in the right mid-insula and a positive correlation between left mid-insula FA and PCS. In sum, while patients showed lower sensitivity to acute noxious stimuli, the neuroimaging findings suggest enhanced nociceptive processing and significantly disrupted modulatory networks, particularly involving the insula cortex, associated with indices of

  14. Spatial summation of heat pain within and across dermatomes in fibromyalgia patients and pain-free subjects.

    Science.gov (United States)

    Staud, Roland; Vierck, Charles J; Robinson, Michael E; Price, Donald D

    2004-10-01

    The mechanisms of spatial summation of pain (SSP) include pain coding dependent on impulse frequency and the number of recruited central neurons. However, SSP may also be influenced by pain inhibitory mechanisms, such as diffuse noxious inhibitory controls. Abnormal interactions between pain inhibitory mechanisms and SSP may be relevant for chronic pain conditions such as fibromyalgia (FM) and may help explain why widespread pain is characteristic for this chronic pain syndrome. The present study was designed to determine the difference of thermal SSP in the upper extremities between FM and normal control (NC) subjects, particularly within and across dermatomes of the hand. Fourteen NC and 19 FM subjects were enrolled in this study. SSP testing sessions involved immersion of each individual fingertip as well as stepwise immersion of the fingers, hands, and forearms in a hot water bath (46 degrees Celsius) for 5s and 20s. In addition, immersion of several fingertips across dermatome C(7)-C(8) was compared to progressive immersion of the index finger (dermatome C(7)). These experiments demonstrated significant spatial summation of heat-induced pain in both FM and NC subjects. SSP was most extensive within the fingers, and became negligible as the stimulus area increased above the hand. Furthermore, SSP was more pronounced within one dermatome such as that of the index finger than across several dermatomes of the hand. These results were similar for both FM and NC subjects. Thus, mechanisms of SSP, including possible inhibitory factors that limit this relevant pain mechanism, appear to be similar for both FM and NC subjects.

  15. The Effect of Dry Needling Compared With Ischemic Pressure on Pain Intensity on Active Trigger Point in Upper Trapezius Muscle

    Directory of Open Access Journals (Sweden)

    Maryam Ziaeifar

    2013-07-01

    Full Text Available Objective: Myofascial trigger point is one of the most common causes of musculoskeletal pain and disorders. Myofascial trigger point in upper trapezius has been reported as a frequent symptom in patients with neck and thoracic pain. The purpose of this study was to investigate the effect of dry needling compared with ischemic pressure on active trigger point in upper trapezius muscle. Materials & Methods: 32 women with active myofascial trigger point in upper trapezius muscle participated in this randomized clinical trial (RCT study. The subjects were randomly assigned into two groups: dry needling (N=15 and ischemic pressure (N=17. The visual analogue scale (VAS was used to assess the pain intensity before and after treatment in both groups. Paired t-test was used to determine any significant difference in pain intensity after treatment sessions compared with pre-treatment score in control and experimental group. Analysis of Covariance (ANCOVA was calculated to determine the significance of differences between the control and experimental groups in post-test scores, with pre-treatment scores used as covariates in the analysis. Results: Statistical analysis (paired t-test revealed significant decrease in pain intensity after treatment sessions in control and experimental group (P=0.00 compared with pre-treatment score. In the ANCOVA, controlling for pre-test scores, no significant difference was found between the two groups (P=0.8. Conclusion: It seems that that both dry needling and ischemic pressure are effective in improvement in the pain intensity in subjects with myofascial trigger points. However, dry needling can be used by clinicians and therapist in physiotherapy clinics.

  16. Pain measurement in the National Social Life, Health, and Aging Project: presence, intensity, and location.

    Science.gov (United States)

    Shega, Joseph W; Tiedt, Andrew D; Grant, Kaelin; Dale, William

    2014-11-01

    To describe the rationale for the pain presence, location, and intensity measures in the National Social Life, Health and Aging Project (NSHAP). Responses to the pain presence, location (pain map), and intensity (verbal descriptor scale) items were analyzed by gender and age (62-69, 70-79, and 80-91). Pain intensity was dichotomized (none to mild vs moderate or higher) and compared by demographics, physical function, mood, and self-rated health. All analyses used Wald tests to compare sample means. Participants completed the pain presence (n = 2,430/2,799), location (n = 2,558/2,799), and intensity (n = 2,589/2,799) items. Pain items varied by gender with women reporting more head, arm, hip/buttock, leg, and foot pain compared to men, (p < .05) at each individual site. Women also reported more intense pain compared to men-2.13 versus 1.94, respectively (p < .05). Pain items demonstrated remarkable similarity among age cohorts. Health indicators were significant and in the expected direction (p < .001). An increase in comorbidity, ADL and IADL dependence, worse self-rated health, and more depressive symptoms were each significantly more common among participants who reported moderate or greater pain compared to none to mild pain. Pain presence, location, and intensity measures were successfully integrated into NSHAP Wave 2 and exhibit construct and external validity. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Shoulder functional assessments in persons with chronic neck/shoulder pain and healthy subjects: Reliability and effects of movement repetition.

    Science.gov (United States)

    Lomond, Karen V; Côté, Julie N

    2011-01-01

    Obtaining reliable functional capacity measures from injured workers is an essential part of the return to work (RTW) process. The present study compares shoulder functional outcomes between healthy individuals and others with neck/shoulder pain, assesses reliability and examines the influence of repetitive movements on shoulder function. Subjects performed trials of flexion and abduction active range of motion (ROM), and cumulative power output (PO) in a pushing/pulling task on the Baltimore Therapeutic Equipment Simulator II in two consecutive sessions. Tasks were assessed before and after performing a repetitive arm task, during which heart rate (HR) was recorded, until scoring 8 on the Borg CR-10 scale or on a 11-point numeric rating scale (NRS) for pain. Persons with chronic neck/shoulder pain (intensity ≥ 3/10 for > 3 months) (n = 16) and an age- and sex-matched control group (n = 16). Functional shoulder measures demonstrated strong inter-session reliability, except PO in the pain group. Average repetitive task duration was shorter in the pain group (4 min vs. 7 min). The protocol detected both pain- and time-related impairments, with HR and PO being sensitive to movement duration and ROM to pain.

  18. AN APP for the Assessment of Pain Intensity: Validity Properties and Agreement of Pain Reports When Used with Young People.

    Science.gov (United States)

    Sánchez-Rodríguez, Elisabet; de la Vega, Rocío; Castarlenas, Elena; Roset, Roman; Miró, Jordi

    2015-10-01

    Painometer is a mobile application that includes four pain intensity scales: the Numerical Rating Scale, the Faces Pain Scale-Revised, the mechanical visual analogue scale and the Colored Analogue Scale. The aim of this study was to analyze the validity and agreement of the intensity reports provided by these scales and their traditional counterparts. Participants were 180 young people (mean age = 14.88; SD= 1.64; age range: 12-19). They were asked to report the maximum intensity of their most frequent pain in the previous three months using traditional and electronic versions of the scales. They also reported their level of fatigue and pain catastrophizing. Construct validity was evaluated by confirmatory factor analysis (CFA) and by convergent and discriminant validity. Criterion validity was assessed as concurrent validity. Agreement was calculated using the Bland and Altman method. Analyses were conducted for two confidence intervals (CI): 95% and 80%. CFA demonstrated that the four electronic versions of the scales measure a single factor. All the scales showed a) moderate to high convergent validity, b) adequate discriminant validity with fatigue ratings, and c) adequate concurrent validity with pain catastrophizing ratings. Results also show that traditional and electronic versions of the four scales are in agreement, at least at the 80% CI. Our results demonstrate that pain intensity scores reported with the scales in Painometer are valid, and concordant with their traditional counterparts. Wiley Periodicals, Inc.

  19. Metal sandwich plates subject to intense air shocks

    National Research Council Canada - National Science Library

    Vaziri, Ashkan; Hutchinson, John W

    2007-01-01

    ... performance in air blasts, due, on the one hand, to the fact that Taylor’s (1963) linear theory for blasts suggests the effect is small and, on the other hand, to the absence of theoretical results for intense air blasts. The fluid–structure interaction theory of Taylor (1963) uses an acoustic approximation wherein the fluid is assumed to undergo relativ...

  20. Altered Pain Perception and Fear-Learning Deficits in Subjects With Posttraumatic Stress Disorder.

    Science.gov (United States)

    Jenewein, Josef; Erni, Jeannine; Moergeli, Hanspeter; Grillon, Christian; Schumacher, Sonja; Mueller-Pfeiffer, Christoph; Hassanpour, Katayun; Seiler, Annina; Wittmann, Lutz; Schnyder, Ulrich; Hasler, Gregor

    2016-12-01

    There is growing evidence that fear-learning abnormalities are involved in the development of posttraumatic stress disorder (PTSD) and chronic pain. More than 50% of PTSD patients suffer from chronic pain. This study aimed to examine the role of fear-learning deficits in the link between pain perception and PTSD. We included 19 subjects with PTSD and 21 age- and sex-matched healthy control subjects in a fear-conditioning experiment. The conditioned stimulus (CS) consisted of visual signs flashed upon a screen in front of each subject. The unconditioned stimulus was either a low or high temperature impulse delivered through a thermal contact thermode on the subjects' hand. A designation of 'CS-' was assigned to CS always followed by nonpainful low-temperature stimuli; a designation of 'CS+' was given to CS that were randomly followed by either a low or a more painful high temperature. Skin conductance was used as a physiological marker of fear. In healthy control subjects, CS+ induced more fear than CS-, and a low-temperature stimulus induced less subjective pain after CS- than after CS+. PTSD subjects failed to demonstrate such adaptive conditioning. Fear ratings after CS presentation were significantly higher in the PTSD group than in the control group. There were significant interaction effects between group and the type of CS on fear and pain ratings. Fear-learning deficits are a potentially promising, specific psychopathological factor in altered pain perception associated with PTSD. Deficits in safety learning may increase fear and, consequently, pain sensations. These findings may contribute to elucidating the pathogenesis behind the highly prevalent comorbidity that exists between PTSD and pain disorders, and to developing new treatments. This study provides new insights into the pathogenesis of chronic pain in patients with PTSD. The findings may help to develop new treatment strategies for this highly prevalent comorbidity in PTSD. Copyright © 2016

  1. Efficacy of pulsed low-intensity electric neuromuscular stimulation in reducing pain and disability in patients with myofascial syndrome.

    Science.gov (United States)

    Iodice, P; Lessiani, G; Franzone, G; Pezzulo, G

    2016-01-01

    Myofascial pain syndrome (MPS) is characterized by chronic pain in multiple myofascial trigger points and fascial constrictions. In recent years, the scientific literature has recognized the need to include the patient with MPS in a multidimensional rehabilitation project. At the moment, the most widely recognized therapeutic methods for the treatment of myofascial syndrome include the stretch and spray pressure massage. Microcurrent electric neuromuscular stimulation was proposed in pain management for its effects on normalizing bioelectricity of cells and for its sub-sensory application. In this study, we tested the efficacy of low-intensity pulsed electric neuromuscular stimulus (PENS) on pain in patients with MPS of cervical spine muscles. We carried out a prospective-analytic longitudinal study at an outpatient clinic during two weeks. Forty subjects (mean age 42±13 years) were divided into two groups: treatment (TrGr, n=20) and control group (CtrlGr, n=20). Visual-analog scale (VAS) values, concerning the spontaneous and movement-related pain in the cervical-dorsal region at baseline (T0) and at the end of the study (T1), showed a reduction from 7 to 3.81 (p pain threshold at T0 was 2.1 vs 4.2 at T1 (p pain and on the restoration of tissue homeostasis. It seems to affect the transmission of pain through the stimulation of A-beta fibers. The above results show that low-intensity PENS can be considered as an effective treatment to reduce pain and disability in patients with MPS.

  2. Comparison of Lumbo-Pelvic Stability between Patients with Chronic Low Back Pain and Healthy Subjects

    OpenAIRE

    Mohammad Hosseinifar

    2016-01-01

    Because of the importance of lumbo-pelvic stability as one of the suggested factors to prevent low back pain and since to date no study accomplished to compare lumbo-pelvic stability between chronic low back pain (CLBP) and healthy subjects, the aim of this study was to determine and to compare lumbo-pelvic stability, lumbar lordosis, and lumbar mobility between CLBP and healthy subjects. Thirty CLBP patients and thirty healthy subjects through simple non-probability sampling participated in ...

  3. Discographic, MRI and psychosocial determinants of low back pain disability and remission: a prospective study in subjects with benign persistent back pain.

    Science.gov (United States)

    Carragee, Eugene J; Alamin, Todd F; Miller, Jonothan L; Carragee, John M

    2005-01-01

    A range of morphologic and psychosocial variables has been suggested as risk factors for serious low back pain (LBP) illness. Although the relative contributions of structural and psychosocial variables are intensely debated, the validity of differing hypotheses has proven difficult to test because the incidence of serious disabling LBP illness is low in healthy subjects. These factors dictate the requirement for large sample sizes, extensive structural imaging and extended longitudinal study. Previous studies included either small cohorts with intensive imaging testing or large population studies that do not establish a detailed morphologic baseline. To establish, using a strict patient sample design, the relative contribution of structural and psychosocial determinants of serious LBP illness among subjects with no previous LBP disability or clinical LBP illness. A prospective, longitudinal study of subjects with high risk factors for serious LBP as determined by structural and psychosocial characteristics. One hundred subjects with known mild persistent low back pain and a 2:1 ratio of chronic (non-lumbar) pain syndrome were recruited from a study population with a predisposition to disc degenerative disease, to undergo baseline examination, testing and 5-year follow-up. Observations were made at 6-month intervals over 4 to 6 years (mean, 5.3) for the after primary outcomes measures: episodes of serious back pain (visual analogue scale [VAS] > or =6), episodes of occupational disability less than 1 week, episodes of occupational disability for 1 week, remission episodes of all back pain symptoms at least 6 months and medical visits primarily for LBP evaluation and treatment. Lumbar magnetic resonance imaging (MRI), lumbar provocative discography (in psychometrically normal subjects), physical examinations, medical and work histories and psychometric testing were performed at baseline. Imaging and psychometric testing were graded by blinded examiners. A scripted

  4. Cancer patient and staff ratings of caring behaviors: relationship to level of pain intensity.

    Science.gov (United States)

    Chang, Yuanmay; Lin, Ya-Ping; Chang, Hsiu-Ju; Lin, Chia-Chin

    2005-01-01

    This study explored differences in the perceived importance of nursing caring behaviors between patients with cancer pain and oncology nurses and to explore the relationship between level of pain intensity and the importance of various nursing caring behaviors. The study included 50 matched cancer patient-staff pairs from oncology inpatient units of 3 hospitals in northern Taiwan. The Brief Pain Inventory-Chinese version (BPI-C) and the Caring Assessment Report Evaluation Q-sort (CARE-Q) were used for data collection. Results revealed that cancer pain patients ranked "being accessible," "monitors and follows through," and "anticipates" as being the most important nursing caring behaviors; the nursing staff ranked "being accessible," "explains and facilitates," and "monitors and follows through" as being the most important behaviors. No correlations were found between cancer pain patients and staff rankings of the perceived importance of various caring behaviors. The self-reported level of pain intensity by patients was significantly positively correlated with the patient rating of the "anticipates" behavior. Patient self-reported level of pain interference was significantly positively correlated with the "monitors and follows through" behavior and significantly negatively correlated with the "explains and facilitates" behavior. Staff perception of both a patient's level of pain intensity and pain interference was significantly positively correlated with staff rating of the "being accessible" behavior. Results demonstrated that greater patient-staff communication is needed for staff to more accurately provide caring interventions to make patients with cancer pain feel cared for.

  5. Relationship between nongenital tender point tenderness and intravaginal muscle pain intensity: ratings in women with provoked vestibulodynia and implications for treatment.

    Science.gov (United States)

    Phillips, Nancy; Brown, Candace; Bachmann, Gloria; Wan, Jim; Wood, Ronald; Ulrich, Dagny; Bachour, Candi; Foster, David

    2016-12-01

    Vulvodynia is a chronic vulvar pain disorder and fibromyalgia is a chronic widespread musculoskeletal pain disorder, both of unknown etiology. Association of these conditions is well documented. Intravaginal algometer measurement of tenderness to pressure applied to the pelvic floor muscles helps define vulvodynia associated with musculoskeletal factors. Women with both vulvodynia and fibromyalgia might have increased pelvic muscle pain compared to women with vulvodynia alone, defining the possible link of these 2 conditions. We sought to: (1) correlate pain intensity during the nongenital tender point tenderness examination to pain intensity with the vaginal algometer in women with provoked vestibulodynia, and (2) determine whether subjects with provoked vestibulodynia and fibromyalgia had higher pain intensity scores with the vaginal algometer than those without fibromyalgia. In all, 92 subjects referred for vulvar pain were confirmed to have provoked vestibulodynia using the cotton swab test. A diagnosis of fibromyalgia was made if pain was present (numeric rating scale >1) in at least 11 sites of the 18-point nongenital tender point tenderness exam. Vaginal pain sensitivity was measured using an intravaginal pressure algometer, where 0.1, 0.3, and 0.5 kg/cm(2) forces were applied digitally in random assignment by force and location to the right and left iliococcygeus muscle regions and the posterior vaginal wall. Both tender point tenderness and algometer pain intensity were reported on a 0 (no pain) to 10 (worse pain) numeric rating scale. Correlations were computed between the composite pain intensity (total of rating scale from each pressure threshold at specified site) of nongenital and those of iliococcygeus regions and the posterior vaginal wall. Independent t tests were used to determine differences in iliococcygeus regions and the posterior vaginal algometer pain ratings and presence or absence of fibromyalgia. The significance level was at P palpation

  6. Development and validation of an observation tool for the assessment of nursing pain management practices in intensive care unit in a standardized clinical simulation setting.

    Science.gov (United States)

    Gosselin, Emilie; Bourgault, Patricia; Lavoie, Stephan; Coleman, Robin-Marie; Méziat-Burdin, Anne

    2014-12-01

    Pain management in the intensive care unit is often inadequate. There is no tool available to assess nursing pain management practices. The aim of this study was to develop and validate a measuring tool to assess nursing pain management in the intensive care unit during standardized clinical simulation. A literature review was performed to identify relevant components demonstrating optimal pain management in adult intensive care units and to integrate them in an observation tool. This tool was submitted to an expert panel and pretested. It was then used to assess pain management practice during 26 discrete standardized clinical simulation sessions with intensive care nurses. The Nursing Observation Tool for Pain Management (NOTPaM) contains 28 statements grouped into 8 categories, which are grouped into 4 dimensions: subjective assessment, objective assessment, interventions, and reassessment. The tool's internal consistency was calculated at a Cronbach's alpha of 0.436 for the whole tool; the alpha varies from 0.328 to 0.518 for each dimension. To evaluate the inter-rater reliability, intra-class correlation coefficient was used, which was calculated at 0.751 (p intensive care nurses' pain management in a standardized clinical simulation. The NOTPaM is the first tool created for this purpose. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  7. [Pain Intensity and Time to Death of Cancer Patients Referred to Palliative Care].

    Science.gov (United States)

    Barata, Pedro; Santos, Filipa; Mesquita, Graça; Cardoso, Alice; Custódio, Maria Paula; Alves, Marta; Papoila, Ana Luísa; Barbosa, António; Lawlor, Peter

    2016-11-01

    Pain is a common symptom experienced by cancer patients, especially in those with advanced disease. Our aim was to describe pain intensity in advanced cancer patients, referred to the palliative care unit, the factors underlying moderate to severe pain and its prognostic values. This was a prospective observational study. All patients with mestastatic solid tumors and with no specific oncologic treatment were included. Pain intensity was accessed using the pain scale from Edmonton Symptom Assessment Scale, rated from 0 to 10 on a numerical scale, where zero = no pain and 10 = worst possible pain. Between October 2012 and June 2015, a total of 301 patients participated in the study. The median age was 69 years, (37 - 94); most of the patients were men (57%) and 64.8% had a performance status of 3/4. About 42% reported pain severity ≥ 4 and 74% were medicated with opioids. Multivariate analysis indicated a correlation between performance status and reported pain (OR: 1.7; IC 95%: 1.0 - 2.7; p = 0.045). Median overall survival was 37 days (IC 95%: 28 - 46). Patients reporting moderate to severe pain (pain severity ≥ 4) had a median survival of 29 days (IC 95%: 21 - 37), comparing with those who had no or moderate pain with median survival of 49 days (IC 95%: 35 - 63) (p = 0.022). The performance status was associated with more intense pain. The performance status, hospitalization, intra-abdominal metastization and opioid analgesia were associated with shorter time to death in advanced cancer patients referred to palliative care. Cancer pain continues to be a major clinical problem in advanced cancer patients.

  8. Is there a relationship between pain intensity and postural sway in patients with non-specific low back pain?

    DEFF Research Database (Denmark)

    Ruhe, A.; Fejer, R.; Walker, B.

    2011-01-01

    Background: Increased center of pressure excursions are well documented in patients suffering from non-specific low back pain, whereby the altered postural sway includes both higher mean sway velocities and larger sway area. No investigation has been conducted to evaluate a relationship between...... pain intensity and postural sway in adults (aged 50 or less) with non-specific low back pain. Methods: Seventy-seven patients with non-specific low back pain and a matching number of healthy controls were enrolled. Center of pressure parameters were measured by three static bipedal standing tasks of 90...... reached with an incremental change in NRS scores of two to three points. Conclusions: COP mean velocity and sway area are closely related to self-reported pain scores. This relationship may be of clinical use as an objective monitoring tool for patients under treatment or rehabilitation....

  9. Sex differences in trauma symptoms, body image and intensity of pain in a Polish sample of patients suffering from chronic pain.

    Science.gov (United States)

    Rzeszutek, Marcin; Oniszczenko, Włodzimierz; Schier, Katarzyna; Biernat-Kałuża, Edyta; Gasik, Robert

    2016-10-01

    The main goal of the current study was to investigate sex differences in the relationship between the level of trauma symptoms appearing in posttraumatic stress disorder (PTSD) and intensity of pain in a sample of 300 Polish patients suffering from chronic pain, specifically rheumatoid arthritis and lower back pain. We also focused on participants' body image with body esteem as a mediator. To assess the intensity of pain among participants, we used the Numerical Rating Scale. The level of trauma symptoms was assessed with the PTSD Factorial Version Inventory. To measure body image among participants, we used the Body Esteem Scale. The results of our study suggest that trauma symptoms and body image dimensions were significant predictors of pain intensity among men suffering from chronic pain. Moreover, trauma symptoms and age were significant predictors of pain intensity among women suffering from chronic pain. Finally, we demonstrated that sex differentiates the reaction to chronic pain.

  10. Effect of Radiofrequency Denervation on Pain Intensity Among Patients With Chronic Low Back Pain: The Mint Randomized Clinical Trials.

    Science.gov (United States)

    Juch, Johan N S; Maas, Esther T; Ostelo, Raymond W J G; Groeneweg, J George; Kallewaard, Jan-Willem; Koes, Bart W; Verhagen, Arianne P; van Dongen, Johanna M; Huygen, Frank J P M; van Tulder, Maurits W

    2017-07-04

    Radiofrequency denervation is a commonly used treatment for chronic low back pain, but high-quality evidence for its effectiveness is lacking. To evaluate the effectiveness of radiofrequency denervation added to a standardized exercise program for patients with chronic low back pain. Three pragmatic multicenter, nonblinded randomized clinical trials on the effectiveness of minimal interventional treatments for participants with chronic low back pain (Mint study) were conducted in 16 multidisciplinary pain clinics in the Netherlands. Eligible participants were included between January 1, 2013, and October 24, 2014, and had chronic low back pain, a positive diagnostic block at the facet joints (facet joint trial, 251 participants), sacroiliac joints (sacroiliac joint trial, 228 participants), or a combination of facet joints, sacroiliac joints, or intervertebral disks (combination trial, 202 participants) and were unresponsive to conservative care. All participants received a 3-month standardized exercise program and psychological support if needed. Participants in the intervention group received radiofrequency denervation as well. This is usually a 1-time procedure, but the maximum number of treatments in the trial was 3. The primary outcome was pain intensity (numeric rating scale, 0-10; whereby 0 indicated no pain and 10 indicated worst pain imaginable) measured 3 months after the intervention. The prespecified minimal clinically important difference was defined as 2 points or more. Final follow-up was at 12 months, ending October 2015. Among 681 participants who were randomized (mean age, 52.2 years; 421 women [61.8%], mean baseline pain intensity, 7.1), 599 (88%) completed the 3-month follow-up, and 521 (77%) completed the 12-month follow-up. The mean difference in pain intensity between the radiofrequency denervation and control groups at 3 months was -0.18 (95% CI, -0.76 to 0.40) in the facet joint trial; -0.71 (95% CI, -1.35 to -0.06) in the sacroiliac joint

  11. Pain Management Practice and Guidelines in Jordanian Pediatric Intensive Care Units.

    Science.gov (United States)

    Ismail, Ahmad; Forgeron, Paula; Polomeno, Viola; Gharaibeh, Huda; Harrison, Denise

    2017-11-15

    Limited knowledge exists of current pain management practices and supporting guidelines in Jordanian pediatric intensive care units. To determine the current pain management practices and the availability and content of practice guidelines in Jordanian pediatric intensive care units, we conducted a cross-sectional and multisite survey of four pediatric intensive care units in Jordan. A questionnaire was developed and orally administered over the phone or in person to head nurses or their nominees to capture pain management practices and the existence and content of guidelines. All units had written pain management guidelines that included pain assessment, documentation, and management. All four units used one or more pain assessment tools. In three units, pain management was considered multidisciplinary and routinely discussed on unit rounds. In two units, continuous infusion of intravenous opioids was used as well as sedatives and neuromuscular blockers for most ventilated patients. In the two other units, continuous intravenous infusion of opioids was not used and only sedatives were administered for patients on mechanical ventilation. In two units, there were no specific guidelines on the use of nonopioid analgesics, patient-controlled anesthesia, or the management of postoperative pain. No unit used an opioid or sedative withdrawal assessment tool or had pain management guidelines on the use of topical anesthetic agents or sucrose. Pain management practices and guidelines varied across the four units, suggesting that there is an opportunity for improvement in pain management in pediatric intensive care units in Jordan. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  12. Factors associated with pain intensity and physical limitations after lateral ankle sprains

    NARCIS (Netherlands)

    Briet, Jan Paul; Houwert, Roderick M.; Hageman, Michiel G J S; Hietbrink, Falco; Ring, David C.; Verleisdonk, Egbert Jan J M

    2016-01-01

    Background Swelling, tenderness, and ecchymosis don't correlate with time to functional recovery in patients with a lateral ankle sprain. It is established that psychosocial factors such as symptoms of depression and low pain self-efficacy correlate with pain intensity and magnitude of limitations

  13. Differential effects of painful and non-painful stimulation on tactile processing in fibromyalgia syndrome and subjects with masochistic behaviour.

    Directory of Open Access Journals (Sweden)

    Bettina Pollok

    Full Text Available BACKGROUND: In healthy subjects repeated tactile stimulation in a conditioning test stimulation paradigm yields attenuation of primary (S1 and secondary (S2 somatosensory cortical activation, whereas a preceding painful stimulus results in facilitation. METHODOLOGY/PRINCIPAL FINDINGS: Since previous data suggest that cognitive processes might affect somatosensory processing in S1, the present study aims at investigating to what extent cortical reactivity is altered by the subjective estimation of pain. To this end, the effect of painful and tactile stimulation on processing of subsequently applied tactile stimuli was investigated in patients with fibromyalgia syndrome (FMS and in subjects with masochistic behaviour (MB by means of a 122-channel whole-head magnetoencephalography (MEG system. Ten patients fulfilling the criteria for the diagnosis of FMS, 10 subjects with MB and 20 control subjects matched with respect to age, gender and handedness participated in the present study. Tactile or brief painful cutaneous laser stimuli were applied as conditioning stimulus (CS followed by a tactile test stimulus (TS 500 ms later. While in FMS patients significant attenuation following conditioning tactile stimulation was evident, no facilitation following painful stimulation was found. By contrast, in subjects with MB no attenuation but significant facilitation occurred. Attenuation as well as facilitation applied to cortical responses occurring at about 70 ms but not to early S1 or S2 responses. Additionally, in FMS patients the amount of attenuation was inversely correlated with catastrophizing tendency. CONCLUSION: The present results imply altered cortical reactivity of the primary somatosensory cortex in FMS patients and MB possibly reflecting differences of individual pain experience.

  14. Risk Factors for Postoperative Pain Intensity in Patients Undergoing Lumbar Disc Surgery: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Marie Dorow

    Full Text Available Pain relief has been shown to be the most frequently reported goal by patients undergoing lumbar disc surgery. There is a lack of systematic research investigating the course of postsurgical pain intensity and factors associated with postsurgical pain. This systematic review focuses on pain, the most prevalent symptom of a herniated disc as the primary outcome parameter. The aims of this review were (1 to examine how pain intensity changes over time in patients undergoing surgery for a lumbar herniated disc and (2 to identify socio-demographic, medical, occupational and psychological factors associated with pain intensity.Selection criteria were developed and search terms defined. The initial literature search was conducted in April 2015 and involved the following databases: Web of Science, Pubmed, PsycInfo and Pubpsych. The course of pain intensity and associated factors were analysed over the short-term (≤ 3 months after surgery, medium-term (> 3 months and < 12 months after surgery and long-term (≥ 12 months after surgery.From 371 abstracts, 85 full-text articles were reviewed, of which 21 studies were included. Visual analogue scales indicated that surgery helped the majority of patients experience significantly less pain. Recovery from disc surgery mainly occurred within the short-term period and later changes of pain intensity were minor. Postsurgical back and leg pain was predominantly associated with depression and disability. Preliminary positive evidence was found for somatization and mental well-being.Patients scheduled for lumbar disc surgery should be selected carefully and need to be treated in a multimodal setting including psychological support.

  15. Association between ongoing pain intensity, health-related quality of life, disability and quality of sleep in elderly people with total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    María Dolores Herrero-Sánchez

    2014-06-01

    Full Text Available The scope of this paper was to study the relationship between pain intensity, health-related quality of life, disability, sleep quality and demographic data in elderly people with total knee arthroplasty (TKA. 24 subjects who had been subjected to TKA the previous month (4 females; 66 ± 9years and 21 comparable controls (8 male; 70 ± 9years participated in the study. Intensity of pain, and highest and lowest pain intensity experienced in the preceding week were collected. The Western Ontario and McMaster Universities index function, quality of life (Medical Outcomes Study Short Form 36, and Pittsburgh Sleep Quality Index were assessed. Age, gender, weight, height, body mass index were also collected. Individuals with TKA presented worse physical function (P < 0.01, social role (P = 0.01, physical performance (P < 0.01, pain (P = 0.04, disability (P = 0.04 and sleep quality (P = 0.03 than the controls. Higher intensity of pain was associated with lower physical function, social role, mental health, vitality and general health, and with higher disability and sleep quality. Disability and sleep quality were negatively associated with several quality of life domains. The associations between the intensity of pain, disability, quality of life and sleep reveal the multidimensional experience of TKA.

  16. Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures.

    Science.gov (United States)

    Gerbershagen, Hans J; Aduckathil, Sanjay; van Wijck, Albert J M; Peelen, Linda M; Kalkman, Cor J; Meissner, Winfried

    2013-04-01

    Severe pain after surgery remains a major problem, occurring in 20-40% of patients. Despite numerous published studies, the degree of pain following many types of surgery in everyday clinical practice is unknown. To improve postoperative pain therapy and develop procedure-specific, optimized pain-treatment protocols, types of surgery that may result in severe postoperative pain in everyday practice must first be identified. This study considered 115,775 patients from 578 surgical wards in 105 German hospitals. A total of 70,764 patients met the inclusion criteria. On the first postoperative day, patients were asked to rate their worst pain intensity since surgery (numeric rating scale, 0-10). All surgical procedures were assigned to 529 well-defined groups. When a group contained fewer than 20 patients, the data were excluded from analysis. Finally, 50,523 patients from 179 surgical groups were compared. The 40 procedures with the highest pain scores (median numeric rating scale, 6-7) included 22 orthopedic/trauma procedures on the extremities. Patients reported high pain scores after many "minor" surgical procedures, including appendectomy, cholecystectomy, hemorrhoidectomy, and tonsillectomy, which ranked among the 25 procedures with highest pain intensities. A number of "major" abdominal surgeries resulted in comparatively low pain scores, often because of sufficient epidural analgesia. Several common minor- to medium-level surgical procedures, including some with laparoscopic approaches, resulted in unexpectedly high levels of postoperative pain. To reduce the number of patients suffering from severe pain, patients undergoing so-called minor surgery should be monitored more closely, and postsurgical pain treatment needs to comply with existing procedure-specific pain-treatment recommendations.

  17. High-intensity focused ultrasound (HIFU) for pancreatic carcinoma: evaluation of feasibility, reduction of tumour volume and pain intensity.

    Science.gov (United States)

    Marinova, Milka; Rauch, Maximilian; Mücke, Martin; Rolke, Roman; Gonzalez-Carmona, Maria A; Henseler, Jana; Cuhls, Henning; Radbruch, Lukas; Strassburg, Christian P; Zhang, Lian; Schild, Hans H; Strunk, Holger M

    2016-11-01

    Prognosis of patients with locally advanced pancreatic adenocarcinoma is extremely poor. They often suffer from cancer-related pain reducing their quality of life. This prospective observational study aimed to evaluate feasibility, local tumour response, and changes in quality of life and symptoms in Caucasian patients with locally advanced pancreatic cancer treated by ultrasound-guided high-intensity focused ultrasound (HIFU). Thirteen patients underwent HIFU, five with stage III, eight with stage IV UICC disease. Ten patients received simultaneous palliative chemotherapy. Postinterventional clinical assessment included evaluation of quality of life and symptom changes using standardized questionnaires. CT and MRI follow-up evaluated the local tumour response. HIFU was successfully performed in all patients. Average tumour reduction was 34.2 % at 6 weeks and 63.9 % at 3 months. Complete or partial relief of cancer-related pain was achieved in 10 patients (77 %), five of whom required less analgesics for pain control. Quality of life was improved revealing increased global health status and alleviated symptoms. HIFU treatment was well tolerated. Eight patients experienced transient abdominal pain directly after HIFU. HIFU ablation of pancreatic carcinoma is a feasible, safe and effective treatment with a crucial benefit in terms of reduction of tumour volume and pain intensity. • US-guided HIFU is feasible and safe for patients with unresectable pancreatic cancer. • HIFU can considerably reduce tumour volume and cancer-related pain. • Patients treated with HIFU experienced significant and lasting reduction of pain intensity. • HIFU has a crucial clinical benefit for patients with pancreatic cancer.

  18. Pattern of neuropathic pain induced by topical capsaicin application in healthy subjects.

    Science.gov (United States)

    Lötsch, Jörn; Dimova, Violeta; Hermens, Hanneke; Zimmermann, Michael; Geisslinger, Gerd; Oertel, Bruno G; Ultsch, Alfred

    2015-03-01

    Human experimental pain models are widely used to study drug effects under controlled conditions, but they require further optimization to better reflect clinical pain conditions. To this end, we measured experimentally induced pain in 110 (46 men) healthy volunteers. The quantitative sensory testing (QST) battery (German Research Network on Neuropathic Pain) was applied on untreated ("control") and topical capsaicin-hypersensitized ("test") skin. Z-transformed QST-parameter values obtained at the test site were compared with corresponding values published from 1236 patients with neuropathic pain using Bayesian statistics. Subjects were clustered for the resemblance of their QST pattern to neuropathic pain. Although QST parameter values from the untreated site agreed with reference values, several QST parameters acquired at the test site treated with topical capsaicin deviated from normal. These deviations resembled in 0 to 7 parameters of the QST pattern observed in patients with neuropathic pain. Higher degrees (50%-60%) of resemblance to neuropathic QST pattern were obtained in 18% of the subjects. Inclusion in the respective clusters was predictable at a cross-validated accuracy of 86.9% by a classification and regression tree comprising 3 QST parameters (mechanical pain sensitivity, wind-up ratio, and z-transformed thermal sensory limen) from the control sites. Thus, we found that topical capsaicin partly induced the desired clinical pattern of neuropathic pain in a preselectable subgroup of healthy subjects to a degree that fuels expectations that experimental pain models can be optimized toward mimicking clinical pain. The subjects, therefore, qualify for enrollment in analgesic drug studies that use highly selected cohorts to enhance predictivity for clinical analgesia.

  19. Knowledge and attitudes of nurses regarding pain in the intensive ...

    African Journals Online (AJOL)

    ... level of education, experience and history of training in pain management between nurses. The researcher used one way ANOVA to compare nurses' scores among hospitals with a significance level α=0.05. A multiple linear regression analysis was used to highlight independent factors associated with best performance.

  20. Low-Intensity Electromagnetic Millimeter Waves for Pain Therapy

    Directory of Open Access Journals (Sweden)

    Taras I. Usichenko

    2006-01-01

    Full Text Available Millimeter wave therapy (MWT, a non-invasive complementary therapeutic technique is claimed to possess analgesic properties. We reviewed the clinical studies describing the pain-relief effect of MWT. Medline-based search according to review criteria and evaluation of methodological quality of the retrieved studies was performed. Of 13 studies, 9 of them were randomized controlled trials (RCTs, only three studies yielded more than 3 points on the Oxford scale of methodological quality of RCTs. MWT was reported to be effective in the treatment of headache, arthritic, neuropathic and acute postoperative pain. The rapid onset of pain relief during MWT lasting hours to days after, remote to the site of exposure (acupuncture points, was the most characteristic feature in MWT application for pain relief. The most commonly used parameters of MWT were the MW frequencies between 30 and 70 GHz and power density up to 10 mW cm−2. The promising results from pilot case series studies and small-size RCTs for analgesic/hypoalgesic effects of MWT should be verified in large-scale RCTs on the effectiveness of this treatment method.

  1. Phantom pain reduction by low-frequency and low-intensity electromagnetic fields.

    Science.gov (United States)

    Bókkon, István; Till, Attila; Grass, Friedrich; Erdöfi Szabó, Attila

    2011-09-01

    Although various treatments have been presented for phantom pain, there is little proof supporting the benefits of pharmacological treatments, surgery or interventional techniques, electroconvulsive therapy, electrical nerve stimulation, far infrared ray therapy, psychological therapies, etc. Here, we report the preliminary results for phantom pain reduction by low-frequency and intensity electromagnetic fields under clinical circumstances. Our method is called as Electromagnetic-Own-Signal-Treatment (EMOST). Fifteen people with phantom limb pain participated. The patients were treated using a pre-programmed, six sessions. Pain intensity was quantified upon admission using a 0-10 verbal numerical rating scale. Most of the patients (n = 10) reported a marked reduction in the intensity of phantom limb pain. Several patients also reported about improvement in their sleep and mood quality, or a reduction in the frequency of phantom pain after the treatments. No improvements in the reduction of phantom limb pain or sleep and mood improvement were reported in the control group (n = 5). Our nonlinear electromagnetic EMOST method may be a possible therapeutic application in the reduction of phantom limb pain. Here, we also suggest that some of the possible effects of the EMOST may be achieved via the redox balance of the body and redox-related neural plasticity.

  2. Effectiveness of attentional bias modification and cognitive behavioral therapy on the reduction of pain intensity in patients with chronic pain

    Directory of Open Access Journals (Sweden)

    Fateme Babai

    2016-08-01

    Full Text Available The aim of the study was to determine the effectiveness of Attentional Bias Modification (ABM and Cognitive Behavioral Therapy (CBT on the reduction of pain intensityin patients with chronic pain. This study was a quasiexperimental pretest-posttest design with control group. All patients who referred to physiotherapy clinics for pain during 2015 were participated in the study. They completed the Brief Pain Inventory-short form (BPI-SF for assessing severity of pain. Attentional bias was evaluated using computerized Dot-Probe task. The patients with chronic pain were screened by diagnostic criteria of DSM-V; neurologic diagnosis, and interview. 36 people were selected and randomly divided to three groups computer-based ABM, CBT, and control (12 cases in each group. Group A was trained in 8 sessions-each 15 minutes with the modified computerized Dot-Probe task for attentional bias modification. Group B was trained in 11 sessions-each 45 minutes with CBT program of Turk and Ferry for the chronic pain treatment. And Placebo program was administered for group C in which they completed 8 classic DotProbe sessions. In the end, for the posttest (T2 the participants were tested to identify the changes in biased attention to the emotional stimuli using classing Dot-Probe tasks, and BPI questionnaire to evaluate the changes of severity of pain. Data were analyzed using one-way variance analysis(ANOVA. On the BPI-SF, CBT more reduced the pain intensitythan computer-based ABM.In addition ABM treatment is more effective in reduction of attentional bias.Both of treatments are effective but CBT is more effective than ABM in reduction of pain intensity.

  3. Owner assessment of chronic pain intensity and results of gait analysis of dogs with hip dysplasia treated with acupuncture.

    Science.gov (United States)

    Teixeira, Lívia R; Luna, Stelio P L; Matsubara, Lídia M; Cápua, Maria L B; Santos, Bianca P C R; Mesquita, Luciane R; Faria, Luis G; Agostinho, Felipe S; Hielm-Björkman, Anna

    2016-11-01

    OBJECTIVE To evaluate pain intensity and kinetic variables in dogs with hip dysplasia (HD) treated with acupuncture, carprofen, or a placebo. DESIGN Randomized, controlled clinical study. ANIMALS 54 HD-affected dogs and 16 healthy dogs. PROCEDURES Seven HD-affected dogs were removed from the study. Dogs with HD were treated in a blinded manner for 30 days with acupuncture (once weekly for 5 sessions; n = 15), carprofen (4.4 mg/kg [2.0 mg/lb], PO, q 24 h; n = 16), or placebo capsules containing lactose (1 mg/kg [0.45 mg/lb], PO, q 24 h; n = 16). Dogs were evaluated 2 weeks and immediately before (baseline) and 2, 4, and 6 weeks after the onset of treatment. Owners evaluated the dogs' pain intensity with 2 validated questionnaires and a visual analogue scale (VAS) for pain and evaluated degree of lameness with a VAS for locomotion. Kinetics of the hind limbs were also evaluated. Sixteen HD-free dogs were used to assess the evaluation protocol. RESULTS Owners' assessments revealed that outcomes of the 3 treatments did not differ significantly. The Canine Brief Pain Inventory and VAS pain intensity assessments were decreased from baseline at weeks 4 and 6, respectively, but only in acupuncture-treated dogs. The locomotion VAS values were decreased at week 4 in acupuncture-treated and carprofen-treated dogs. Kinetic evaluation findings did not differ among the groups or over time. CONCLUSIONS AND CLINICAL RELEVANCE Neither acupuncture nor carprofen was significantly different from placebo. Acupuncture and carprofen reduced the degree of subjectively evaluated lameness, and acupuncture was associated with a decrease in validated chronic pain scores.

  4. P03.03. Body Schema and Feldenkrais®: Effects Upon Subjects With Low Back Pain

    Science.gov (United States)

    2013-01-01

    Focus Areas: Integrative Approaches to Care, Alleviating Pain Background and Purpose: Back problems continue to be the number one symptom disorder for consulting complementary and alternative medicine (CAM) practitioners. Neuroscience continues to indicate that the human brain undergoes a process of somato-topic cortical reorganization in association with sustained states of chronic pain. Feldenkrais® practitioners aim to create individualized multimodal learning experiences that are believed to clarify an improved neuroplasticity-based change in the cognitive construct of one's own body schema. A specific protocol is applied to observe some responses in subjects with mechanical, non-specific low back pain (LBP) in a clinical practice setting. Methods: Forty subjects (30 female, 10 male) diagnosed with persistent LBP attended a Feldenkrais®-based physical therapy intervention series of sessions while assessing usual baseline measures—including Pain Intensity on VAS and observations of Gait Quality. Using anatomical skeleton models and proprioceptive touch, 3 inquiries for primary learning conditions were made for clarifying anatomical imagery including (1) The Hip Socket axis of rotation, (2) Inner ilia pelvis as an inner bridge of leg support, and (3) correlating the vestibular apparatus in combination with global Feldenkrais® movements. No attention was given to treating isolated lumbar segments directly. Results: All conditions were novel interpretations of body awareness for subject's previous notions of body schema. Pain on VAS reduced from 6/10 average to 2/10. All subjects had a more balanced gait. Conclusions: Body schema–based somatic education interventions, like the Feldekrais® method, deserve further investigation and do not appear to rely on treating the anatomical regions of perceived involvement directly.

  5. Striatal μ-opioid receptor availability predicts cold pressor pain threshold in healthy human subjects

    DEFF Research Database (Denmark)

    Hagelberg, Nora; Aalto, Sargo; Tuominen, Lauri

    2012-01-01

    Previous PET studies in healthy humans have shown that brain μ-opioid receptor activation during experimental pain is associated with reductions in the sensory and affective ratings of the individual pain experience. The aim of this study was to find out whether brain μ-opioid receptor binding...... at the resting state, in absence of painful stimulation, can be a long-term predictor of experimental pain sensitivity. We measured μ-opioid receptor binding potential (BP(ND)) with μ-opioid receptor selective radiotracer [(11)C]carfentanil and positron emission tomography (PET) in 12 healthy male subjects...... the potential associations between μ-opioid receptor BP(ND) and psychophysical measures. The results show that striatal μ-opioid receptor BP(ND) predicts cold pressor pain threshold, but not cold pressor pain tolerance or tactile sensitivity. This finding suggests that striatal μ-opioid receptor density...

  6. Time course of subjective pain ratings, and wound and leg tenderness after hysterectomy

    DEFF Research Database (Denmark)

    Møiniche, S; Dahl, J B; Erichsen, C J

    1997-01-01

    .0002). CONCLUSION: These results indicate that wound pressure algometry correlates to postoperative pain at rest and during movement and may be an alternative way of assessing wound pain and tenderness. Increased tenderness to mechanical stimulation remote from the surgical wound could not be demonstrated.......BACKGROUND: Little information is available on time course of wound tenderness and relationship to subjective pain ratings following surgery. Furthermore, it is not clarified whether surgical procedures may induce hyperalgesia to mechanical stimulation outside the area of the surgical incision. We...... have therefore assessed postoperative pain and pressure pain thresholds (PPT) adjacent to and remote from the surgical incision in 16 patients undergoing hysterectomy. METHODS: Pressure pain threshold was assessed with pressure algometry preoperatively, 4 and 6 and 1, 4 and 8 d after surgery...

  7. Exploring Changes in Valued Action in the Presence of Chronic Debilitating Pain in Acceptance and Commitment Therapy for Youth - A Single-Subject Design Study.

    Science.gov (United States)

    Kemani, Mike K; Olsson, Gunnar L; Holmström, Linda; Wicksell, Rikard K

    2016-01-01

    Objective: The objective of the study was to improve the understanding of processes of change in Acceptance and Commitment Therapy for youth with chronic debilitating pain by exploring the relation between individual change patterns in pain intensity and valued activities. Method: A single-subject design across three adolescents suffering from longstanding debilitating pain was utilized. Pain intensity and participation in valued activities were rated daily. Visual analysis of the graphed data was performed to evaluate the effects of the intervention, and the relationship between pain intensity and values-based activity. Results: The graphed data illustrated that pain levels did not decrease from the baseline period to the follow-up period. In contrast, compared to baseline ratings values oriented behaviors increased from the start of treatment to the follow-up period. Conclusion: Results illustrate that increases in values-based behavior may occur without corresponding decreases in pain, and warrant further research on change processes in ACT for youth suffering from chronic pain.

  8. Pilates versus general exercise effectiveness on pain and functionality in non-specific chronic low back pain subjects.

    Science.gov (United States)

    Mostagi, Fernanda Queiroz Ribeiro Cerci; Dias, Josilainne Marcelino; Pereira, Ligia Maxwell; Obara, Karen; Mazuquin, Bruno Fles; Silva, Mariana Felipe; Silva, Monica Angelica Cardoso; de Campos, Renata Rosa; Barreto, Maria Simone Tavares; Nogueira, Jéssyca Fernandes; Lima, Tarcísio Brandão; Carregaro, Rodrigo Luiz; Cardoso, Jefferson Rosa

    2015-10-01

    Low back pain (LBP) is one of the most common causes of disability, and the Pilates method has been associated with improvements in symptoms. The purpose of this study was to assess the effectiveness of the Pilates method, when compared to general exercises, on pain and functionality after eight weeks (16 sessions, 2×/week) and a follow-up of three months, in subjects with non-specific chronic low back pain (NSCLBP). A randomised controlled trial composed of 22 subjects was proposed. Subjects were allocated into two groups: the Pilates group (PG) (n = 11) and the general exercise group (GEG) (n = 11). The PG protocol was based on the Pilates method and the GEG performed exercises to manage NSCLBP. There were no differences between the groups. When analysed over time, the GEG demonstrated improvements in functionality between baseline and the end of treatment (P = .02; Cohen'sd¯ = 0.34) and baseline and follow-up (P = .04; Cohen'sd¯ = 0.31). There were no differences between the Pilates and general exercises with regard to pain and functionality in NSCLBP subjects but general exercises were better than Pilates for increasing functionality and flexibility. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Rigid and Elastic taping changes scapular kinematics and pain in subjects with shoulder impingement syndrome; an experimental study.

    Science.gov (United States)

    Shaheen, Aliah F; Bull, Anthony M J; Alexander, Caroline M

    2015-02-01

    Rigid and Elastic scapular taping is used in physical rehabilitation of shoulder impingement syndrome (SIS). It is believed to reduce pain and normalise scapular movement patterns. However, there is insufficient evidence to support its use. The aim of the study was to investigate the effect of Rigid and Elastic taping techniques on the scapular kinematics and pain in patients with SIS. Eleven patients with SIS participated in the study. They performed elevation and lowering of the arm in the scapular and sagittal planes under three conditions: Baseline, Rigid taping and Elastic taping. The movements of the thorax, humerus and scapula were tracked. Scapular displacements and scapulothoracic joint rotations were calculated. Subjects used a visual analogue scale to rate the intensity of pain at rest and during movements in both planes. Both taping techniques externally rotated the scapula in sagittal plane movements (ppain. In the scapular plane, Elastic taping increased the scapular retraction (ppain in this plane. In conclusion, both taping techniques had an effect on scapular kinematics and pain in movements occurring in the sagittal plane. Elastic taping also affected scapular kinematics in scapular plane movements, but without the concomitant decrease in pain. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Power and pain: the location of pain and fear in dentistry and the creation of a dental subject.

    Science.gov (United States)

    Nettleton, S

    1989-01-01

    It has been argued that the meaning of pain in childbirth and in general medicine has changed and that this change was part of a cognitive transformation that occurred in medicine during the post World War II period. This paper uses Foucault's notion of the gaze and his unique conception of power to explore the extent to which the understanding of pain, and the associated concept of fear, in dentistry, reflects those understandings found in medicine and obstetrics. Within the discourse of dentistry the conception of pain is both object and effect of the profession's techniques of observation and analysis. Analyses of pain and fear occurred on two levels: the micro-level of the individual and the macro-level of the population. The examples of the case history and the epidemiological survey are used to demonstrate these two levels of power/knowledge. The first technique contributed to the constitution of the psychological space, the second technique confirmed the social space. Within these spatialisations new conceptualisations of pain were realised and a subjective dental subject was manufactured. The findings of this paper add weight to the thesis that the functioning of power/knowledge transcends professional and disciplinary boundaries and is a process which is far more subtle and fundamental than one of political manoeuverings by interested groups or individuals or the accumulation of an increasingly sophisticated knowledge.

  11. Chronic pain acceptance questionnaire: confirmatory factor analysis, reliability, and validity in Italian subjects with chronic low back pain.

    Science.gov (United States)

    Monticone, Marco; Ferrante, Simona; Rocca, Barbara; Nava, Tiziana; Parini, Chiara; Cerri, Cesare

    2013-06-01

    Cross-sectional evaluation of the psychometric properties of a translated questionnaire. To validate the Italian version of the Chronic Pain Acceptance Questionnaire (CPAQ) to allow its use with Italian-speaking patients with chronic low back pain (LBP). Growing attention is being given to cognitive-behavioral measures to improve interventions for LBP. The CPAQ has never been validated in Italian subjects with chronic LBP. The psychometric testing included confirmatory factor analysis, reliability by internal consistency (Cronbach α), test-retest reliability (intraclass correlation coefficient), sensitivity to change by calculating the smallest detectable change, and construct validity by comparing CPAQ with a pain numerical rating scale, the Roland-Morris Disability Questionnaire Scale, the Hospital Anxiety and Depression Scale, the Pain Catastrophizing Scale, and the Tampa Scale of Kinesiophobia (Pearson correlations). Hierarchical multiple regression analyses were computed to further investigate construct validity of the CPAQ subscales. The questionnaire was administered to 142 subjects with chronic LBP. Factor analysis confirmed a 2-factor (viz., Activities Engagement and Pain Willingness) 20-item solution, achieving a good data-model fit. Internal consistency (α = 0.88) and test-retest reliability (intraclass correlation coefficient = 0.86) were good. The smallest detectable change was 22. Construct validity showed a moderate correlation between the CPAQ and numerical rating scale (r = -0.485), Roland-Morris Disability Questionnaire Scale (r = -0.594), and Tampa Scale of Kinesiophobia (r = -0.595), and a close correlation with Hospital Anxiety and Depression Scale (r = -0.610 for the Anxiety score and r = -0.659 for the Depression score) and Pain Catastrophizing Scale (r = -0.658). The standardized regression coefficients for Activity Engagement were significant in all of the equations, and those for Pain Willingness were significant in the anxiety

  12. The effects of listening to preferred music on pain intensity after open heart surgery.

    Science.gov (United States)

    Jafari, Hedayat; Emami Zeydi, Amir; Khani, Soghra; Esmaeili, Ravanbakhsh; Soleimani, Aria

    2012-01-01

    Pain is a common phenomenon after surgery. Cardiac surgeries are no exception and patients generally experience acute pain after these surgeries. Inadequate pain management after cardiac surgery predisposes patients to many complications. Therefore, the aim of this study was to determine the effects of listening to preferred music on pain intensity after open heart surgery. This study was a randomized clinical trial (RCT) conducted in open heart intensive care unit (ICU) of a university hospital in Sari, Iran. A total of 60 patients who were scheduled to undergo open heart surgery were randomly allocated in two groups. Patients in the intervention group (n = 30) listened to their preferred music by headphones for 30 minutes, whereas those in the control group (n = 30) did not listen to music. Using a Numerical Rating Scale (NRS), pain intensity was measured among the patients before the intervention, and immediately, 30 minutes and one hour after the intervention. Data was analyzed by Chi-square test, student's t-test and repeated measures analysis of variance (ANOVA). Mean pain intensity in the intervention group before, immediately after, 30 minutes and one hour after the intervention were 5.8, 3.1, 2.5 and 2.4, respectively. Corresponding numbers in the control group were 4.7, 4.7, 4.8 and 4.9, respectively. Repeated measures ANOVA showed music to significantly reduce pain intensity (p = 0.0001). Music can be effective as a non-pharmacological, inexpensive, non-invasive and side effect free method for pain management after open heart surgery.

  13. Procedural pain does not raise plasma levels of cortisol or catecholamines in adult intensive care patients after cardiac surgery

    NARCIS (Netherlands)

    L. van Gulik (Laura); Ahlers, S. (Sjgm); M. van Dijk (Monique); P. Bruins (Peter); Meima, M.E.; Y.B. de Rijke (Yolanda); Biemond-Moeniralam, H.S.; D. Tibboel (Dick); C.A.J. Knibbe (Catherijne)

    2016-01-01

    textabstractThe gold standard for quantification of pain is a person's self-report. However, we need objective parameters for pain measurement when intensive care patients, for example, are not able to report pain themselves. An increase in pain is currently thought to coincide with an increase in

  14. Differences in pain intensity in anti- and pro-nociceptive pain profile subgroups in patients with knee osteoarthritis.

    Science.gov (United States)

    Bossmann, Tanja; Brauner, Torsten; Horstmann, Thomas

    2018-01-01

    Facilitated temporal summation is one component of central sensitization. The aim of this exploratory study was to classify pro-, eu- and antinociceptive subgroups based on wind-up ratio cut-off scores in patients with knee osteoarthritis (OA).  A total of 56 patients with knee OA met the inclusion criteria. Temporal summation was measured and wind-up ratio was calculated. Reference values of 180 healthy subjects were used to define wind-up ratio cut-off scores. Twenty-seven percent of patients showed a pro-nociceptive pain profile. Sixteen percent of patients showed an anti-nociceptive pain profile. A eu-nociceptive pain profile was present in 57% of patients. Central pain sensitization was present in approximately a third of knee OA patients. The results should be confirmed in larger studies.

  15. Association between ongoing pain intensity, health-related quality of life, disability and quality of sleep in elderly people with total knee arthroplasty.

    Science.gov (United States)

    Herrero-Sánchez, María Dolores; García-Iñigo, María Del Carmen; Nuño-Beato-Redondo, Blanca Soledad; Fernández-de-Las-Peñas, César; Alburquerque-Sendín, Francisco

    2014-06-01

    The scope of this paper was to study the relationship between pain intensity, health-related quality of life, disability, sleep quality and demographic data in elderly people with total knee arthroplasty (TKA). 24 subjects who had been subjected to TKA the previous month (4 females; 66 ± 9years) and 21 comparable controls (8 male; 70 ± 9years) participated in the study. Intensity of pain, and highest and lowest pain intensity experienced in the preceding week were collected. The Western Ontario and McMaster Universities index function, quality of life (Medical Outcomes Study Short Form 36), and Pittsburgh Sleep Quality Index were assessed. Age, gender, weight, height, body mass index were also collected. Individuals with TKA presented worse physical function (P disability (P = 0.04) and sleep quality (P = 0.03) than the controls. Higher intensity of pain was associated with lower physical function, social role, mental health, vitality and general health, and with higher disability and sleep quality. Disability and sleep quality were negatively associated with several quality of life domains. The associations between the intensity of pain, disability, quality of life and sleep reveal the multidimensional experience of TKA.

  16. Prevalence, intensity and impact of dental pain in 5-year-old preschool children.

    Science.gov (United States)

    Moura-Leite, Fabíola Rocha; Ramos-Jorge, Maria Letícia; Bonanato, Karina; Paiva, Saul Martins; Vale, Míriam Pimenta; Pordeus, Isabela Almeida

    2008-01-01

    The aim of this study was to assess the impact of clinical oral health conditions, and the prevalence, intensity and the impact of dental pain on daily living among 5-year-old preschool children. A cross-sectional survey was carried out on a sample of 578 children attending preschools in Belo Horizonte, Brazil. Data were collected by means of a pretested questionnaire given to the parents and a visual analogue scale of faces applied to the children. The children underwent dental examinations. According to the parents' reports, the lifetime prevalence of dental pain was 25.0% (95% confidence interval, 95% CI = 21.4 to 28.6), and dental pain caused crying in 16.8% (95% CI = 13.6 to 19.9) of the children; 10.7% (95% CI = 8.1 to 13.3) of children had dental pain in the 2 months prior to the dental examination. Among this group of children with dental pain, 59.3% experienced a negative impact as a result of pain. The following clinical conditions had mostly caused dental pain in the 2 months prior to the dental examination: root remnants, fistula and pulp caries. This recent pain resulted in a visit to the clinician in 13.6% of the children. Prevalence, intensity and the impact of dental pain in 5-year-old children were high in Belo Horizonte, Brazil. Dental pain assessed in the present study was associated with avoidable pathological factors. However, only few children were treated professionally for the dental pain they were experiencing. Public policies should be developed and implemented to promote fair, comprehensive treatment for the population.

  17. Myofascial trigger points in subjects presenting with mechanical neck pain: a blinded, controlled study.

    Science.gov (United States)

    Fernández-de-las-Peñas, C; Alonso-Blanco, C; Miangolarra, J C

    2007-02-01

    The aim of this study was to describe the differences in the presence of myofascial trigger points (TrPs) in the upper trapezius,sternocleidomastoid, levator scapulae and suboccipital muscles between patients presenting with mechanical neck pain and control healthy subjects. Twenty subjects with mechanical neck pain and 20 matched healthy controls participated in this study. TrPs were identified, by an assessor blinded to the subjects' condition, when there was a hypersensible tender spot in a palpable taut band, local twitch response elicited by the snapping palpation of the taut band, and reproduction of the referred pain typical of each TrP. The mean number of TrPs present on each neck pain patient was 4.3 (SD: 0.9), of which 2.5 (SD: 1.3) were latent and 1.8 (SD: 0.8) were active TrPs. Control subjects also exhibited TrPs (mean: 2; SD: 0.8). All were latent TrPs. Differences in the number of TrPs between both study groups were significant for active TrPs (P latent TrPs (P > 0.5). Moreover, differences in the distribution of TrPs within the analysed cervical muscles were also significant (P Active TrPs were more frequent in patients presenting with mechanical neck pain than in healthy subjects. ©2006 Elsevier Ltd.

  18. Evaluation Of Pain In Newborn In Intensive Therapy In The Vision Of Health Professionals

    Directory of Open Access Journals (Sweden)

    Bruna Teles dos Santos Motta

    2017-02-01

    Full Text Available Objective: Evaluate how health professionals perceive the pain in the NBs hospitalized in the Neonatal Intensive Care Unit. Method: This is a descriptive, exploratory research with a qualitative approach, developed in the maternity hospital Instituto de Saúde Elpídio de Almeida (ISEA, in the period from February to March 2016, after approval by the Research Ethics Committee (CESED, where the technique of data collection was through an interview with a prior script divided into two parts: the first part deals with socio-demographic issues, while the second part deals with issues related to pain in the NB, where they were recorded and transcribed in their entirety, using the content treatment through content analysis of the thematic type proposed by Laurence Bardin. Results: The results show that all health professionals perceive the pain in the neonate, where three categories emerged: "relates the evaluation of pain with physiological and behavioral measurements"; "know, but do not evaluate with pain score", "do not evaluate with pain score". Regarding the use of some method for pain relief, two categories emerged: "use of non-pharmacological methods for pain relief"; "Use of simultaneous pharmacological and non-pharmacological methods". Conclusion: All the professionals contributed to the growth of this research, being necessary more studies about the pain, mainly with regard to the use of multidimensional scales, since there is a lack of knowledge on the part of the professionals and teams that work in the NICU.

  19. Who can benefit from virtual reality to reduce experimental pain? A crossover study in healthy subjects.

    Science.gov (United States)

    Demeter, N; Josman, N; Eisenberg, E; Pud, D

    2015-11-01

    The present study aimed to identify predicting factors affecting experimental pain stimuli reduction by using 'EyeToy', which is an Immersive Virtual Reality System (IVRS). Sixty-two healthy subjects (31 M, 31 F) underwent a battery of pain tests to determine each participant's baseline sensitivity to nociceptive. The battery included thermal pain tests (hot and cold) as well as a paradigm to induce conditioned pain modulation (CPM). Later on, each subject participated in two study conditions in random order: (1) An exposure to tonic heat stimulation (46.5 °C/135 s) to the ankle while participating in VR environment which included an activity requiring limb movements; (2) Same heat stimulation with no exposure to VR. Six pain measures were taken during each study condition (baseline, test 1-5). An interaction of time × treatment was found (RM ANOVA, F(5, 305)  = 24.33, p manipulation for pain reduction in individuals with efficient CPM and in women. These findings constitute a promising platform for future research and hold potential for the improvement and facilitation of clinical treatment. © 2015 European Pain Federation - EFIC®

  20. Neurophysiologic Correlates of Headache Pain in Subjects With Major Depressive Disorder.

    Science.gov (United States)

    Scanlon, Graham C; Jain, Felipe A; Hunter, Aimee M; Cook, Ian A; Leuchter, Andrew F

    2017-05-01

    Headache pain is often comorbid with major depressive disorder (MDD) and is associated with greater symptom burden, disability, and suicidality. The biological correlates of headache pain in MDD, however, remain obscure. The purpose of this study was to examine the association between brain oscillatory activity and headache pain in MDD subjects. A total of 64 subjects with MDD who were free of psychoactive medications were evaluated for severity of headache pain in the past week. Brain function was assessed using resting-state quantitative electroencephalography (qEEG). We derived cordance in the theta (4-8 Hz) and alpha (8-12 Hz) frequency bands at each electrode, and examined correlations with headache pain in regions of interest while controlling for depression severity. Frontal and posterior asymmetry in alpha power was calculated in regions of interest. Headache pain severity was associated with depression severity ( r = 0.447, P depression severity. The direction of the correlation was positive anteriorly and negative posteriorly. Frontal left dominant alpha asymmetry correlated with severity of headache but not depression symptoms. Alterations in brain oscillations identified by alpha cordance and alpha asymmetry may be associated with the pathophysiology of headache pain in depression. These findings should be prospectively confirmed.

  1. Does adherence to treatment mediate the relationship between patients' treatment outcome expectancies and the outcomes of pain intensity and recovery from acute low back pain?

    Science.gov (United States)

    Haanstra, Tsjitske M; Kamper, Steven J; Williams, Christopher M; Spriensma, Alette S; Lin, Chung-Wei Christine; Maher, Christopher G; de Vet, Henrica C W; Ostelo, Raymond W J G

    2015-08-01

    It is believed that patients' expectancies about the effectiveness of treatment influence their treatment outcomes, but the working mechanism is rarely studied in patients with low back pain. Theoretical models suggest that adherence to treatment may be an important pathway. The aim of this study was to assess the mediating role of adherence to treatment in the relationship between expectancies and the outcomes of recovery and pain intensity in patients with acute low back pain. This study used data from a randomized placebo-controlled trial of paracetamol for acute low back pain. Expectancies were measured with the Credibility Expectancy Questionnaire. Adherence was measured with a medication diary. Pain intensity was recorded daily in a diary on a 0 to 10 pain scale, and recovery was defined as the first of 7 consecutive days scoring 0 or 1 on a 6-point pain scale. Cox regression (dependent variable: recovery) and linear mixed-model analyses (dependent variable: daily pain intensity scores) were performed. The "difference in coefficients" approach was used to establish mediation. A total of 1573 participants were included in current analyses. There was a small but highly significant relationship between expectancies and outcomes; 3.3% of the relationship between expectancies and recovery and 14.2% of the relationship between expectancies and pain intensity were mediated by adherence to treatment. This study does not convincingly support the theory that adherence is a key pathway in the relationship between treatment outcome expectancies and recovery and pain intensity in this acute low back pain population.

  2. The effect of phenylephrine on pain and flare intensity in eyes with uveitis.

    Science.gov (United States)

    Zaczek, A; Zetterström, C

    2000-10-01

    To investigate the influence of protein concentration in the anterior chamber, measured by laser flare meter, on pain sensation after phenylephrine instillation in patients with iridocyclitis. Twenty-five consecutive patients with iridocyclitis were included. Patients with cataract, exfoliation syndrome, diabetes mellitus, glaucoma or any other previous ocular diseases or ocular surgery were excluded. Patients were divided into two groups: Group 1--without fibrinoid reaction (FR) in the anterior chamber (18 patients), and Group 2--with FR (7 patients). Protein concentration in the anterior chamber was measured with laser flare meter (FC 500, Kowa Co., Japan). Pupil size was measured by Alcon Tilo Scale, and pain sensation was estimated by Visual Analogue Scale (VAS, Kabi Pharmacia). All measurements were done before and 1 hour after topical instillation of 10% phenylephrine hydrochloride into the subconjunctival sac of the inflamed eyes. Eyes with iridocyclitis and fibrinoid reaction (FR) have a higher flare intensity compared to those without FR (pPupil size was significantly increased after phenylephrine instillation in both study groups (Wilcoxon test, pinfluence of phenylephrine instillation was found on VAS pain and flare intensity. After phenylephrine instillation, flare intensity and pain were significantly decreased only in eyes with iridocyclitis and without FR. The decreasing level of flare intensity, and paralysis of the pupil after phenylephrine instillation seem to alleviate pain in those eyes.

  3. High but not moderate-intensity endurance training increases pain tolerance: a randomised trial.

    Science.gov (United States)

    O'Leary, Thomas J; Collett, Johnny; Howells, Ken; Morris, Martyn G

    2017-11-01

    To examine the effect of high-intensity interval training (HIIT) compared to volume-matched moderate-intensity continuous training (CONT) on muscle pain tolerance and high-intensity exercise tolerance. Twenty healthy adults were randomly assigned (1:1) to either 6 weeks of HIIT [6-8 × 5 min at halfway between lactate threshold and maximal oxygen uptake (50%Δ)] or volume-matched CONT (~60-80 min at 90% lactate threshold) on a cycle ergometer. A tourniquet test to examine muscle pain tolerance and two time to exhaustion (TTE) trials at 50%Δ to examine exercise tolerance were completed pre- and post-training; the post-training TTE trials were completed at the pre-training 50%Δ (same absolute-intensity) and the post-training 50%Δ (same relative-intensity). HIIT and CONT resulted in similar improvements in markers of aerobic fitness (all P ≥ 0.081). HIIT increased TTE at the same absolute- and relative-intensity as pre-training (148 and 43%, respectively) to a greater extent than CONT (38 and -4%, respectively) (both P ≤ 0.019). HIIT increased pain tolerance (41%, P intensity (r = 0.51, P = 0.011) as pre-training. The repeated exposure to a high-intensity training stimulus increases muscle pain tolerance, which is independent of the improvements in aerobic fitness induced by endurance training, and may contribute to the increase in high-intensity exercise tolerance following HIIT.

  4. Estudo do impacto da enxaqueca na severidade da dor miofascial da musculatura mastigatória Muscle pain intensity of patients with myofascial pain with different additional diagnoses

    Directory of Open Access Journals (Sweden)

    Rafael dos Santos Silva

    2011-08-01

    Full Text Available OBJETIVO: comparar a severidade da dor subjetiva e objetiva, além de outras características associadas entre pacientes com dor miofascial com e sem o diagnóstico adicional de enxaqueca. MÉTODOS: foram selecionados 203 pacientes, com idade média de 40,3 anos (89,2% do sexo feminino, que se apresentaram à Clínica de Dor Orofacial da Universidade da Califórnia, Los Angeles, EUA - todos com diagnóstico primário de dor miofascial. Pacientes com diagnóstico secundário de enxaqueca foram incluídos (n=83 e formaram o grupo 2. O teste de Mann-Whitney foi utilizado para comparar o grupo 1 (dor miofascial com o 2 (dor miofascial + enxaqueca quanto à intensidade de dor à palpação e subjetiva, através de Escalas Analógicas Visuais (EAV. Também com o auxílio de EAV, foram comparados estado de humor, problemas com a função, qualidade do sono e incapacidade. Em todos os testes foi adotado um nível de significância de 5%. RESULTADOS: o grupo 2 apresentou níveis de dor à palpação muscular estatisticamente maiores que o grupo 1 (pOBJECTIVES: To compare subjective and objective pain intensity and associated characteristics in myofascial pain (MFP patients with and without migraine. METHODS: The sample was comprised by 203 consecutive patients, mean age of 40.3 (89.2% of females, primarily diagnosed with MFP, who presented to the UCLA Orofacial Pain Clinic. Patients with secondary diagnosis of migraine (n=83 were included and comprised group 2. In order to compare group 1 (MFP with group 2 (MFP + migraine regarding objective pain (palpation scores and subjective by means of visual analog scales (VAS pain levels. Also, comparisons of mood problems, jaw function problems, sleep quality and disability levels using VAS were performed using the Mann-Whitney test. A significance level of 5% was adopted. RESULTS: Mann-Whitney test revealed that group 2 presented significantly higher pain levels on palpation of masticatory and cervical muscles

  5. ASSESSMENT AND COMPARISION OF CERVICAL JOINT POSITION SENSE IN SUBJECTS WITH CHRONIC NECK PAIN vs NORMALS

    Directory of Open Access Journals (Sweden)

    Oberoi Mugdha

    2015-06-01

    Full Text Available Background: The abundance of mechanoreceptors in the cervical spine and their central and reflex afferent connections to the vestibular, visual and postural control system suggests that the cervical proprioceptive information provides important somatosensory information influencing postural stability, head orientation and eye movement control. Disturbances to the afferent input from the cervical region is thought to underlie symptoms of dizziness, unsteadiness, visual disturbances and signs of altered postural stability, cervical proprioception and head and eye movement control in people with chronic neck pain. This study aimed to assess and compare cervical joint position sense in subjects with chronic neck pain vs normals. Methods: Total 60 subjects, divided into two groups chronic neck pain group (n=30 (12 males and 18 females with mean age of 40.7 years and control group (n=30 with age and gender matched normal individuals were assessed for baseline data and demographic variables. Head repositioning accuracy test was used to assess cervical joint position sense in degrees. Results: The difference in the head repositioning error values were found to be extremely significant (p<0.0001 for all the neck movements for subjects with chronic neck pain as compared to normals. Conclusion: Cervical joint position sense in subjects with chronic neck pain is found to be altered as compared to age and gender matched normals.

  6. A Comparison of the Deep Cervical Flexor Muscle Thicknesses in Subjects with and without Neck Pain during Craniocervical Flexion Exercises.

    Science.gov (United States)

    Jun, Ilsub; Kim, Kyoung

    2013-11-01

    [Purpose] The purpose of the present study was to examine the amount of change in the thicknesses of the deep cervical flexor (DCF) and sternocleidomastoid (SCM) muscles in subjects with neck pain and subjects without neck pain during craniocervical flexion exercise (CCFE). [Subjects] The total number of subjects was 40, comprising 20 in the no-pain group (males 11, females 9) and 20 in the pain group (males 8, females 12). [Methods] Muscle images were obtained using ultrasound, and the thicknesses of the individual muscles were measured using the NIH ImageJ software. [Results] During CCFE, as pressure increased, the no-pain group recruited the DCF more than the pain group, while the pain group recruited the SCM more. [Conclusion] Selective DCF contraction exercises are considered very useful in the treatment of patients with neck pain.

  7. Increased pain intensity is associated with greater verbal communication difficulty and increased production of speech and co-speech gestures.

    Science.gov (United States)

    Rowbotham, Samantha; Wardy, April J; Lloyd, Donna M; Wearden, Alison; Holler, Judith

    2014-01-01

    Effective pain communication is essential if adequate treatment and support are to be provided. Pain communication is often multimodal, with sufferers utilising speech, nonverbal behaviours (such as facial expressions), and co-speech gestures (bodily movements, primarily of the hands and arms that accompany speech and can convey semantic information) to communicate their experience. Research suggests that the production of nonverbal pain behaviours is positively associated with pain intensity, but it is not known whether this is also the case for speech and co-speech gestures. The present study explored whether increased pain intensity is associated with greater speech and gesture production during face-to-face communication about acute, experimental pain. Participants (N = 26) were exposed to experimentally elicited pressure pain to the fingernail bed at high and low intensities and took part in video-recorded semi-structured interviews. Despite rating more intense pain as more difficult to communicate (t(25)  = 2.21, p =  .037), participants produced significantly longer verbal pain descriptions and more co-speech gestures in the high intensity pain condition (Words: t(25)  = 3.57, p  = .001; Gestures: t(25)  = 3.66, p =  .001). This suggests that spoken and gestural communication about pain is enhanced when pain is more intense. Thus, in addition to conveying detailed semantic information about pain, speech and co-speech gestures may provide a cue to pain intensity, with implications for the treatment and support received by pain sufferers. Future work should consider whether these findings are applicable within the context of clinical interactions about pain.

  8. Comparison of the Effect of Dry Cupping Therapy and Acupressure at BL23 Point on Intensity of Postpartum Perineal Pain Based on the Short Form of McGill Pain Questionnaire.

    Science.gov (United States)

    Akbarzade, Marzieh; Ghaemmaghami, Mehrnoush; Yazdanpanahi, Zahra; Zare, Najaf; Mohagheghzadeh, Abdolali; Azizi, Amir

    2016-01-01

    Perineal pain is a major morbidity in the first few days after delivery. This study aimed to investigate the effect of dry cupping therapy and acupressure at BL23 point on the intensity of postpartum perineal pain based on the short-form of McGill pain questionnaire (SMPQ). The present clinical trial was conducted on 150 subjects in 3 groups of 50 cases. After at least 4-8 hr of delivery, cupping therapy was performed for 15-20 min up to 3 times a week (once a day) and acupressure was performed for 15-20 min based on clockwise model. The short-form of McGill pain questionnaire was completed both before and after the intervention. The SPSS statistical software was used to analyze the data using repeated measures ANOVA. Besides, pcupping therapy group, mean of the perineal pain intensity reduced from 37.5±6.8 before the intervention to 11.1±6.1, 6.9±4.7, and 3.8±3.6 immediately, 24 hr, and 2 weeks after the intervention, respectively. The results of study showed that the differences between the intervention and control groups were statistically significant (pcupping therapy and acupressure reduced perineal pain. Therefore, they may be considered as effective treatments for reducing pain intensity of allowing delivery.

  9. Comparison of the Effect of Dry Cupping Therapy and Acupressure at BL23 Point on Intensity of Postpartum Perineal Pain Based on the Short Form of McGill Pain Questionnaire

    Science.gov (United States)

    Akbarzade, Marzieh; Ghaemmaghami, Mehrnoush; Yazdanpanahi, Zahra; Zare, Najaf; Mohagheghzadeh, Abdolali; Azizi, Amir

    2016-01-01

    Background: Perineal pain is a major morbidity in the first few days after delivery. This study aimed to investigate the effect of dry cupping therapy and acupressure at BL23 point on the intensity of postpartum perineal pain based on the short-form of McGill pain questionnaire (SMPQ). Methods: The present clinical trial was conducted on 150 subjects in 3 groups of 50 cases. After at least 4–8 hr of delivery, cupping therapy was performed for 15–20 min up to 3 times a week (once a day) and acupressure was performed for 15–20 min based on clockwise model. The short-form of McGill pain questionnaire was completed both before and after the intervention. The SPSS statistical software was used to analyze the data using repeated measures ANOVA. Besides, pcupping therapy group, mean of the perineal pain intensity reduced from 37.5±6.8 before the intervention to 11.1±6.1, 6.9±4.7, and 3.8±3.6 immediately, 24 hr, and 2 weeks after the intervention, respectively. The results of study showed that the differences between the intervention and control groups were statistically significant (pcupping therapy and acupressure reduced perineal pain. Therefore, they may be considered as effective treatments for reducing pain intensity of allowing delivery. PMID:26962482

  10. Intensive short-term vasodilation effect in the pain area of sciatica patients--case study.

    Science.gov (United States)

    Skorupska, Elżbieta; Rychlik, Michał; Pawelec, Wiktoria; Bednarek, Agata; Samborski, Włodzimierz

    2014-09-09

    Varied and complicated etiology of low back pain radiating distally to the extremities is still causing disagreement and controversy around the issue of its diagnosis and treatment. Most clinicians believe that the source of that pain is generally radicular. While some of them postulate the clinical significance of the sacroiliac joint syndrome, others demonstrate that almost one in five people with back pain experience symptoms indicative of the neuropathic pain component. To date, neuropathic involvement has not been completely understood, and different mechanisms are thought to play an important role. It has been established that muscle pain (myofascial pain) e.g. active trigger points from the gluteus minimus, can mimic pain similar to sciatica, especially in the chronic stage. This paper describes patients presenting with radicular sciatica (case one and two) and sciatica-like symptoms (case three). For the first time, intensive short-term vasodilation in the pain area following needle infiltration of the gluteus minimus trigger point was recorded. Three Caucasian, European women suffering from radicular sciatica (case one and two) and sciatica-like symptoms (case three) at the age of 57, 49 and 47 respectively underwent infrared camera observation during needle infiltration of the gluteus minimus trigger point. The patients were diagnosed by a neurologist; they underwent magnetic resonance imaging, electromyography, neurography and blood test analysis. Apart from that, the patients were diagnosed by a clinician specializing in myofascial pain diagnosis. In the examined cases, trigger points-related short-term vasodilation was recorded. Confirmation of these findings in a controlled, blinded study would indicate the existence of a link between the pain of sciatica patients (radicular or sciatica-like pain) and the activity of the autonomic nervous system. Further studies on a bigger group of patients are still needed.

  11. High Intensity Laser Therapy (HILT) versus TENS and NSAIDs in low back pain: clinical study

    Science.gov (United States)

    Zati, Allesandro; Fortuna, Damiano; Valent, A.; Filippi, M. V.; Bilotta, Teresa W.

    2004-09-01

    Low back pain, caused by lumbar disc herniation, is prevalently treated with a conservative approach. In this study we valued the efficacy of High Intensity Laser Therapy (HILT), compared with accepted therapies such as TENS and NSAIDs. Laser therapy obtained similar results in the short term, but better clinical effect over time than TENS and NSAIDs. In conclusion high intensity laser therapy appears to be a interesting new treatment, worthy of further research.

  12. Associations between daily chronic pain intensity, daily anger expression, and trait anger expressiveness: An ecological momentary assessment study

    Science.gov (United States)

    Bruehl, Stephen; Liu, Xiaoxia; Burns, John W.; Chont, Melissa; Jamison, Robert N.

    2013-01-01

    Links between elevated trait anger expressiveness (anger-out) and greater chronic pain intensity are well documented, but pain-related effects of expressive behaviors actually used to regulate anger when it is experienced have been little explored. This study used ecological momentary assessment methods to explore prospective associations between daily behavioral anger expression and daily chronic pain intensity. Forty-eight chronic low back pain (LBP) patients and 36 healthy controls completed electronic diary ratings of momentary pain and behavioral anger expression in response to random prompts 4 times daily for 7 days. Across groups, greater trait anger-out was associated with greater daily behavioral anger expression (P chronic pain intensity in the subsequent assessment period (P chronic pain intensity and later increases in behavioral anger expression that were restricted largely to individuals low in trait anger-out (P pain intensity on subsequent behavioral anger expression occurring among low anger-in persons (P chronic pain intensity. Trait anger regulation style may moderate associations between behavioral anger expression and chronic pain intensity. PMID:22940462

  13. Comparison between Epidural Block vs. High Intensity Laser Therapy for Controlling Chronic Low Back Pain

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    Badiozaman Radpay

    2016-01-01

    Full Text Available Background: Chronic low back pain is among a wide spread musculoskeletal conditions that is related to disability with high economy cost. There are several treatment modalities for controlling chronic low back pain (CLBP, among them high intensity laser therapy (HILT and epidural blocks (EB use more commonly. This study aimed to evaluate the benefits and hazards of each of these two methods.Materials and Methods: We designed a randomized controlled double blind study during 24 months.101 patients divided in 2 groups (52 in EB and 49 in HILT group. Pain intensity was assessed by using faces pain scales (FPS and LINKERT questionaries' before procedure and during one, four, 12, and 24 weeks after beginning the procedures.Results: There were no differences between two groups in FPS lumber tenderness, straight leg rising test (SLRT, paresthesia, deep tendon reflex (DTR, and imaging changes. Motor problems seem was less in HILT group comparing EB.Conclusion: This study showed both EB and HILT approaches can control the pain intensity and motor activities in CLBP patients. Future studies will clarify the precise importance of each these methods.

  14. Association Between Acute Pain and Hemodynamic Parameters in a Postoperative Surgical Intensive Care Unit.

    Science.gov (United States)

    Asgar Pour, Hossein

    2017-06-01

    I conducted a prospective repeated-measure study in the general surgery intensive care unit to investigate the associations among acute postoperative pain, analgesic therapy, and hemodynamic parameters. I selected 33 patients and recorded 84 episodes of pain. I measured intensity of pain and hemodynamic parameters after patients were transferred from the postanesthesia care unit to the general surgery intensive care unit, immediately before analgesic therapy and at 15, 30, and 45 minutes after analgesic therapy. Acute pain increased systolic (SBP), diastolic (DBP), and mean arterial blood pressure (MAP); pulse rate (PR); and arterial oxygen saturation. Fifteen minutes after analgesic therapy, SBP and PR decreased, and DBP, MAP, and oxygen saturation increased. Thirty minutes after therapy, SBP, MAP, and PR decreased, and DBP and oxygen saturation increased. Forty-five minutes after therapy, SBP, MAP, and PR decreased, and DBP and oxygen saturation increased. I saw no significant hemodynamic parameter changes during postoperative episodes of pain. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  15. Body Pain Intensity and Interference in Adults (45-53 Years Old): A Cross-Sectional Survey in Chongqing, China.

    Science.gov (United States)

    Xu, Xianglong; Li, Bing; Liu, Lingli; Zhao, Yong

    2016-09-07

    Culture and national care models matter both in reporting and treatment of pain status. However, most findings on body pain intensity and interference in adults are from Western studies, with little reliable evidence from China. This study aimed to assess body pain intensity and interference and its associations with demographic, socioeconomic characteristics, and health behaviors in adults. A cross-sectional survey was performed to collect data from 1224 adults, who were recruited via multistage stratified random sampling. The SF-36 quality-of-life instrument was used to investigate body pain intensity and interference. Ordinal logistic regression analysis was used in this study. Our results showed that 64.1% of the participants (males: 687; females: 537) reported body pain, and 45.7% of the participants reported body pain interference. Middle-aged respondents who were female, were unmarried/divorced or separated/widowed, had a negative relationship with their family, had poor sleep quality, and were not satisfied with their current living conditions had a higher body pain intensity rating (ordered logistic regression/six-level pain intensity criterion; odds ratios, p family, and were not satisfied with their current living conditions had a higher body pain interference rating (ordered logistic regression/five-level pain interference criterion; odds ratios, p adults reported body pain, and 45.7% of middle-aged adults reported body pain interference. These results provide a clue for possible interventions for improving body pain intensity and interference in adults, especially among middle-aged people. These factors should be taken into consideration in the prevention of pain, pain management and treatment planning in order to help relieve the stress of pain among adults.

  16. Body Pain Intensity and Interference in Adults (45–53 Years Old: A Cross-Sectional Survey in Chongqing, China

    Directory of Open Access Journals (Sweden)

    Xianglong Xu

    2016-09-01

    Full Text Available Culture and national care models matter both in reporting and treatment of pain status. However, most findings on body pain intensity and interference in adults are from Western studies, with little reliable evidence from China. This study aimed to assess body pain intensity and interference and its associations with demographic, socioeconomic characteristics, and health behaviors in adults. A cross-sectional survey was performed to collect data from 1224 adults, who were recruited via multistage stratified random sampling. The SF-36 quality-of-life instrument was used to investigate body pain intensity and interference. Ordinal logistic regression analysis was used in this study. Our results showed that 64.1% of the participants (males: 687; females: 537 reported body pain, and 45.7% of the participants reported body pain interference. Middle-aged respondents who were female, were unmarried/divorced or separated/widowed, had a negative relationship with their family, had poor sleep quality, and were not satisfied with their current living conditions had a higher body pain intensity rating (ordered logistic regression/six-level pain intensity criterion; odds ratios, p < 0.05. Respondents who were unmarried/divorced or separated/widowed, with a low education level, were unemployed, had lower incomes, had a negative relationship with their family, and were not satisfied with their current living conditions had a higher body pain interference rating (ordered logistic regression/five-level pain interference criterion; odds ratios, p < 0.05. In conclusion, an estimated 64.1% of middle-aged adults reported body pain, and 45.7% of middle-aged adults reported body pain interference. These results provide a clue for possible interventions for improving body pain intensity and interference in adults, especially among middle-aged people. These factors should be taken into consideration in the prevention of pain, pain management and treatment planning in

  17. Comparison of static postural balance between healthy subjects and those with low back pain.

    Science.gov (United States)

    Braga, Alice Bernardi; Rodrigues, Ana Carolina de Mello Alves; de Lima, Giliane Vanessa Moraes Pereira; de Melo, Larissa Rabello; de Carvalho, Alberito Rodrigo; Bertolini, Gladson Ricardo Flor

    2012-01-01

    To compare the static postural balance between women suffering from chronic low back pain and healthy subjects, by moving the center of pressure. The study included 15 women with low back pain (LBP group) and 15 healthy women (healthy group). They were instructed to remain in standing on the force platform for 30 seconds. We analyzed the area and the speed of displacement of center of pressure of both groups. Data analysis was performed using the Student's t-test, with significance of 5%. Individuals with chronic low back pain showed a larger area of displacement of the center of pressure relative to the healthy ones but there was no significant difference in the speed of displacement of the center of pressure. Individuals with chronic low back pain had alterations in static balance with respect to healthy ones. Level of Evidence III, Prognostic Studies.

  18. Missed Opportunities for Sedation and Pain Management at a Level III Neonatal Intensive Care Unit, India

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    Shikha Yashwant Kothari

    2016-02-01

    Full Text Available Background:Neonates in the neonatal intensive care unit (NICU undergo a multitude of painful and stressful procedures during the first days of life. Stress from this pain can lead to neurodevelopmental problems that manifest in later childhood and should be prevented.Objective:To determine the number of painful procedures performed per day for each neonate, to verify documentation of painful procedures performed, and to, subsequently, note missed opportunities for providing pain relief to neonates.Methods:We conducted a cross-sectional study at a level III NICUlocated in a rural part of western India. A total of 69 neonates admitted for more than 24 hours were included.Twenty-nine neonates were directly observedfor a total of 24 hours each, and another 40 neonatal records were retrospectively reviewed for the neonate’s first 7 days of admission. All stressful and painful procedures performed on the neonate were recorded.Also recorded were any pharmaceutical pain relief agents or central nervous system depressants administered to the neonate before or at the time of the procedures. Averagenurse: patient ratio was also calculated. Data was analyzed using descriptive statistics.Results: A documentation deficit of 2.2% was observed. The average nurse: patient ratio was 1.53:1. A total of 13711 procedures were recorded, yielding 44.1 (38.1 stressful, 3.8 mildly painful and 2.2 moderately painful procedures per patient-day. Common stressful procedures were position changing (2501 and temperature recording (2208. Common mildly and moderately painful procedures were heel prick (757 and endotracheal suctioning (526 respectively. Use of pharmacological agents coincided with 33.48% of the procedures. The choice of drug and time of administration were inappropriate, indicating that the pharmacological agents were intended not for pain relief but rather for a coexisting pathology or as sedation from ventilation with no analgesia.Conclusion: Stressful

  19. Missed Opportunities for Sedation and Pain Management at a Level III Neonatal Intensive Care Unit, India.

    Science.gov (United States)

    Kothari, Shikha Y; Dongara, Ashish R; Nimbalkar, Somashekhar M; Phatak, Ajay G; Nimbalkar, Archana S

    2016-01-01

    Neonates in the neonatal intensive care unit (NICU) undergo a multitude of painful and stressful procedures during the first days of life. Stress from this pain can lead to neurodevelopmental problems that manifest in later childhood and should be prevented. To determine the number of painful procedures performed per day for each neonate, to verify documentation of painful procedures performed, and to, subsequently, note missed opportunities for providing pain relief to neonates. We conducted a cross-sectional study at a level III NICU located in a rural part of western India. A total of 69 neonates admitted for more than 24 h were included. Twenty-nine neonates were directly observed for a total of 24 h each, and another 40 neonatal records were retrospectively reviewed for the neonate's first 7 days of admission. All stressful and painful procedures performed on the neonate were recorded. Also recorded were any pharmaceutical pain relief agents or central nervous system depressants administered to the neonate before or at the time of the procedures. Average nurse-patient ratio was also calculated. Data were analyzed using descriptive statistics. A documentation deficit of 2.2% was observed. The average nurse-patient ratio was 1.53:1. A total of 13711 procedures were recorded, yielding 44.1 (38.1 stressful, 3.8 mildly painful, and 2.2 moderately painful) procedures per patient day. Common stressful procedures were position changing (2501) and temperature recording (2208). Common mildly and moderately painful procedures were heel prick (757) and endotracheal suctioning (526), respectively. Use of pharmacological agents coincided with 33.48% of the procedures. The choice of drug and time of administration were inappropriate, indicating that the pharmacological agents were intended not for pain relief but rather for a coexisting pathology or as sedation from ventilation with no analgesia. Stressful procedures are common in the NICU; mildly and moderately

  20. A Cross-Cultural Study of Pain Intensity in Egyptian and Dutch Women With Rheumatoid Arthritis

    NARCIS (Netherlands)

    Vlaar, Alexander P.J.; ten Klooster, Peter M.; Taal, Erik; Gheith, Rasha E.; El-Garf, Ayman K.; Rasker, Hans J.; van de Laar, Mart A F J

    2007-01-01

    It has been suggested that patients from Mediterranean cultures tend to report more intense pain than their Northern or Western European counterparts in comparable medical conditions. However, empirical data to support this hypothesis are limited. The goals of the present study were to examine

  1. Chronic neuropathic facial pain after intense pulsed light hair removal. Clinical features and pharmacological management.

    Science.gov (United States)

    Gay-Escoda, Cosme; Párraga-Manzol, Gabriela; Sánchez-Torres, Alba; Moreno-Arias, Gerardo

    2015-10-01

    Intense Pulsed Light (IPL) photodepilation is usually performed as a hair removal method. The treatment is recommended to be indicated by a physician, depending on each patient and on its characteristics. However, the use of laser devices by medical laypersons is frequent and it can suppose a risk of damage for the patients. Most side effects associated to IPL photodepilation are transient, minimal and disappear without sequelae. However, permanent side effects can occur. Some of the complications are laser related but many of them are caused by an operator error or mismanagement. In this work, we report a clinical case of a patient that developed a chronic neuropathic facial pain following IPL hair removal for unwanted hair in the upper lip. The specific diagnosis was painful post-traumatic trigeminal neuropathy, reference 13.1.2.3 according to the International Headache Society (IHS). Neuropathic facial pain, photodepilation, intense pulse light.

  2. Effectiveness of dry needling on reducing pain intensity in patients with myofascial pain syndrome: a Meta-analysis.

    Science.gov (United States)

    Rodríguez-Mansilla, Juan; González-Sánchez, Blanca; De Toro García, Álvaro; Valera-Donoso, Enrique; Garrido-Ardila, Elisa María; Jiménez-Palomares, María; González López-Arza, María Victoria

    2016-02-01

    To summarize the literature about the effectiveness of dry needling (DN) on relieving pain and increasing range of motion (ROM) in individuals with myofascial pain syndrome (MPS). Papers published from January 2000 to January 2013 were identified through an electronic search in the databases MEDLINE, Dialnet, Cochrane Library Plus, Physiotherapy Evidence Data-base (PEDro) and Spanish Superior Council of Scientific Research (CSIC). The studies included were randomized controlled trials written in English and/or Spanish about the effectiveness of DN on pain and ROM in individuals with MPS. Out of 19 clinical trials that were potentially relevant, a total of 10 were included in the Meta-analysis. Regarding pain intensity reduction when measured before and immediately after the intervention, DN achieved improvement compared with the placebo treatment [d = - 0.49; 95% CI (- 3.21, 0.42)] and with the control group [d = - 9.13; 95% C (- 14.70, - 3.56)]. However, other treatments achieved better results on the same variable compared with DN, considering the measurements for pre-treatment and immediately after [d = 2.54; 95% CI (- 0.40, 5.48)], as well as the pre-treatment and after 3-4 weeks [d = 4.23; 95% CI (0.78, 7.68)]. DN showed a significantly increased ROM when measured before the intervention and immediately after, in comparison with the placebo [d = 2.00; 95% C (1.60, 2.41)]. However, other treatments achieved a significant better result regarding ROM when it was measured before the intervention and immediately after, as compared with DN [d = - 1.42; 95% CI (- 1.84, - 0.99)]. DN was less effective on decreasing pain comparing to the placebo group. Other treatments were more effective than DN on reducing pain after 3-4 weeks. However, on increasing ROM, DN was more effective comparing to that of placebo group, but less than other treatments.

  3. Differences in performance on the functional movement screen between chronic low back pain patients and healthy control subjects

    OpenAIRE

    Ko, Min-Joo; Noh, Kyung-Hee; Kang, Min-Hyeok; Oh, Jae-Seop

    2016-01-01

    [Purpose] Differences in scores on the Functional Movement Screen between patients with chronic lower back pain and healthy control subjects were investigated. [Subjects and Methods] In all, 20 chronic lower back pain patients and 20 healthy control subjects were recruited. Chronic lower back pain patients and healthy controls performed the Functional Movement Screen (deep squat, hurdle step, inline lunge, shoulder mobility, active straight leg raise, trunk stability pushup, and rotary stabil...

  4. Ensemble encoding of nociceptive stimulus intensity in the rat medial and lateral pain systems

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    Woodward Donald J

    2011-08-01

    Full Text Available Abstract Background The ability to encode noxious stimulus intensity is essential for the neural processing of pain perception. It is well accepted that the intensity information is transmitted within both sensory and affective pathways. However, it remains unclear what the encoding patterns are in the thalamocortical brain regions, and whether the dual pain systems share similar responsibility in intensity coding. Results Multichannel single-unit recordings were used to investigate the activity of individual neurons and neuronal ensembles in the rat brain following the application of noxious laser stimuli of increasing intensity to the hindpaw. Four brain regions were monitored, including two within the lateral sensory pain pathway, namely, the ventral posterior lateral thalamic nuclei and the primary somatosensory cortex, and two in the medial pathway, namely, the medial dorsal thalamic nuclei and the anterior cingulate cortex. Neuron number, firing rate, and ensemble spike count codings were examined in this study. Our results showed that the noxious laser stimulation evoked double-peak responses in all recorded brain regions. Significant correlations were found between the laser intensity and the number of responsive neurons, the firing rates, as well as the mass spike counts (MSCs. MSC coding was generally more efficient than the other two methods. Moreover, the coding capacities of neurons in the two pathways were comparable. Conclusion This study demonstrated the collective contribution of medial and lateral pathway neurons to the noxious intensity coding. Additionally, we provide evidence that ensemble spike count may be the most reliable method for coding pain intensity in the brain.

  5. Motor control patterns during an active straight leg raise in pain-free subjects.

    Science.gov (United States)

    Beales, Darren John; O'Sullivan, Peter Bruce; Briffa, N Kathryn

    2009-01-01

    Repeated measures. To investigate motor control (MC) patterns of normal subjects during the low level physical load of the active straight leg raise (ASLR). Aberrant MC patterns, as observed with the ASLR test, are considered to be a mechanism for ongoing pain and disability in subjects with chronic musculoskeletal pelvic girdle pain. These patterns may not only affect the provision of lumbopelvic stability, but also respiration and the control of continence. Greater understanding of MC patterns in pain-free subjects may improve the management of pelvic girdle pain. METHODS.: Fourteen pain-free nulliparous women were examined during the ASLR. Electromyography of the anterior abdominal wall, right chest wall and the anterior scaleni, intraabdominal pressure (IAP), intrathoracic pressure (ITP), respiratory rate, pelvic floor kinematics, and downward leg pressure of the nonlifted leg were compared between a left and right ASLR. There was greater activation of obliquus internus abdominis and obliquus externus abdominis on the side of the ASLR. The predominant pattern of activation for the chest wall was tonic activation during an ipsilateral ASLR, and phasic respiratory activation lifting the contralateral leg. Respiratory fluctuation of both IAP and ITP did not differ lifting either leg. The baseline shifts of these pressure variables in response to the physical demand of lifting the leg was also the same either side. There was no difference in respiratory rate, pelvic floor kinematics, or downward leg pressure. Pain-free subjects demonstrate a predominant pattern of greater ipsilateral tonic activation of the abdominal wall and chest wall on the side of the ASLR. This was achieved with minimal apparent disruption to IAP and ITP. The findings of this study demonstrate the plastic nature of the abdominal cylinder and the flexibility of the neuromuscular system in controlling load transference during an ASLR.

  6. Amputation, phantom pain and subjective well-being : a qualitative study

    NARCIS (Netherlands)

    Bosmans, J.C.; Suurmeijer, T.P.B.M.; Hulsink, M.; van der Schans, C.P.; Geertzen, J.H.B.; Dijkstra, P.U.

    The purpose of this qualitative study was to explore the impact of an amputation and of phantom pain on the subjective well-being of amputees. Sixteen lower-limb amputees were interviewed. A semi-structured interview and two Visual Analogue Scales were used. To interpret the results, a new

  7. Intensive care unit team perception of palliative care: the discourse of the collective subject

    OpenAIRE

    Gulini, Juliana El Hage Meyer de Barros; Nascimento, Eliane Regina Pereira do; Moritz, Rachel Duarte; Rosa, Luciana Martins da; Silveira, Natyele Rippel; Vargas, Mara Ambrosina de Oliveira

    2017-01-01

    Abstract OBJECTIVE To learn the perception of health professionals in an intensive care unit towards palliative care. METHOD This was a descriptive and qualitative study based on the converging care approach conducted at an intensive care unit in the South of Brazil. Semi-structured interviews were used to investigate the understanding of the professionals about palliative care in this unit. The data were organized and analyzed using the discourse of the collective subject method with the h...

  8. A Controlled and Retrospective Study of 144 Chronic Low Back Pain Patients to Evaluate the Effectiveness of an Intensive Functional Restoration Program in France.

    Science.gov (United States)

    Caby, Isabelle; Olivier, Nicolas; Janik, Frédérick; Vanvelcenaher, Jacques; Pelayo, Patrick

    2016-04-27

    A controlled and retrospective study of 144 chronic low back pain patients to evaluate the effectiveness of an intensive functional restoration program in France. Evaluating the efficiency of an intensive, dynamic and multidisciplinary functional restoration program in patients with chronic low back pain (LBP), during 6 and 12 months follow up. Chronic low back pain disease has a multifactor nature, involving physical, psychological professional and social factors. A functional restoration program (FRP) has been included in a multidisciplinary training program which provides an efficient therapeutic solution. However, the effectiveness of an FRP has not been yet established. 144 subjects (71 males, 73 females) with chronic low back pain were included in a functional restoration program. The FRP includes physiotherapy and occupational therapy interventions together with psychological counselling. Patients participated as in- or outpatients 6 h per day, 5 days a week over 5 weeks. Pain intensity, trunk flexibility, trunk strength, lifting ability, quality of life and return to work were recorded before, immediately after, and at 6 months and 12 months after the treatment period. All outcome measures were significantly higher just after the FRP (144 patients) and at 6 and 12 months (from available data in 31 subjects) compared to pre-treatment values. This FRP for chronic low back pain maintained its benefits whatever the patient's activities. The effects reflected on all outcome measures, both on short and long term follow-up. The multidisciplinary FRP for chronic low back pain patients durably stopped the de-conditioning syndrome and involved new life-style habits for the patient, daily pain management and a return to work.

  9. A Controlled and Retrospective Study of 144 Chronic Low Back Pain Patients to Evaluate the Effectiveness of an Intensive Functional Restoration Program in France

    Directory of Open Access Journals (Sweden)

    Isabelle Caby

    2016-04-01

    Full Text Available Study Design: A controlled and retrospective study of 144 chronic low back pain patients to evaluate the effectiveness of an intensive functional restoration program in France. Objective: Evaluating the efficiency of an intensive, dynamic and multidisciplinary functional restoration program in patients with chronic low back pain (LBP, during 6 and 12 months follow up. Summary of background data: Chronic low back pain disease has a multifactor nature, involving physical, psychological professional and social factors. A functional restoration program (FRP has been included in a multidisciplinary training program which provides an efficient therapeutic solution. However, the effectiveness of an FRP has not been yet established. Methods: 144 subjects (71 males, 73 females with chronic low back pain were included in a functional restoration program. The FRP includes physiotherapy and occupational therapy interventions together with psychological counselling. Patients participated as in- or outpatients 6 h per day, 5 days a week over 5 weeks. Pain intensity, trunk flexibility, trunk strength, lifting ability, quality of life and return to work were recorded before, immediately after, and at 6 months and 12 months after the treatment period. Results: All outcome measures were significantly higher just after the FRP (144 patients and at 6 and 12 months (from available data in 31 subjects compared to pre-treatment values. This FRP for chronic low back pain maintained its benefits whatever the patient’s activities. Conclusions: The effects reflected on all outcome measures, both on short and long term follow-up. The multidisciplinary FRP for chronic low back pain patients durably stopped the de-conditioning syndrome and involved new life-style habits for the patient, daily pain management and a return to work.

  10. The NeckPix(©): development of an evaluation tool for assessing kinesiophobia in subjects with chronic neck pain.

    Science.gov (United States)

    Monticone, Marco; Vernon, Howard; Brunati, Roberto; Rocca, Barbara; Ferrante, Simona

    2015-01-01

    To develop and validate NeckPix(©), a multi-image instrument for assessing daily activities in the context of pain-related fear, in order to allow its use in patients with chronic neck pain (NP). The measure was developed by means of item generation followed by reduction/selection. The psychometric testing included exploratory factor analysis; content validity by investigating clarity, specificity, appropriateness for the target population, relevance and completeness; reliability by internal consistency (Cronbach's alpha) and test-retest stability (intra-class coefficient correlation, ICC); and construct validity by comparing NeckPix with the Tampa Scale of Kinesiophobia (TSK), the Pain Catastrophising Scale (PCS), the Neck Disability Index (NDI) and a Numerical Rating Scale of pain intensity (NRS) (Pearson's correlation). The measure, which includes ten images used to assess everyday activities in the context of pain-related fear, was administered to 118 subjects with chronic non-specific NP, and proved to be acceptable and feasible. Factor analysis revealed a one-factor solution (which explained 71.12 % of variance). The content of the images was considered adequate, appropriate for the target population, comprehensive, and relevant for evaluating activity-related kinesiophobia. The instrument's internal consistency was good (α = 0.954), as was its test-retest stability (ICC 0.979). Construct validity demonstrated a close correlation with the TSK (r = 0.759), and moderate correlations with the PCS (r = 0.583), the NDI (r = 0.520), and a NRS (r = 0.455). NeckPix(©), which was successfully developed following international recommendations, proved to have a good factorial structure and satisfactory psychometric properties. Its use is recommended for research purposes.

  11. The effect of sleep deprivation on pain perception in healthy subjects: a meta-analysis.

    Science.gov (United States)

    Schrimpf, Marlene; Liegl, Gregor; Boeckle, Markus; Leitner, Anton; Geisler, Peter; Pieh, Christoph

    2015-11-01

    There is strong evidence indicating an interaction between sleep and pain. However, the size of this effect, as well as the clinical relevance, is unclear. Therefore, this meta-analysis was conducted to quantify the effect of sleep deprivation on pain perception. A systematic literature search was conducted using the electronic databases PubMed, Cochrane, Psyndex, Psycinfo, and Scopus. By conducting a random-effect model, the pooled standardized mean differences (SMDs) of sleep deprivation on pain perception was calculated. Studies that investigated any kind of sleep deprivation in conjunction with a pain measurement were included. In cases of several pain measurements within a study, the average effect size of all measures was calculated. Five eligible studies (N = 190) for the between-group analysis and ten studies (N = 266) for the within-group analysis were identified. Sleep deprivation showed a medium effect in the between-group analysis (SMD = 0.62; CI95: 0.12, 1.12; z = 2.43; p = 0.015) and a large effect in the within-group analysis (SMD = 1.49; CI95: 0.82, 2.17; z = 4.35; p sleep deprivation on pain perception. As this meta-analysis is based on experimental studies in healthy subjects, the clinical relevance should be clarified. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Body Pain Intensity and Interference in Adults (45?53 Years Old): A Cross-Sectional Survey in Chongqing, China

    OpenAIRE

    Xianglong Xu; Bing Li; Lingli Liu; Yong Zhao

    2016-01-01

    Culture and national care models matter both in reporting and treatment of pain status. However, most findings on body pain intensity and interference in adults are from Western studies, with little reliable evidence from China. This study aimed to assess body pain intensity and interference and its associations with demographic, socioeconomic characteristics, and health behaviors in adults. A cross-sectional survey was performed to collect data from 1224 adults, who were recruited via multis...

  13. Sedation and memories of patients subjected to mechanical ventilation in an intensive care unit.

    Science.gov (United States)

    Costa, Jaquilene Barreto da; Marcon, Sonia Silva; Macedo, Claudia Rejane Lima de; Jorge, Amaury Cesar; Duarte, Péricles Almeida Delfino

    2014-01-01

    To investigate the relationship between sedation and the memories reported by patients subjected to mechanical ventilation following discharge from the intensive care unit. This prospective, observational, cohort study was conducted with individuals subjected to mechanical ventilation who remained in the intensive care unit for more than 24 hours. Clinical statistics and sedation records were extracted from the participants' clinical records; the data relative to the participants' memories were collected using a specific validated instrument. Assessment was performed three months after discharge from the intensive care unit. A total of 128 individuals were assessed, most of whom (84.4%) reported recollections from their stay in the intensive care unit as predominantly a combination of real and illusory events. The participants subjected to sedation (67.2%) at deep levels (Richmond Agitation-Sedation Scale [RASS] -4 and -5) for more than two days and those with psychomotor agitation (33.6%) exhibited greater susceptibility to occurrence of illusory memories (p>0.001). The probability of the occurrence of illusory memories was greater among the participants who were subjected to deep sedation. Sedation seems to be an additional factor that contributed to the occurrence of illusory memories in severely ill individuals subjected to mechanical ventilation.

  14. Comparative effects of proprioceptive and isometric exercises on pain intensity and difficulty in patients with knee osteoarthritis: A randomised control study.

    Science.gov (United States)

    Ojoawo, Adesola O; Olaogun, Matthew O B; Hassan, Mariam A

    2016-11-14

    The study compared the effects of isometric quadriceps exercise and proprioceptive exercise on pain, joint stiffness and physical difficulties of patients with knee osteoarthritis. Forty-five patients with history of knee osteoarthritis were randomly allocated into two groups; A with 23 subjects and B with 22 subjects. All subjects received infrared radiation for 20 minutes and kneading massage with methyl salicylate ointment. Group A underwent proprioceptive exercises while Group B had isometric quadriceps exercise. Each exercise session lasted for 10 minutes according to standard protocol, twice in a week for six weeks. Pre-treatment, 3rd week and 6th week pain intensity, joint stiffness and physical difficulties were assessed using Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. Statistical package for social sciences (SPSS) version 17 was used to analyse the data while descriptive and inferential statistics were used to summarise the result. Proprioceptive exercises reduced pain intensity significantly (F = 4.76; p = 0.00) at 6th week with effect size of 2.79, and physical difficulty (F = 3.69; p exercises. There was a significant reduction in the pain intensity (F = 12.08; p exercises are effective but proprioceptive exercises may be more effective in the management of patients with knee osteoarthritis (KOA) than isometric exercises.

  15. Comparison of static postural balance between healthy subjects and those with low back pain

    OpenAIRE

    Braga, Alice Bernardi; Rodrigues, Ana Carolina de Mello Alves; de Lima, Giliane Vanessa Moraes Pereira; Melo, Larissa Rabello de; Carvalho, Alberito Rodrigo de; Bertolini,Gladson Ricardo Flor

    2012-01-01

    Objective To compare the static postural balance between women suffering from chronic low back pain and healthy subjects, by moving the center of pressure. Methods The study included 15 women with low back pain (LBP group) and 15 healthy women (healthy group). They were instructed to remain in standing on the force platform for 30 seconds. We analyzed the area and the speed of displacement of center of pressure of both groups. Data analysis was performed using the Student's t-test, with signi...

  16. Socio-material assemblies, the subjectivity of pain and work identity

    DEFF Research Database (Denmark)

    Nickelsen, Niels Christian Mossfeldt

    2015-01-01

    Based on science and technology studies (STS) and actor-network theory (ANT) a roleplay from a production hall, is discussed in relation to the notions of subjectivity and work identity. The article argues that an instance of arthralgia (pain) may both be seen as an effect and a driver of human–machine...... identities.. It is argued that pain should not simply be seen as illness, or as resistance against the dominant engineering practice and general increase of speed, but also as an important actor in mobilizing a machine operator network. The strength of the analytical approach is that it elucidates...

  17. The burden of venipuncture pain in neonatal intensive care units: EPIPPAIN 2, a prospective observational study.

    Science.gov (United States)

    Courtois, Emilie; Cimerman, Patricia; Dubuche, Valérie; Goiset, Marie-France; Orfèvre, Claire; Lagarde, Audrey; Sgaggero, Betty; Guiot, Céline; Goussot, Mélanie; Huraux, Etienne; Nanquette, Marie-Christine; Butel, Céline; Ferreira, Anne-Marie; Lacoste, Sylvie; Séjourné, Sandrine; Jolly, Valérie; Lajoie, Gladys; Maillard, Valérie; Guedj, Romain; Chappuy, Hélène; Carbajal, Ricardo

    2016-05-01

    Newborns in intensive care units (ICUs) undergo numerous painful procedures including venipunctures. Skin-breaking procedures have been associated with adverse neurodevelopment long-term effects in very preterm neonates. The venipuncture frequency and its real bedside pain management treatment are not well known in this setting. To describe venipuncture frequency, its pain intensity, and the analgesic approach in ICU newborns; to determine the factors associated with the lack of preprocedural analgesia and with a high pain score during venipuncture. Further analysis of EPIPPAIN 2 (Epidemiology of Procedural Pain In Neonates), which is a descriptive prospective epidemiologic study. All 16 neonatal and pediatric ICUs in the Paris region in France. All newborns in the ICU with a maximum corrected age under 45 weeks of gestation on admission who had at least one venipuncture during the study period. Data on all venipunctures, their pain score assessed with the DAN scale and their corresponding analgesic therapies were prospectively collected. The inclusion period lasted six weeks, from June 2, 2011, to July 12, 2011. Newborns were followed from their admission to the 14th day of their ICU stay or discharge, whichever occurred first. 495 newborns who underwent venipunctures were included. The mean (SD) gestational age was 33.0 (4.4) weeks and duration of participation was 8.0 (4.5) days. A total of 257 (51.9%) neonates were very preterm (neonate during the study period was 3.8 (2.8; 1-19) for all neonates and 4.1 (2.9; 1-17) for neonates sedation/analgesia. High pain scores were significantly associated with absence of parents during procedures, surgery during the study period, and higher number of attempts. Venipuncture is very frequent in preterm and term neonates in the ICUs. 76% were performed with preprocedural analgesia. Strategies to reduce the number of attempts and to promote parental presence seem necessary. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Statistical Models for the Analysis of Zero-Inflated Pain Intensity Numeric Rating Scale Data.

    Science.gov (United States)

    Goulet, Joseph L; Buta, Eugenia; Bathulapalli, Harini; Gueorguieva, Ralitza; Brandt, Cynthia A

    2017-03-01

    Pain intensity is often measured in clinical and research settings using the 0 to 10 numeric rating scale (NRS). NRS scores are recorded as discrete values, and in some samples they may display a high proportion of zeroes and a right-skewed distribution. Despite this, statistical methods for normally distributed data are frequently used in the analysis of NRS data. We present results from an observational cross-sectional study examining the association of NRS scores with patient characteristics using data collected from a large cohort of 18,935 veterans in Department of Veterans Affairs care diagnosed with a potentially painful musculoskeletal disorder. The mean (variance) NRS pain was 3.0 (7.5), and 34% of patients reported no pain (NRS = 0). We compared the following statistical models for analyzing NRS scores: linear regression, generalized linear models (Poisson and negative binomial), zero-inflated and hurdle models for data with an excess of zeroes, and a cumulative logit model for ordinal data. We examined model fit, interpretability of results, and whether conclusions about the predictor effects changed across models. In this study, models that accommodate zero inflation provided a better fit than the other models. These models should be considered for the analysis of NRS data with a large proportion of zeroes. We examined and analyzed pain data from a large cohort of veterans with musculoskeletal disorders. We found that many reported no current pain on the NRS on the diagnosis date. We present several alternative statistical methods for the analysis of pain intensity data with a large proportion of zeroes. Published by Elsevier Inc.

  19. Chronic low back pain patients with accompanying leg pain : The relationship between pain extent and pain intensity, disability and health status

    NARCIS (Netherlands)

    Prins, Maarten R.; van der Wurff, Peter; Groen, Gerbrand J.

    2013-01-01

    Accompanying leg pain is commonly observed in patients with chronic low back pain (CLBP) and is assumed to be an indicator for the disorder severity. However, it is still unknown whether it is possible to estimate a patient's functional status by the extent of leg pain present. In a post

  20. Are intensive data collection methods in pain research feasible in those with physical disability? A study in persons with chronic pain and spinal cord injury.

    Science.gov (United States)

    Kratz, A L; Kalpakjian, C Z; Hanks, R A

    2017-03-01

    Intensive repeated measures data collection procedures, such as ecological momentary assessment (EMA) and end-of-day (EOD) diaries, are becoming more prominent in pain research. Existing data on the feasibility of such methods is encouraging; however, almost nothing is known about feasibility in clinical populations with significant physical disabilities. Research methodology feasibility is crucial to the inclusion of individuals with physical disability in pain research given the high prevalence and impact of pain in these populations. The aim of this study was to examine study compliance, protocol acceptability, and reactivity of intensive data collection methods in adults with chronic pain and spinal cord injury (SCI). Secondary analysis of data from a 7-day EMA and EOD diary study in a sample of 131 community dwelling adults with SCI. Results showed rates of missing data ranged from 18.4 to 22.8% across measures. Participant compliance was related to time of day/presence of audible prompts, mobility aid use, race, and baseline levels of pain and pain interference, with more missing data at wake and bedtimes/no prompts, and for those who used hand-held mobility devices, identified as black/African American, and/or reported higher baseline pain and pain interference. Participants rated the study methodology as generally highly acceptable and expressed willingness to participate in similar studies of much longer duration. There was no evidence of reactivity, defined as temporal shifts in pain or pain interference ratings. Overall, intensive pain data collection is feasible in persons with SCI with no evidence that the methodology impacts pain intensity or pain interference ratings.

  1. Interactive effects of music tempi and intensities on grip strength and subjective affect.

    Science.gov (United States)

    Karageorghis, C I; Cheek, P; Simpson, S D; Bigliassi, M

    2018-03-01

    Pretask music is widely used by athletes albeit there is scant empirical evidence to support its use. The present study extended a line of work into pretask music by examining the interactive effects of music tempo and intensity (volume) on the performance of a simple motor skill and subjective affect. A 2 × 2 within-subjects factorial design was employed with an additional no-music control, the scores from which were used as a covariate. A sample of 52 male athletes (M age  = 26.1 ± 4.8 years) was exposed to five conditions: fast/loud (126 bpm/80 dBA), fast/quiet (126 bpm/70 dBA), slow/loud (87 bpm/80 dBA), slow/quiet (87 bpm/70 dBA) music, and a no-music control. Dependent variables were grip strength, measured with a handgrip dynamometer, and subjective affect, assessed by use of the Affect Grid. The tempo and intensity components of music had interactive effects for grip strength but only main effects for subjective affect. Fast-tempo music played at a high intensity yielded the highest grip strength, while fast-tempo music played at a low-intensity resulted in much lower grip strength (M diff.  = -1.11 Force kg). For affective valence, there were main effects of tempo and intensity, with fast and loud music yielding the highest scores. For affective arousal, there was no difference between tempi although there was between intensities, with the high-intensity condition yielding higher scores. The present findings indicate the utility of fast/loud pretask music in enhancing affective valence and arousal in preparation for a simple or gross motor task. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. The effect of virtual body swapping with mental rehearsal on pain intensity and body perception disturbance in complex regional pain syndrome.

    Science.gov (United States)

    Hwang, Haesol; Cho, Sungkun; Lee, Jang-Han

    2014-06-01

    The present study investigated the effects of virtual body swapping with mental rehearsal on pain intensity and body perception disturbance (BPD) in patients with complex regional pain syndrome. Patients with complex regional pain syndrome were assigned randomly to three experimental groups: the 'virtual body swapping with mental rehearsal' (VBS) group (n=13), the 'watching movement only' group (n=13), and the 'mental rehearsal only' (n=13) group. Then, pretreatment pain intensity and BPD were compared with post-treatment perceptions. The results showed that pain intensity did not decrease significantly after treatment in all of the groups. However, BPD improved significantly after treatment in the VBS group, but not in the other groups. Therefore, this study is the first to show the effects of a single session of VBS on BPD. Further studies should apply an elevated degree of immersion and create a more realistic virtual body.

  3. Psychological Factors Are Related to Pain Intensity in Back-Healthy People Who Develop Clinically Relevant Pain During Prolonged Standing: A Preliminary Study.

    Science.gov (United States)

    Sorensen, Christopher J; George, Steven Z; Callaghan, Jack P; Van Dillen, Linda R

    2016-11-01

    An induced-pain paradigm has been used to examine risk factors for the development of low back pain (LBP) during prolonged standing in back-healthy people (standing paradigm). Previous studies that used induced-pain methods suggest that pain intensity may be related to psychologic factors. It is not currently known, however, whether pain intensity reported during the standing paradigm is related to psychologic factors. To examine the relationship between LBP symptom intensity and psychological factors (fear of pain and pain catastrophizing) in back-healthy people who develop LBP during prolonged standing. We hypothesized that symptom intensity during standing would be positively related to initial levels of fear of pain and pain catastrophizing in people who developed LBP during standing. Cross-sectional. Movement science research center at an academic medical center. Fifty seven back-healthy participants. Participants completed the Fear of Pain Questionnaire-III (FPQ-III) and Pain Catastrophizing Scale (PCS) before a 2-hour standing protocol. Participants rated LBP intensity on a 100-mm visual analogue scale (VAS) throughout standing and were classified as pain developers (PDs) or nonpain developers (NPDs). Relationships between LBP intensity and psychological measures were examined in PDs that did and did not have a ≥20 mm maximum VAS score. FPQ-III and PCS total scores, maximum and average VAS scores during standing. There were 24 (42%) PDs. Five PDs reported a maximum VAS score ≥20 mm. For PDs with a maximum VAS score <20 mm, correlations between average VAS scores and each psychological measure were small and nonsignificant (FPQ-III: r = 0.16, P = .50; PCS: r = 0.27, P = .26). For PDs with a maximum VAS score ≥20 mm, correlation between average VAS scores and FPQ-III was large and significant (r = 0.91, P = .03), and large for PCS but nonsignificant (r = 0.87, P = .06). These preliminary data suggest that if pain exceeds a clinically meaningful threshold

  4. Increased intensity discrimination thresholds in tinnitus subjects with a normal audiogram

    DEFF Research Database (Denmark)

    Epp, Bastian; Hots, J.; Verhey, J. L.

    2012-01-01

    Recent auditory brain stem response measurements in tinnitus subjects with normal audiograms indicate the presence of hidden hearing loss that manifests as reduced neural output from the cochlea at high sound intensities, and results from mice suggest a link to deafferentation of auditory nerve...

  5. EFFICACY OF POST ISOMETRIC RELAXATION VERSUS STATIC STRECHING IN SUBJECTS WITH CHRONIC NON SPECIFIC NECK PAIN

    Directory of Open Access Journals (Sweden)

    P.Haritha

    2015-12-01

    Full Text Available Background: Neck pain is a common problem within our society. Upper trapezius sternocleidomastoid and the levator scapulae are the most common postural muscles that tends to get shorten leading to restricted neck mobility. There is lack of evidence to allow conclusions to be drawn about the effectiveness of post isometric relaxation when compared with static stretching exercises. The aim is to find out the effectiveness of Post isometric relaxation Versus Static stretching in the subjects with chronic nonspecific neck pain. To evaluate the effectiveness of post isometric relaxation technique on pain by using Visual analoge scale, range of motion by using Universal Goniometry, and functional disability by using Neck Disability Index in chronic nonspecific neck pain. Methods: A convenient sample of thirty seven subjects was diagnosed with nonspecific neck pain was randomly allocated to one of the two treatment groups on the basis of the inclusion criteria. The experimental group (n=15 received three sessions of post isometric relaxation technique for trapezius, sternocleidomastoid and the levator scapulae and control group (n=15 received the three sessions of static stretching for trapezius, sternocliedomastiod and levator scapulae for four weeks. Results: Non parametric tests demonstrated a statistically significant difference with experimental group showing greater improvement in ROM, VAS, and NDI than the control group and significant difference within the group also. Conclusion: This study concluded and the results reflected that post isometric relaxation technique group had better improvement in reduction of pain, improvement in the range of motion, and increased neck functional activities than the static stretching group.

  6. A Model of Population and Subject (MOPS) Intensities With Application to Multiple Sclerosis Lesion Segmentation.

    Science.gov (United States)

    Tomas-Fernandez, Xavier; Warfield, Simon K

    2015-06-01

    White matter (WM) lesions are thought to play an important role in multiple sclerosis (MS) disease burden. Recent work in the automated segmentation of white matter lesions from magnetic resonance imaging has utilized a model in which lesions are outliers in the distribution of tissue signal intensities across the entire brain of each patient. However, the sensitivity and specificity of lesion detection and segmentation with these approaches have been inadequate. In our analysis, we determined this is due to the substantial overlap between the whole brain signal intensity distribution of lesions and normal tissue. Inspired by the ability of experts to detect lesions based on their local signal intensity characteristics, we propose a new algorithm that achieves lesion and brain tissue segmentation through simultaneous estimation of a spatially global within-the-subject intensity distribution and a spatially local intensity distribution derived from a healthy reference population. We demonstrate that MS lesions can be segmented as outliers from this intensity model of population and subject. We carried out extensive experiments with both synthetic and clinical data, and compared the performance of our new algorithm to those of state-of-the art techniques. We found this new approach leads to a substantial improvement in the sensitivity and specificity of lesion detection and segmentation.

  7. A Model of Population and Subject (MOPS) Intensities with Application to Multiple Sclerosis Lesion Segmentation

    Science.gov (United States)

    Tomas-Fernandez, Xavier; Warfield, Simon K.

    2015-01-01

    White matter (WM) lesions are thought to play an important role in multiple sclerosis (MS) disease burden. Recent work in the automated segmentation of white matter lesions from MRI has utilized a model in which lesions are outliers in the distribution of tissue signal intensities across the entire brain of each patient. However, the sensitivity and specificity of lesion detection and segmentation with these approaches have been inadequate. In our analysis, we determined this is due to the substantial overlap between the whole brain signal intensity distribution of lesions and normal tissue. Inspired by the ability of experts to detect lesions based on their local signal intensity characteristics, we propose a new algorithm that achieves lesion and brain tissue segmentation through simultaneous estimation of a spatially global within-the-subject intensity distribution and a spatially local intensity distribution derived from a healthy reference population. We demonstrate that MS lesions can be segmented as outliers from this intensity model of population and subject (MOPS). We carried out extensive experiments with both synthetic and clinical data, and compared the performance of our new algorithm to those of state-of-the art techniques. We found this new approach leads to a substantial improvement in the sensitivity and specificity of lesion detection and segmentation. PMID:25616008

  8. Dependency-like behaviors and pain coping styles in subjects with chronic migraine and medication overuse: results from a 1-year follow-up study.

    Science.gov (United States)

    Biagianti, Bruno; Grazzi, Licia; Usai, Susanna; Gambini, Orsola

    2014-09-19

    Even after successful detoxification, 20-40% of subjects presenting chronic migraine with symptomatic medication overuse (CMwMO) relapse into medication overuse within one year. In this restrospective analysis on subjects referred to our center for detoxification, we investigated whether personality traits, dependency-like behaviors and pain coping styles predicted those who relapsed into medication overuse within the 12 months following the detoxification and those who did not. 63 patients with CMwMO were assessed for personality traits, mood and anxiety, pain coping styles and dependency-like behaviors prior-to and one year after a detoxification program. Of the 42 subjects who attended 1-year follow-up interviews, 11 relapsed into medication overuse despite a temporary benefit from detoxification and did not show clinical or psychological improvement, instead reporting increased anxiety and unmodified perpetuation of severe dependency-like behaviors. In contrast, subjects who did not relapse into medication overuse had clinical improvements that generalized to untreated domains, including decreased depressive symptoms and dependency-like behaviors, although showing unmodified low internal control over pain. Subjects who did not fall into medication overuse throughout the 12 months following the detoxification showed improved clinical, affective and dependence-related outcomes, but not pain coping strategies. Conversely, subjects who relapsed within one year into CMwMO continued to experience significant disability, pain intensity, and dependency-like behaviors. We believe that the persistence of maladaptive pain coping strategies and residual symptomatology increase the risk for recurrent relapses, against which pharmacological interventions are only partially effective. Further studies investigating predictors of relapse are needed to inform multi-disciplinary interventions for CMwMO.

  9. Head repositioning accuracy in patients with neck pain and asymptomatic subjects: concurrent validity, influence of motion speed, motion direction and target distance.

    Science.gov (United States)

    Dugailly, Pierre-Michel; De Santis, Roberta; Tits, Mathieu; Sobczak, Stéphane; Vigne, Anna; Feipel, Véronique

    2015-12-01

    Cervicocephalic kinesthetic deficiencies have been demonstrated in patients with chronic neck pain (NP). On the other hand, authors emphasized the use of different motion speeds for assessing functional impairment of the cervical spine. The objectives of this study were (1) to investigate the head repositioning accuracy in NP patients and control subjects and (2) to assess the influence of target distance, motion speed, motion direction and pain. Seventy-one subjects (36 healthy subjects and 35 NP patients; age 30-55 years) performed the head repositioning test (HRT) at two different speeds for horizontal and vertical movements and at two different distances. For each condition, six consecutive trials were sampled. The study showed the validity and reproducibility of the HRT, confirming a dysfunctional threshold of 4.5°. Normative values of head repositioning error up to 3.6° and 7.1° were identified for healthy and NP subjects, respectively. A distance of 180 cm from the target and a natural motion speed increased HRT accuracy. Repositioning after extension movement showed a significantly larger error in both groups. Intensity, duration of pain as well as pain level did not significantly alter head repositioning error. The assessment of proprioceptive performance in healthy and NP subjects allowed the validation of the HRT. The HRT is a simple, not expensive and fast test, easily implementable in daily practice to assess and monitor treatment and evolution of proprioceptive cervical deficits.

  10. Relationship Between Lower Extremity Strength and Subjective Function in Individuals With Patellofemoral Pain.

    Science.gov (United States)

    Glaviano, Neal R; Saliba, Susan

    2017-05-17

    Evaluate the relationship between subjective knee function and lower extremity strength in individuals with patellofemoral pain(PFP). Cohort. Laboratory. Participants were 30 individuals with PFP (20 females, 10 males; 76.02±17.88kg, 173.04±7.58cm, 24.9±7years). Subjects completed the Activities of Daily Living Scale(ADLS) and had lower extremity hip and knee isometric strength assessed. Strength was compared between low and high subjective function ADLS groups. Correlations for strength and subjective function were assessed; with a linear regression utilized to determine if strength predicted subjective function. Quadriceps strength was significantly greater in the high subjective function group 38.5±13.9%BM than low subjective function: 27.88±8.96%BM, p=.02. Significant correlations were seen between the ADLS and all five lower extremity strength measures(r=0.376-0.535). Quadriceps strength was a strong predictor of subjective function in those with PFP, explaining 28.6% of the total variance in the ADLS. Quadriceps strength was a strong predictor of subjective function when assessed by the ADLS PFP patients and significantly greater in those with higher subjective function. A strong relationship exists between self-reported function and lower extremity strength, suggesting the need to evaluate and treat lower extremity weakness.

  11. Attachment styles, pain intensity and emotional variables in women with fibromyalgia.

    Science.gov (United States)

    Peñacoba, Cecilia; Perez-Calvo, Soledad; Blanco, Sheila; Sanroman, Lucía

    2017-09-08

    This study aims to explore the relations between attachment styles and pain intensity and certain emotional variables (anxiety, depression and alexithymia) in a sample of fibromyalgia patients, in comparison with healthy women. Data were collected from 146 women with fibromyalgia and 122 healthy women. The variables studied were attachment style, pain intensity, anxiety, depression and alexithymia dimensions. Patients with fibromyalgia showed lower percentages of secure attachment style (69.9% vs. 86%) whilst showing higher avoidant attachment (19.8% vs. 7.4%), as well as increased numbers of anxious-ambivalent attachment (10.3% vs. 6.6%) than healthy women (X2  = 9.915, p = .007). Also, fibromyalgia patients showed significantly higher scores in two of the insecure attachment factors (p attachment factor (p = .008) in comparison with healthy women. Higher scores of alexithymia were found in women showing anxious-ambivalent and avoidant attachment styles in comparison with those showing a secure attachment style, regardless of the group they belonged to. In fibromyalgia patients, higher anxiety (p = .005) was found among the women with anxious-ambivalent attachment styles (Mean = 15.15; SD = 1.15) in comparison with those with secure attachment style (Mean = 11.18; SD = .45). No relation was found between attachment style and pain intensity. Avoidant attachment seems to carry out a contradictory role and warrants further research. The results found seem to highlight the need for the Attachment-Diathesis Model of Chronic Pain to include attachment styles as a predictor of the emotional experience of pain in fibromyalgia patients. © 2017 Nordic College of Caring Science.

  12. Association between intensity of pain and impairment in onset and activation of the deep cervical flexors in patients with persistent neck pain.

    Science.gov (United States)

    Falla, Deborah; O'Leary, Shaun; Farina, Dario; Jull, Gwendolen

    2011-05-01

    This study evaluates the relationship between clinical symptoms and the function of the deep cervical flexor muscles in women with persistent neck pain. Thirty-two women with a history of neck pain more than 6 months participated in the study. Measures for neck pain area, intensity, duration, and perceived disability were taken. Electromyography was acquired from the deep cervical flexor muscles by a nasopharyngeal electrode suctioned over the posterior oropharyngeal wall as the patients performed 2 tasks: rapid arm movements (shoulder flexion and extension) and isometric craniocervical flexion contractions. The patients' average score for the Neck Disability Index (0 to 50) was 11.0±2.6 and their average pain intensity rated on a visual analog scale (0 to 10) was 4.7±1.8. A correlation was observed between the average intensity of pain rated on the visual analog scale and the normalized electromyography amplitude recorded from the deep cervical flexors during the craniocervical flexion contractions (r=-0.36; PDisability Index score of the patient. This study shows a relationship between the levels of neck pain intensity and the function of the deep cervical flexor muscles in women with persistent neck pain but not in other clinical features, such as location or duration of the disorder. These findings may partially explain the heterogeneity in motor control impairments in patients with neck pain.

  13. Impact of postpartum lumbopelvic pain on disability, pain intensity, health-related quality of life, activity level, kinesiophobia, and depressive symptoms.

    Science.gov (United States)

    Gutke, Annelie; Lundberg, Mari; Östgaard, Hans Christian; Öberg, Birgitta

    2011-03-01

    The majority of women recover from pregnancy-related lumbopelvic pain within 3 months of delivery. Since biomechanical and hormonal changes from pregnancy are largely reversed by 3 months postpartum, consequently, it is assumed that other factors might interfere with recovery. Relative to the fear-avoidance model and with reference to previous studies, we chose to investigate some pre-decided factors to understand persistent lumbopelvic pain. The evaluation of lumbopelvic pain postpartum is mostly based on self-administered questionnaires or interviews. Clinical classification of the lumbopelvic pain may increase our knowledge about postpartum subgroups. Two hundred and seventy-two consecutively registered pregnant women evaluated at 3 months postpartum, answered questionnaires concerning disability (Oswestry disability index), pain intensity on visual analog scale, health-related quality of life (HRQL, EQ5D), activity level, depressive symptoms (Edinburgh postnatal Depression Scale) and kinesiophobia (Tampa Scale for Kinesiophobia). Women were classified into lumbopelvic pain subgroups according to mechanical assessment of the lumbar spine, pelvic pain provocation tests, standard history, and pain drawings. Multiple linear regression analysis was performed to explain the variance of disability. Thirty-three percent of postpartum women were classified with lumbopelvic pain; 40% reported moderate to severe disability. The impacts were similar among subgroups. Pain intensity, HRQL and kinesiophobia explained 53% of postpartum disability due to lumbopelvic pain. In conclusion, one of three postpartum women still had some lumbopelvic pain and the impacts were equivalent irrespective of symptoms in lumbar or pelvic areas. The additional explanations of variance in disability by HRQL and kinesiophobia were minor, suggesting that pain intensity was the major contributing factor.

  14. Does Working Memory Moderate the Within-Person Associations between Pain Intensity and Negative Affect and Pain's Interference with Work Goal Pursuit?

    Science.gov (United States)

    Mun, Chung Jung; Karoly, Paul; Okun, Morris A

    2017-11-10

    Chronic pain exerts a pervasive negative influence on workers' productivity. However, a paucity of research has addressed the mechanisms underlying the pain → productivity relation. In the present study using intensive daily diary data, we examined whether working memory (WM) moderates the positive within-person associations between (a) morning pain intensity and (b) morning negative affect and later day pain's interference of work-goal pursuit. A community sample of 131 adults with chronic pain completed a battery of questionnaires, laboratory-measured WM, and a 21-day daily diary. WM did not moderate the positive within-person association between morning pain intensity and afternoon/evening ratings of pain's interference with work goal pursuit. However, individuals with higher WM showed significantly attenuated positive within-person association between morning negative affect and pain's interference with afternoon/evening work goal pursuit. WM appears to protect goal-relevant information from distractions due to negative affective arousal. The continued use of ecologically valid observational and intervention studies would shed further light on the influence of WM on the pursuit of valued work goals in the face of pain and negative affect.

  15. Slow versus fast subcutaneous heparin injections for prevention of bruising and site pain intensity.

    Science.gov (United States)

    Mohammady, Mina; Janani, Leila; Akbari Sari, Ali

    2017-11-01

    corresponding 95% confidence intervals (CIs). We pooled data using fixed-effect and random-effects models. We used GRADE to assess the overall quality of evidence supporting outcomes assessed in this review. For this update, we identified three new studies and therefore included in the Review four studies with a total of 459 participants who received subcutaneous injections of LMWH into the abdomen. Only one trial reported the injected drug volume (0.4 mL). Owing to the nature of the intervention, it was not possible to blind participants and care givers (personnel) in any included study. Two studies described blinding of outcome assessors; therefore overall, the methodological quality of included studies was moderate. The duration of the fast injection was 10 seconds and the duration of the slow injection was 30 seconds in all included studies.Three studies reported site pain intensity after each injection at different time points. Two studies assessed site pain intensity immediately after each injection, and meta-analysis on 140 participants showed no clear difference in site pain intensity immediately post slow injection when compared to fast injection (low-quality evidence; P = 0.15). In contrast, meta-analysis of two studies with 59 participants showed that 48 hours after the heparin injection, slow injection was associated with less pain intensity compared to fast injection (low-quality evidence; P = 0.007). One study (40 participants) reported pain intensity at 60 and 72 hours after injection. This study described no clear difference in site pain intensity at 60 and 72 hours post slow injection compared to fast injection.All four included studies assessed bruise size at 48 hours after each injection. Meta-analysis on 459 participants showed no difference in bruise size after slow injection compared to fast injection (low-quality evidence; P = 0.07). None of the included studies measured the incidence of haematoma as an outcome. We found four RCTs that evaluated the

  16. Hypnosis, Massage Relaxation, Endorphins and Pain Intensity First Stage of Normal Delivery Primapara BPS Semarang

    OpenAIRE

    W, Melyana N; Irmawati, Irmawati; Wijayati, Sugih

    2012-01-01

    The purpose of this study was to determine the effectiveness of the method of hypnosis, massage and relaxation endorphins to the intensity of pain during on the first stage of Normal Delivery in BPS (Private Practice Midwives) Semarang City area. The research method used was non-equivalent experimental design, a sample of 20 mothers maternity on each - each treatment group. Test used was ANOVA test followed Post Hock Tukey test. These results obtained p-value = 0.001 (significant) followed po...

  17. EFFICACY OF POST ISOMETRIC RELAXATION VERSUS STATIC STRECHING IN SUBJECTS WITH CHRONIC NON SPECIFIC NECK PAIN

    OpenAIRE

    P Haritha; Shanthi, C; Madhavi, K.

    2015-01-01

    Background: Neck pain is a common problem within our society. Upper trapezius sternocleidomastoid and the levator scapulae are the most common postural muscles that tends to get shorten leading to restricted neck mobility. There is lack of evidence to allow conclusions to be drawn about the effectiveness of post isometric relaxation when compared with static stretching exercises. The aim is to find out the effectiveness of Post isometric relaxation Versus Static stretching in the subjects wit...

  18. Short-term test-retest-reliability of conditioned pain modulation using the cold-heat-pain method in healthy subjects and its correlation to parameters of standardized quantitative sensory testing.

    Science.gov (United States)

    Gehling, Julia; Mainka, Tina; Vollert, Jan; Pogatzki-Zahn, Esther M; Maier, Christoph; Enax-Krumova, Elena K

    2016-08-05

    Conditioned Pain Modulation (CPM) is often used to assess human descending pain inhibition. Nine different studies on the test-retest-reliability of different CPM paradigms have been published, but none of them has investigated the commonly used heat-cold-pain method. The results vary widely and therefore, reliability measures cannot be extrapolated from one CPM paradigm to another. Aim of the present study was to analyse the test-retest-reliability of the common heat-cold-pain method and its correlation to pain thresholds. We tested the short-term test-retest-reliability within 40 ± 19.9 h using a cold-water immersion (10 °C, left hand) as conditioning stimulus (CS) and heat pain (43-49 °C, pain intensity 60 ± 5 on the 101-point numeric rating scale, right forearm) as test stimulus (TS) in 25 healthy right-handed subjects (12females, 31.6 ± 14.1 years). The TS was applied 30s before (TSbefore), during (TSduring) and after (TSafter) the 60s CS. The difference between the pain ratings for TSbefore and TSduring represents the early CPM-effect, between TSbefore and TSafter the late CPM-effect. Quantitative sensory testing (QST, DFNS protocol) was performed on both sessions before the CPM assessment. paired t-tests, Intraclass correlation coefficient (ICC), standard error of measurement (SEM), smallest real difference (SRD), Pearson's correlation, Bland-Altman analysis, significance level p test-retest-reliability of the early CPM-effect using the heat-cold-pain method in healthy subjects achieved satisfying results in terms of the ICC. The SRD of the early CPM effect showed that an individual change of > 20 NRS can be attributed to a real change rather than chance. The late CPM-effect was weaker and not reliable.

  19. Influence of specific muscle training on pain, activity limitation and kinesiophobia in women with back pain post-partum--a 'single-subject research design'.

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    Gustafsson, Johanna; Nilsson-Wikmar, Lena

    2008-03-01

    Many women suffer from back pain and experience activity limitation post-partum. To our knowledge the physiological factors and physiotherapy related to back pain post-partum have received limited evaluation and the effectiveness of specific physiotherapeutic approaches to exercise should be tested. In addition, there has been limited research on kinesiophobia in women with back pain post-partum. The purpose of the current study was to test the influence of specific trunk muscle training on pain, activity limitation and kinesiophobia in 10 subjects with back pain post-partum. The treatment consisted of specific deep muscle training of the transversus abdominus and multifidus muscles. Pain was rated based on the visual analogue scale (VAS) and pain drawings. Activity limitation was recorded using the Disability Rating Index. Kinesiophobia was evaluated using the Swedish version of the Tampa Scale for Kinesiophobia. An A-B-A single-subject research design was used and a number of measurements were obtained during each phase. The analysis consisted of a visual inspection and a two standard deviation band test (2-SD). The visual analysis showed a trend towards reduced pain and activity limitation for all 10 subjects. The 2-SD test showed mixed results among all subjects. In addition, all subjects reported kinesiophobia before and after treatment. Individual specific deep muscle training of the transversus abdominus and multifidus muscles reduced pain and activity limitation in women with back pain post-partum. Further research is needed to determine more precisely how kinesiophobia affects women with back pain post-partum.

  20. Differences in cortical coding of heat evoked pain beyond the perceived intensity: an fMRI and EEG study.

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    Haefeli, Jenny; Freund, Patrick; Kramer, John L K; Blum, Julia; Luechinger, Roger; Curt, Armin

    2014-04-01

    Imaging studies have identified a wide network of brain areas activated by nociceptive stimuli and revealed differences in somatotopic representation of highly distinct stimulation sites (foot vs. hand) in the primary (S1) and secondary (S2) somatosensory cortices. Somatotopic organization between adjacent dermatomes and differences in cortical coding of similarly perceived nociceptive stimulation are less well studied. Here, cortical processing following contact heat nociceptive stimulation of cervical (C4, C6, and C8) and trunk (T10) dermatomes were recorded in 20 healthy subjects using functional magnetic resonance imaging (fMRI) and electroencephalography (EEG). Stimulation of T10 compared with the C6 and C8 revealed significant higher response intensity in the left S1 (contralateral) and the right S2 (ipsilateral) even when the perceived pain was equal between stimulation sites. Accordingly, contact heat evoked potentials following stimulation of T10 showed significantly higher N2P2 amplitudes compared to C6 and C8. Adjacent dermatomes did not reveal a distinct somatotopical representation. Within the assessed cervical and trunk dermatomes, nociceptive cortical processing to heat differs significantly in magnitude even when controlling for pain perception. This study provides evidence that controlling for pain perception is not sufficient to compare directly the magnitude of cortical processing [blood oxygen level dependence (BOLD) response and amplitude of evoked potentials] between body sites. Copyright © 2013 Wiley Periodicals, Inc.

  1. Effect of preoperative gabapentin on pain intensity and development of chronic pain after carpal tunnel syndrome surgical treatment in women: randomized, double-blind, placebo-controlled study

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    Eduardo Jun Sadatsune

    Full Text Available ABSTRACT CONTEXT AND OBJECTIVES: Effective postoperative analgesia is important for reducing the incidence of chronic pain. This study evaluated the effect of preoperative gabapentin on postoperative analgesia and the incidence of chronic pain among patients undergoing carpal tunnel syndrome surgical treatment. DESIGN AND SETTINGS: Randomized, double-blind controlled trial, Federal University of São Paulo Pain Clinic. METHODS: Forty patients aged 18 years or over were randomized into two groups: Gabapentin Group received 600 mg of gabapentin preoperatively, one hour prior to surgery, and Control Group received placebo. All the patients received intravenous regional anesthesia comprising 1% lidocaine. Midazolam was used for sedation if needed. Paracetamol was administered for postoperative analgesia as needed. Codeine was used additionally if the paracetamol was insufficient. The following were evaluated: postoperative pain intensity (over a six-month period, incidence of postoperative neuropathic pain (over a six-month period, need for intraoperative sedation, and use of postoperative paracetamol and codeine. The presence of neuropathic pain was established using the DN4 (Douleur Neuropathique 4 questionnaire. Complex regional pain syndrome was diagnosed using the Budapest questionnaire. RESULTS: No differences in the need for sedation, control over postoperative pain or incidence of chronic pain syndromes (neuropathic or complex regional pain syndrome were observed. No differences in postoperative paracetamol and codeine consumption were observed. CONCLUSIONS: Preoperative gabapentin (600 mg did not improve postoperative pain control, and did not reduce the incidence of chronic pain among patients undergoing carpal tunnel syndrome surgery.

  2. Psychophysiologic and affective parameters associated with pain intensity of cardiac cardioverter defibrillator shock discharges.

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    Baumert, Jens; Schmitt, Claus; Ladwig, Karl-Heinz

    2006-01-01

    Pain caused by intracardiac shock discharge of an implanted cardioverter defibrillator (ICD) is an important clinical issue in the treatment of ICD patients. The present study aimed to examine whether the strength of perceived shock pain is influenced by affective and psychophysiologic parameters. Among 204 ICD patients drawn from the German Heart Center Munich, 95 patients (46.6%) experienced > or =1 shock discharge. Pain perception (PPC) was measured by a visual analog scale ranged from 0 to 100 points. Standard instruments were administered to measure psychological distress. A startle paradigm was assessed to measure psychophysiologic arousal with skin conductance responses (SCR) and electromyogram responses (EMG) as dependant variables. Classification and regression tree (CART) analysis was applied to assess the effects of psychodiagnostic and psychophysiologic parameters on pain perception. Mean ICD shock PPC was 53.7 points (SD 31.6), with a median of 59.0 points (interquartile range 30-80). Pain intensity was highly associated with shock discomfort (p one shock experience and an anxiety score >7 (Symptom Checklist-90) expressed the highest mean PPC (74.8 points; 95% CI, 60.5-89.2). Without heightened anxiety, an increased EMG amplitude and impaired EMG habituation yielded a mean PPC of 71.2 (95% CI, 61.6-80.9). Augmented PPC of ICD shocks is predominantly associated with the number of perceived shocks, postshock anxiety, and accompanied by heightened levels of EMG magnitude and impaired EMG habituation, which points to sensitization of central neural structures.

  3. Pelvic girdle pain - associations between risk factors in early pregnancy and disability or pain intensity in late pregnancy: a prospective cohort study

    Science.gov (United States)

    2010-01-01

    Background Recent studies have shown high prevalence rates for pelvic girdle pain (PGP) in pregnancy. Some risk factors for developing PGP have been suggested, but the evidence is weak. Furthermore there is almost no data on how findings from clinical examinations are related to subsequent PGP. The main purpose for this study was to study the associations between socio-demographical, psychological and clinical factors measured at inclusion in early pregnancy and disability or pain intensity in gestation week 30. Methods This is a prospective cohort study following women from early to late pregnancy. Eligible women were recruited at their first attendance at the maternity care unit. 268 pregnant women answered questionnaires and underwent clinical examinations in early pregnancy and in gestation week 30. We used scores on disability and pain intensity in gestation week 30 as outcome measures to capture the affliction level of PGP. Multiple linear regression analysis was used to study the associations between potential risk factors measured in early pregnancy and disability or pain intensity in gestation week 30. Results Self-reported pain locations in the pelvis, positive posterior pelvic pain provocation (P4) test and a sum of pain provocation tests in early pregnancy were significantly associated with disability and pain intensity in gestation week 30 in a multivariable statistic model. In addition, distress was significantly associated with disability. The functional active straight leg raise (ASLR) test, fear avoidance beliefs and the number of pain sites were not significantly associated with either disability or pain intensity. Conclusions The results suggest that a clinical examination, including a few tests, performed in early pregnancy may identify women at risk of a more severe PGP late in pregnancy. The identification of clinical risk factors may provide a foundation for development of targeted prevention strategies. PMID:20465798

  4. Pelvic girdle pain - associations between risk factors in early pregnancy and disability or pain intensity in late pregnancy: a prospective cohort study

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    Mengshoel Anne

    2010-05-01

    Full Text Available Abstract Background Recent studies have shown high prevalence rates for pelvic girdle pain (PGP in pregnancy. Some risk factors for developing PGP have been suggested, but the evidence is weak. Furthermore there is almost no data on how findings from clinical examinations are related to subsequent PGP. The main purpose for this study was to study the associations between socio-demographical, psychological and clinical factors measured at inclusion in early pregnancy and disability or pain intensity in gestation week 30. Methods This is a prospective cohort study following women from early to late pregnancy. Eligible women were recruited at their first attendance at the maternity care unit. 268 pregnant women answered questionnaires and underwent clinical examinations in early pregnancy and in gestation week 30. We used scores on disability and pain intensity in gestation week 30 as outcome measures to capture the affliction level of PGP. Multiple linear regression analysis was used to study the associations between potential risk factors measured in early pregnancy and disability or pain intensity in gestation week 30. Results Self-reported pain locations in the pelvis, positive posterior pelvic pain provocation (P4 test and a sum of pain provocation tests in early pregnancy were significantly associated with disability and pain intensity in gestation week 30 in a multivariable statistic model. In addition, distress was significantly associated with disability. The functional active straight leg raise (ASLR test, fear avoidance beliefs and the number of pain sites were not significantly associated with either disability or pain intensity. Conclusions The results suggest that a clinical examination, including a few tests, performed in early pregnancy may identify women at risk of a more severe PGP late in pregnancy. The identification of clinical risk factors may provide a foundation for development of targeted prevention strategies.

  5. Pelvic girdle pain--associations between risk factors in early pregnancy and disability or pain intensity in late pregnancy: a prospective cohort study.

    Science.gov (United States)

    Robinson, Hilde Stendal; Veierød, Marit B; Mengshoel, Anne Marit; Vøllestad, Nina K

    2010-05-13

    Recent studies have shown high prevalence rates for pelvic girdle pain (PGP) in pregnancy. Some risk factors for developing PGP have been suggested, but the evidence is weak. Furthermore there is almost no data on how findings from clinical examinations are related to subsequent PGP. The main purpose for this study was to study the associations between socio-demographical, psychological and clinical factors measured at inclusion in early pregnancy and disability or pain intensity in gestation week 30. This is a prospective cohort study following women from early to late pregnancy. Eligible women were recruited at their first attendance at the maternity care unit. 268 pregnant women answered questionnaires and underwent clinical examinations in early pregnancy and in gestation week 30. We used scores on disability and pain intensity in gestation week 30 as outcome measures to capture the affliction level of PGP. Multiple linear regression analysis was used to study the associations between potential risk factors measured in early pregnancy and disability or pain intensity in gestation week 30. Self-reported pain locations in the pelvis, positive posterior pelvic pain provocation (P4) test and a sum of pain provocation tests in early pregnancy were significantly associated with disability and pain intensity in gestation week 30 in a multivariable statistic model. In addition, distress was significantly associated with disability. The functional active straight leg raise (ASLR) test, fear avoidance beliefs and the number of pain sites were not significantly associated with either disability or pain intensity. The results suggest that a clinical examination, including a few tests, performed in early pregnancy may identify women at risk of a more severe PGP late in pregnancy. The identification of clinical risk factors may provide a foundation for development of targeted prevention strategies.

  6. Effect of a single session of ear acupuncture on pain intensity and postural control in individuals with chronic low back pain: a randomized controlled trial

    Science.gov (United States)

    Ushinohama, Andrea; Cunha, Bianca P.; Costa, Leonardo O. P.; Barela, Ana M. F.; de Freitas, Paulo B.

    2016-01-01

    ABSTRACT Background Ear Acupuncture (EA) is a form of acupuncture in which needles are applied to the external ear and has been used in multiple painful conditions. Low back pain (LBP) is highly prevalent in active individuals and causes high economic burden to health systems worldwide. LBP affects the person’s ability to keep balance, especially in challenging conditions. Objective The aim of the study was to examine the effects of a single session of EA on pain intensity and body sway during postural tasks. Method Eighty adults with LBP and pain intensity equal to or greater than 4 (0-10 scale) were randomly allocated (1:1) to EA group (EAG) or placebo group (PG). Initially, the level of pain intensity was assessed. Next, participants stood still on a force plate either with feet in parallel or in semi-tandem and with eyes open or closed. Then, the EAG was treated with EA for 20 min and the PG was treated with detuned ultrasound. After the treatment, pain intensity was assessed again and the postural test was repeated. Pain intensity was the primary outcome and center of pressure sway area and speed were the secondary outcomes measured. Results Results revealed that pain intensity decreased in both groups after treatment, but decreased more in the EAG. For postural control, no effect of treatment and no interaction between treatment and postural condition on body sway were found. Conclusion Those findings indicate that EA is better than placebo to reduce pain, but neither treatment has any effect on postural control. PMID:27556389

  7. Effect of a single session of ear acupuncture on pain intensity and postural control in individuals with chronic low back pain: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Andrea Ushinohama

    2016-01-01

    Full Text Available ABSTRACT Background Ear Acupuncture (EA is a form of acupuncture in which needles are applied to the external ear and has been used in multiple painful conditions. Low back pain (LBP is highly prevalent in active individuals and causes high economic burden to health systems worldwide. LBP affects the person’s ability to keep balance, especially in challenging conditions. Objective The aim of the study was to examine the effects of a single session of EA on pain intensity and body sway during postural tasks. Method Eighty adults with LBP and pain intensity equal to or greater than 4 (0-10 scale were randomly allocated (1:1 to EA group (EAG or placebo group (PG. Initially, the level of pain intensity was assessed. Next, participants stood still on a force plate either with feet in parallel or in semi-tandem and with eyes open or closed. Then, the EAG was treated with EA for 20 min and the PG was treated with detuned ultrasound. After the treatment, pain intensity was assessed again and the postural test was repeated. Pain intensity was the primary outcome and center of pressure sway area and speed were the secondary outcomes measured. Results Results revealed that pain intensity decreased in both groups after treatment, but decreased more in the EAG. For postural control, no effect of treatment and no interaction between treatment and postural condition on body sway were found. Conclusion Those findings indicate that EA is better than placebo to reduce pain, but neither treatment has any effect on postural control.

  8. EFFECT OF ECCENTRIC EXERCISE PROGRAMME ON PAIN AND GRIP STRENGTH FOR SUBJECTS WITH MEDIAL EPICONDYLITIS

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    Mishra Prashant Akhilesh

    2014-04-01

    Full Text Available Background and Objective: Therapeutic eccentric exercise may provide both a structural and functional benefit during tendinopathy rehabilitation. The objective is to find the effect of eccentric exercises on improvement of pain and grip strength for subjects with Medial Epicondylitis. Method: Pre to post test experimental study design randomized thirty subjects with medial epicondylitis, 15 each into Group A and Group B. Group B subjects were treated with conventional therapy and Eccentric exercises. Group A subjects were treated with conventional therapy. Results: When means of post intervention were compared using Independent ‘t’ between groups there was no statistically significant difference in improvements obtained in VAS scores and grip strength. There was a statistically significant change in means of VAS score and Grip strength when means were analyzed by using Paired‘t’ test and Wilcoxon signed rank test within the groups with positive percentage of change. Conclusion: It is concluded that four weeks of Eccentric Exercise Programme combined with conventional therapy shown significant effect on improving pain and Grip strength, however the improvement obtained has no difference when compared with control conventional treatment for Subjects with Medial Epicondylitis.

  9. The safety and efficacy of pregabalin for treating subjects with fibromyalgia and moderate or severe baseline widespread pain.

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    Clair, Andrew; Emir, Birol

    2016-01-01

    To evaluate pregabalin's efficacy (≤12 weeks) for pain relief and sleep improvement in patients with fibromyalgia (FM) and moderate-to-severe baseline pain. Data were pooled from five randomized, double-blind, placebo-controlled, phase III clinical trials of pregabalin (300-450 mg/day) for FM treatment. Subjects, aged ≥18 years, had moderate (≥4-pregabalin and placebo in both baseline pain severity groups. Mean ± SD baseline pain severity scores were equivalent between pregabalin and placebo within moderate (5.8 ± 0.8) or severe pain (7.9 ± 0.7) subgroups. All subjects reported reduced pain and improved sleep quality through Weeks 8 and 12, with larger effects observed with pregabalin over placebo and with baseline severe over moderate pain (all p Pregabalin was generally well tolerated, AE findings were consistent with previously published trials, and AE profiles were similar between moderate and severe baseline pain subgroups. Limitations of this pooled analysis included differences in individual trial designs (e.g., dosing schedules, racial distribution, exclusion criteria that did not enroll mild severity patients). Pregabalin was efficacious through 12 weeks for reducing pain and improving sleep quality in FM patients with baseline moderate or severe pain, with larger effects in the baseline severe pain subgroup. AEs were consistent with pregabalin's known safety profile and did not differ between moderate and severe pain subgroups.

  10. Pregabalin reduces opioid consumption and hyperalgesia but not pain intensity after laparoscopic donor nephrectomy.

    Science.gov (United States)

    Myhre, M; Romundstad, L; Stubhaug, A

    2017-11-01

    Gabapentinoids are increasingly used to reduce acute postoperative pain, opioid consumption and opioid-related adverse effects. We explored the opioid-sparing, analgesic and anti-hyperalgesic effect of perioperative administered pregabalin in laparoscopic living donor nephrectomy. In this randomized controlled trial, 80 patients were recruited and randomized to receive pregabalin 150 mg twice daily or placebo on the day of surgery and the first postoperative day as part of a multimodal analgesic regimen. Primary outcome was opioid consumption 0-48 h after surgery. Secondary outcomes were pain intensity at rest and with movement 0-48 h after surgery using the 0-10 Numeric Rating Scale and incisional hyperalgesia measured 24 h post-surgery and at hospital discharge. Further secondary outcomes were adverse effects. Persistent post-surgical pain was registered 6 weeks, 6 and 12 months after surgery. Pregabalin significantly reduced opioid consumption compared with placebo 0-48 h after surgery (median mg [25th, 75th percentile]); 29.0 (22.0-45.5) vs. 41.8 (25.8-63.6) (P = 0.04). Pain intensity 0-48 h after surgery calculated as area under the pain (NRS) vs. time curve was not statistically different between groups at rest (P = 0.12) or with movement (P = 0.21). Pregabalin decreased incisional hyperalgesia 24 h after surgery (median cm [25th, 75th percentile] 8.5 (1.0-18.5) vs. 15.5 (9.5-24.0) (P = 0.02). Nausea (P ≤ 0.01), use of antiemetics (P ≤ 0.01) and pain-related sleep interference (P = 0.02) were reduced with pregabalin. Perioperative pregabalin added to a multimodal analgesic regimen was opioid-sparing, but made no difference to pain intensity score 0-48 h after surgery. Pregabalin may reduce incisional hyperalgesia on the first day after surgery. © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  11. Changes in pain intensity and oral health-related quality of life in patients with temporomandibular disorders during stabilization splint therapy--a pilot study.

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    Alajbeg, Iva Z; Gikić, Marijana; Valentić-Peruzović, Melita

    2014-03-01

    The aim of the study was to evaluate changes in pain intensity and self-perceived quality of life in patients with temporomandibular disorders (TMD) during stabilization splint therapy. The hypothesis was that the clinical subtype of TMD, depending on whether pain is of muscular or temporomandibular joint origin, and pain chronicity (acute vs. chronic pain) differently affect treatment response. Thirty patients were included and treated with a stabilization splint in a 6-month clinical trial. Treatment outcomes included pain-free maximal mouth opening (MO), assisted maximal MO, path of MO, asymmetry in lateral excursions, spontaneous pain intensity (visual analog scale, VAS), and self-perceived quality of life (Oral Health Impact Profile, OHIP-14). Overall, VAS and OHIP-14 scores changed significantly over time (VAS: F = 80.85, p quality of life did not differ significantly between MP and DD groups (F = 0.213, p = 0.847, effect size = 0.008), or between AP and CP patients (F = 0.816, p = 0.489, effect size = 0.029). Linear regression analysis was used to assess the contribution of each predictor variable to the explanation of the OHIP summary score variance. Results showed pain reduction (coefficient = 0.303; 95% CI: 0.120 to 0.485) and MO increase (coefficient = 0.149; 95% CI: 0.037 to 0.260) to be independent predictors of the OHIP-14 summary score changes (R2 = 0.453), whereas other variables did not affect treatment outcome as assessed by OHIP-14. In conclusion, during 6-month stabilization splint therapy, significant changes in VAS and OHIP-14 summary scores were found. However, there were no significant differences in improvement rates between subjects with acute and chronic pain. Furthermore, no significant differences in improvement rates were found depending on whether pain was of muscular or temporomandibular joint origin.

  12. Infield masticatory muscle activity in subjects with pain-related temporomandibular disorders diagnoses.

    Science.gov (United States)

    Khawaja, S N; McCall, W; Dunford, R; Nickel, J C; Iwasaki, L R; Crow, H C; Gonzalez, Y

    2015-04-01

    Pain-related temporomandibular disorders (TMDs) are the most prevalent conditions among TMDs. There is contrasting evidence available for association of pain-related TMD and masticatory muscle activity (MMA). The present investigation assesses the associations between MMA levels of masseter and temporalis muscles during awake and sleep among pain-related TMD diagnostic groups. The department of Oral Diagnostic Sciences, University at Buffalo. Twenty females and six males participated in this study. Using the diagnostic criteria for temporomandibular disorders (DC-TMDs), participants were diagnostically categorized. Subjects used a custom monitoring system, which recorded infield muscle activities. A factorial model tested for association between independent variable (muscle, time period, MMA level, and diagnostic group) effects and the logarithm of MMA. Greenhouse-Geisser test was used to determine any statistically significant associations (p≤0.003). No statistically significant association was found between four-way, three-way, and two-way analyses. However, among the main effects, range of magnitudes was the only variable to be statistically significant. Although the data suggest a trend of increased masseter MMA in the pain-related TMD diagnoses group both during awake and sleep time periods, such observation is not maintained for the temporalis muscle. In addition, temporalis MMA was found to be higher in the pain-related TMD diagnoses group only at extreme activity levels (<25 and ≥80% ranges). This data support the association between masticatory muscle hyperactivity and painful TMD conditions. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. In-field masticatory muscle activity in subjects with pain-related TMD diagnoses

    Science.gov (United States)

    Khawaja, S.N.; McCall, W.; Dunford, R.; Nickel, J.C.; Iwasaki, L.R.; Crow, H.C.; Gonzalez, Y.

    2015-01-01

    Objectives Pain-related Temporomandibular disorders (TMD) are the most prevalent conditions among TMDs. There is contrasting evidence available for association of pain-related TMD and masticatory muscle activity (MMA). The present investigation assesses the associations between MMA levels of masseter and temporalis muscles during awake and sleep among pain-related TMD diagnostic groups. Setting and Sample Population The department of Oral Diagnostic Sciences, University at Buffalo. Twenty females and 6 males participated in this study. Material & Methods Using the Diagnostic Criteria for Temporomandibular Disorders (DC-TMD), participants were diagnostically categorized. Subjects used a custom monitoring system, which recorded in–field muscle activities. A factorial model tested for association between independent variable (muscle, time period, MMA level, diagnostic group) effects and the logarithm of MMA. Greenhouse–Geisser test was used to determine any statistically significant associations (p ≤ 0.003). Results No statistically significant association was found among four-way, three-way, and two-way analyses. However, among the main effects, range of magnitudes was the only variable to be statistically significant. Although the data suggest a trend of increased masseter MMA in the pain-related TMD diagnoses group both during awake and sleep time periods, such observation is not maintained for the temporalis muscle. In addition, temporalis MMA was found to be higher in the pain-related TMD diagnoses group only at extreme activity levels (<25% and ≥80% ranges). Conclusion This data support the association between masticatory muscle hyperactivity and painful-TMD conditions. PMID:25865542

  14. Comparison of Lumbo-Pelvic Stability between Patients with Chronic Low Back Pain and Healthy Subjects

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    Mohammad Hosseinifar

    2016-10-01

    Full Text Available Because of the importance of lumbo-pelvic stability as one of the suggested factors to prevent low back pain and since to date no study accomplished to compare lumbo-pelvic stability between chronic low back pain (CLBP and healthy subjects, the aim of this study was to determine and to compare lumbo-pelvic stability, lumbar lordosis, and lumbar mobility between CLBP and healthy subjects. Thirty CLBP patients and thirty healthy subjects through simple non-probability sampling participated in this cross-sectional analytical study. Lumbar lordosis, lumbar flexion and extension range of motion, lumbo-pelvic stability was measured through flexible ruler, modified modified schober test, and Pressure Biofeedback Unit (PBU respectively. ANCOVA test were used for statistical analysis (p0.05. Also lumbar lordosis, and lumbar flexion and extension range of motion did not significantly differ between two groups (p>0.05. There is no difference between CLBP and healthy subjects in terms of the lumbo-pelvic stability, lumbar lordosis, lumbar flexion and extension range of motion. The present study supported that lumbar lordosis, lumbar mobility, and lumbo-pelvic stability not affected by CLBP.

  15. Pain intensity and cervical range of motion in women with myofascial pain treated with acupuncture and electroacupuncture: a double-blinded, randomized clinical trial

    Science.gov (United States)

    Aranha, Maria F. M.; Müller, Cristina E. E.; Gavião, Maria B. D.

    2015-01-01

    BACKGROUND: Acupuncture stimulates points on the body, influencing the perception of myofascial pain or altering physiologic functions. OBJECTIVE: The aim was to evaluate the effect of electroacupuncture (EAC) and acupuncture (AC) for myofascial pain of the upper trapezius and cervical range of motion, using SHAM acupuncture as control. METHOD: Sixty women presenting at least one trigger point at the upper trapezius and local or referred pain for more than six months were randomized into EAC, AC, and SHAM groups. Eight sessions were scheduled and a follow-up was conducted after 28 days. The Visual Analog Scale assessed the intensity of local and general pain. A fleximeter assessed cervical movements. Data were analyzed using paired t or Wilcoxon's tests, ANOVA or Friedman or Kruskal-Wallis tests and Pearson's correlation (α=0.05). RESULTS: There was reduction in general pain in the EAC and AC groups after eight sessions (P<0.001). A significant decrease in pain intensity occurred for the right trapezius in all groups and for the left trapezius in the EAC and AC groups. Intergroup comparisons showed improvement in general pain in the EAC and AC groups and in local pain intensity in the EAC group (P<0.05), which showed an increase in left rotation (P=0.049). The AC group showed increases in inclination (P=0.005) sustained until follow-up and rotation to the right (P=0.032). CONCLUSION : EAC and AC were effective in reducing the pain intensity compared with SHAM. EAC was better than AC for local pain relief. These treatments can assist in increasing cervical range of motion, albeit subtly. PMID:25714602

  16. Diagnosis of retrodiscal tissue in painful temporomandibular joint (TMJ) by fluid-attenuated inversion recovery (FLAIR) signal intensity.

    Science.gov (United States)

    Kuroda, Migiwa; Otonari-Yamamoto, Mika; Sano, Tsukasa; Fujikura, Mamiko; Wakoh, Mamoru

    2015-10-01

    The purpose of the present study is to analyze the fluid-attenuated inversion recovery (FLAIR) signal intensity of the retrodiscal tissue in a painful temporomandibular joint (TMJ), and to develop a diagnostic system based on FLAIR data. The study was based on 33 joints of 17 patients referred for MR imaging of the TMJ. Regions of interest were placed over retrodiscal tissue and gray matter (GM) on FLAIR images. Using signal intensities of GM as reference points, signal intensity ratios (SIR) of retrodiscal tissue were calculated. SIRs in painful TMJ were compared with those in painless TMJ. Wilcoxon's Rank Sum Test was used to analyze the difference in SIRs between the painful and painless groups (Ppainful joints than in painless joints. FLAIR sequences provide a high signal in patients having painful TMJ, and it suggests that retrodiscal tissue in painful TMJ contains elements such as protein.

  17. Intensive blood pressure lowering increases cerebral blood flow in older subjects with hypertension.

    Science.gov (United States)

    Tryambake, Dinesh; He, Jiabao; Firbank, Michael J; O'Brien, John T; Blamire, Andrew M; Ford, Gary A

    2013-06-01

    Hypertension is associated with reduced cerebral blood flow (CBF). Intensive (blood pressure (BP) lowering in older people might give greater reduction in cardiovascular risk, but there are concerns that this might produce hypoperfusion which may precipitate falls and possibly stroke. We determined the effect of intensive compared with usual BP lowering on CBF in hypertensive older subjects. Individuals aged >70 years with a history of systolic hypertension on 1 or no BP lowering drugs were recruited from primary care (n=37; age, 75±4 years; systolic BP, >150 mm Hg) and randomized to receive intensive (target BP, hypertension increases CBF, compared with BP lowering to usual target. These findings suggest hypertension in older people shifts the autoregulatory CBF curve rightward and downward and is reversible with BP lowering.

  18. Will it hurt less if I believe I can control it? Influence of actual and perceived control on perceived pain intensity in healthy male individuals: a randomized controlled study.

    Science.gov (United States)

    Müller, Matthias J

    2012-10-01

    We explored the effects of uncontrollability and subjective helplessness (SHL) on perceived pain intensity (PPI) in 64 healthy men randomly assigned to groups receiving controllable (C) or uncontrollable (UC) painful electric skin stimuli. SHL (d = 1.43), perceived unpleasantness (d = 1.03), and PPI (d = 0.58) were more pronounced in the UC group than in the C group. Multiple regression and bootstrap analyses for testing mediation showed a direct relationship between stressor uncontrollability and PPI (r = 0.28; P controllability on pain intensity ratings is mediated mainly by ratings of SHL.

  19. TO STUDY THE EFFECT OF PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION ON BACK MUSCLE STRENGTH, PAIN AND QUALITY OF LIFE IN SUBJECTS WITH CHRONIC LOW BACK PAIN AN EXPERIMENTAL STUDY

    Directory of Open Access Journals (Sweden)

    Trupti Jadeja

    2015-10-01

    Full Text Available Background: Back pain is a prevalent and expensive problem in society. 60-80% of people will suffer at least one episode of low back pain sometime in their lives and 30-40% of these will experience low back pain each year. Therefore the need of the following study is to see the effect of proprioceptive neuromuscular facilitation on back muscle strength, pain and QOL in subjects with Chronic Low Back Pain. Methods: Ethical approval was taken before study. Forty patients with chronic low back pain (28 male, 12 female were included in the study and divided into two groups each containing 20 subjects. All the participants were signed written consent after being informed in detail about the study. Group A has been given the proprioceptive neuromuscular facilitation exercises including Rhythmic Stabilization (RST and Combination of Isotonics (COI and Conventional back exercises. Group B was given conventional back exercises only. Outcome measures were taken at the end of one month i.e. after the treatment protocol. VAS, SF-36Questionnaire and Core stability gradation were taken in both groups. Results: There is significant improvement in VAS score in both groups but Group A was having more significant improvement than Group B. Also there is significant improvement in core stability grading and SF 36 score in Group A. Conclusion: It is concluded that proprioceptive neuromuscular facilitation exercises on back is effective in reducing pain and improving core muscle strength in subjects with Chronic Low Back Pain.

  20. Patients with moderate chemotherapy-induced mucositis: pain therapy using low intensity lasers.

    Science.gov (United States)

    Nes, A G; Posso, M B S

    2005-03-01

    Intensive cancer therapy normally affects malignant and normal cells with high replication rates. Cells in the gastrointestinal tract are therefore commonly affected by cytotoxins. This often results in the development of chemotherapy-induced oral mucositis (COM). COM is the inflammatory response of the oral mucous membrane to the chemotherapy drugs. Low level laser therapy (LLLT) has proved to be effective in treating and repairing biologically damaged tissue and to reduce pain. LLLT has also proven to be an efficient method for the prevention of oral mucositis. To investigate the effect of LLLT on pain relief among patients who have developed COM. The study was performed as a clinical test with a sample consisting of 13 adult patients receiving oncology treatment. The patients were treated during a 5-day period, and the pain was measured before and after each laser application. The laser used was an AsGaAl, with a wavelength of 830 nm and a potency of 250 mW. The energy given was 35 J cm(-2). The results were analysed using the Wilcoxon test. There was a significant (P = 0.007) 67% decrease in the daily average experience of pain felt before and after each treatment, confirming that LLLT can relieve pain among patients who have developed COM. The low number of COM patients at the hospital did not allow a control group to be included in the study, and therefore the results contain a potential placebo effect. IMPLICATIONS FOR NURSING CARE: The most important benefit the authors consider to be the value for the patients of better and quicker treatment with a drastic reduction in painful mucositis.

  1. Association of pain intensity, pain-related disability, and depression with hypothalamus-pituitary-adrenal axis function in female patients with chronic temporomandibular disorders.

    Science.gov (United States)

    Jo, Kyung B; Lee, Young J; Lee, Il G; Lee, Sang C; Park, Jai Y; Ahn, Ryun S

    2016-07-01

    Patients with temporomandibular disorders (TMD) commonly experience myofascial and joint pain, pain-related disability, and other pain conditions including depression. The present study was carried out to explore the function of the hypothalamus-pituitary-adrenal (HPA) axis in relation to variables of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis II and comorbid depression in female patients with TMD. Cortisol and dehydroepiandrosterone (DHEA) levels were determined in saliva samples that had been collected at various periods after waking (0, 30, and 60min) and at nighttime (2100-2200h) from 52 female patients with chronic TMD pain and age- and gender-matched controls (n=54, 20-40 years old). There were no significant differences in the levels and diurnal patterns of cortisol and DHEA secretion between groups of patients with TMD and controls. In patients, the cortisol awakening response (CAR) or diurnal cortisol rhythm were not associated with any variables of the RDC/TMD Axis II or the Beck Depression Inventory (BDI)-II total scores. However, the ratio of overall cortisol secretion within the first hour after waking (CARauc) to overall DHEA secretion during the post-waking period (Daucawk), defined as CARauc/Daucawk, was significantly associated with pain-related RDC/TMD variables (pain intensity and pain-related disability) and BDI-II total scores. Pain intensity and pain-related disability scores were also significantly associated with BDI-II total scores. These results indicated that an increase in molar cortisol/DHEA ratio due to the dissociation between cortisol and DHEA secretion was associated with pain intensity, pain-related disability, and depression in female patients with TMD. Copyright © 2016. Published by Elsevier Ltd.

  2. The impact of pain on anxiety and depression is mediated by objective and subjective sleep characteristics in fibromyalgia patients.

    Science.gov (United States)

    Diaz-Piedra, Carolina; Catena, Andres; Miro, Elena; Martinez, Maria P; Sanchez, Ana I; Buela-Casal, Gualberto

    2014-10-01

    Pain is the cardinal feature in fibromyalgia syndrome (FM) and increases the risk of anxiety and depression. Patients with FM frequently report sleep disturbances as well. Sleep may mediate the association between pain and emotional symptoms, an idea which has been scarcely studied. The objective of this study was to uncover the role of subjective and objective sleep characteristics as mediators of the relationship between pain and anxiety and depression in FM. Fifty-five female with FM (mean age, 47.62 ± 7.64 y) were assessed to obtain self-reported measures of pain, sleep quality, anxiety and depression levels, and self-efficacy to cope with pain. An ambulatory polysomnographic recording was performed to assess sleep architecture. Subjective poor sleep quality was found in all participtants. Pain correlated with subjective and objective sleep parameters, self-efficacy, anxiety, and, marginally, with depression. The mediated regression analysis suggested that the best models to explain the impact of pain on anxiety and depression included, as mediators, subjective sleep quality, objective sleep efficiency, and self-efficacy (these models explained 34% of the variance), with objective sleep efficiency being the mediator with the highest influence (Panxiety and depression. In fact, the impact of chronic pain on the later emotional variables was mediated not only by self-efficacy but also by subjective sleep quality and, especially, by objective sleep efficiency.

  3. Compliance and subjective relief by corset treatment in chronic low back pain.

    Science.gov (United States)

    Alaranta, H; Hurri, H

    1988-01-01

    The aim of this questionnaire-based 12-month follow-up study of 113 patients was to elucidate patient compliance and subjective help achieved with a first, elastic or semirigid corset in chronic, idiopathic low back pain. Subjective help obtained from the corset was reported as excellent or good in 37% of the returned questionnaires. A total of 60% reported having worn the corset even during the preceding month. Low semirigid and elastic models were found to be better by the males and high semirigid ones by the females (p less than 0.001). Age, height, weight, body mass index, retirement or physical strenuousness of work showed no statistically significant correlation with the subjective relief gained from the corset. It is important that sufficient time be allocated to fitting the corset and that adequate information be provided about wearing the brace and about suitable trunk exercises.

  4. EFFECTIVENESS OF NEURAL TISSUE MOBILISATION ON PAIN, PAIN FREE PASSIVE SLR RANGE OF MOTION AND FUNCTIONAL DISABILITY IN LOW BACK ACHE SUBJECTS WITH SCIATICA

    Directory of Open Access Journals (Sweden)

    V. B. Geethika

    2015-10-01

    Full Text Available Background: Low back pain is a common, benign, and self-limiting disease that affects almost all persons, with a lifetime prevalence of up to 84%. In contrast, sciatica affects only 40 % of all persons in the Western industrialized countries. In sciatica, pain radiates down the legs, below the knee along the distribution of sciatic nerve. Nerve root compression is the most common cause of sciatica. Neuro dynamics or Neural Tissue Mobilization is relatively new approach in treatment of neuro musculoskeletal disorders. The aim of the study to determine the effectiveness of Neural Tissue mobilization on pain, pain free passive SLR ROM &functional disability in LBA subjects with Sciatica. Objective of the study is to study and compare the effectiveness of Neural tissue mobilization in LBA subjects with sciatica in terms of pain, pain free SLR ROM and Oswestry Disability Index. Methods: 30 subjects were selected by simple random sampling and assigned in to Control(n=15 &Experimental group(n=15.The subjects in control group were given conventional physiotherapy and those in Experimental group were given Neural Tissue Mobilization in addition to conventional therapy. All the participants were assessed with VAS, ODI and pain free passive SLR ROM. Results: After the analysis, the results were found to be significant improvement in pain, pain free SLR ROM, ODI in both groups (p< 0.00.But there is a high significance in Experimental group when compared to control group. Conclusion: Results suggest that NEURAL TISSUE MOBILIZATION along with conventional therapy is more effective in reducing pain, decreasing disability and improving SLR ROM.

  5. The effects of topical Arnica on performance, pain and muscle damage after intense eccentric exercise.

    Science.gov (United States)

    Pumpa, Kate L; Fallon, Kieran E; Bensoussan, Alan; Papalia, Shona

    2014-01-01

    The aim of the study was to determine if topical Arnica is effective in reducing pain, indicators of inflammation and muscle damage, and in turn improve performance in well-trained males experiencing delayed onset muscle soreness (DOMS). Twenty well-trained males matched by maximal oxygen uptake (V̇O2 Max) completed a double-blind, randomised placebo-controlled trial. Topical Arnica was applied to the skin superficial to the quadriceps and gastrocnemius muscles immediately after a downhill running protocol designed to induce DOMS. Topical Arnica was reapplied every 4 waking hours for the duration of the study. Performance measures (peak torque, countermovement and squat jump), pain assessments (visual analogue scale (VAS) and muscle tenderness) and blood analysis (interleukin-1 beta, interleukin-6, tumour necrosis factor-alpha, C-reactive protein, myoglobin and creatine kinase) were assessed at seven time points over five days (pre-, post-, 4, 24, 48, 72 and 96 hours after the downhill run). Participants in the topical Arnica group reported less pain as assessed through muscle tenderness and VAS 72 hours post-exercise. The application of topical Arnica did not affect any performance assessments or markers of muscle damage or inflammation. Topical Arnica used immediately after intense eccentric exercise and for the following 96 hours did not have an effect on performance or blood markers. It did however demonstrate the possibility of providing pain relief three days post-eccentric exercise.

  6. Correlation between skin surface temperature over masticatory muscles and pain intensity in women with myogenous temporomandibular disorder.

    Science.gov (United States)

    Dibai-Filho, Almir Vieira; Costa, Ana Cláudia de Souza; Packer, Amanda Carine; Rodrigues-Bigaton, Delaine

    2013-01-01

    Pain is a common clinical manifestation in individuals with temporomandibular disorder (TMD). The literature report changes in microcirculation in this condition. The aim of the present study was to correlate skin surface temperature at the central point of the masticatory muscles with pain intensity in women with myogenous TMD. The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and the visual analogue scale (VAS) were used to divide 40 female university students into four groups: control group (n=10), mild pain group (n=10), moderate pain group (n=10) and severe pain group (n=10). Infrared thermography was used to assess the masticatory muscles. No significant correlations were found between pain intensity and skin surface temperature over the left masseter (p=0.368), right masseter (p=0.618), left anterior temporalis (p=0.293) and right anterior temporalis (p=0.922) muscles. No correlations were found between pain intensity and asymmetry of the masseter (p=0.375) and anterior temporalis (p=0.090) muscles. Moreover, no significant difference in skin surface temperature (p> 0.05) was found among the different groups. Pain intensity in women with myogenous TMD was not associated with skin surface temperature at the central point of the masseter and anterior temporalis muscles.

  7. Dysregulation of the autonomic nervous system and its association with the presence and intensity of chronic widespread pain

    NARCIS (Netherlands)

    Barakat, A.; Vogelzangs, N.; Licht, C.M.M.; Geenen, R.; Macfarlane, G.J.; de Geus, E.J.C.; Smit, J.H.; Penninx, B.W.J.H.; Dekker, J.

    2012-01-01

    Objective To test the hypotheses that dysregulation of the autonomic nervous system (ANS) is associated with the presence of chronic widespread pain (CWP), and that dysregulation of the ANS is associated with higher pain intensity in CWP. Methods Cross-sectional data were obtained from 1,574

  8. Feasibility of a Nurse-Managed Pain, Agitation, and Delirium Protocol in the Surgical Intensive Care Unit.

    Science.gov (United States)

    Rozycki, Alan; Jarrell, Andrew S; Kruer, Rachel M; Young, Samantha; Mendez-Tellez, Pedro A

    2017-12-01

    Society of Critical Care Medicine guidelines recommend the use of pain, agitation, and delirium protocols in the intensive care unit. The feasibility of nurse management of such protocols in the surgical intensive care unit has not been well assessed. To evaluate the percentage of adherent medication interventions for patients assessed by using a pain, sedation, and delirium protocol. Data on all adult patients admitted to a surgical intensive care unit from January 2013 through September 2013 who were assessed at least once by using a pain, sedation, and delirium protocol were retrospectively reviewed. Protocol adherence was evaluated for interventions implemented after a nursing assessment. Patients were further divided into 2 groups on the basis of adherence, and achievement of pain and sedation goals was evaluated between groups. Data on 41 patients were included. Of the 603 pain assessments, 422 (70.0%) led to an intervention adherent to the protocol. Of the 249 sedation assessments, 192 (77.1%) led to an adherent intervention. Among patients with 75% or greater adherent pain interventions, all interventions met pain goals with significantly less fentanyl than that used in interventions that did not meet goals. Despite 75% or greater adherence with interventions for sedation assessments, only 8.7% of the interventions met sedation goals. A nurse-managed pain, agitation, and delirium protocol can be feasibly implemented in a surgical intensive care unit. © 2017 American Association of Critical-Care Nurses.

  9. Dysregulation of the Autonomic Nervous System and Its Association With the Presence and Intensity of Chronic Widespread Pain

    NARCIS (Netherlands)

    Barakat, Ansam; Vogelzangs, Nicole; Licht, Carmilla M. M.; Geenen, Rinie; Macfarlane, Gary J.; de Geus, Eco J. C.; Smit, Johannes H.; Penninx, Brenda W. J. H.; Dekker, Joost

    Objective. To test the hypotheses that dysregulation of the autonomic nervous system (ANS) is associated with the presence of chronic widespread pain (CWP), and that dysregulation of the ANS is associated with higher pain intensity in CWP. Methods. Cross-sectional data were obtained from 1,574

  10. Ligamentum flavum hypertrophy in asymptomatic and chronic low back pain subjects.

    Directory of Open Access Journals (Sweden)

    Justin J Munns

    Full Text Available To examine ligamentum flavum thickness using magnetic resonance (MR images to evaluate its association with low back pain symptoms, age, gender, lumbar level, and disc characteristics.Sixty-three individuals were part of this IRB-approved study: twenty-seven with chronic low back pain, and thirty-six as asymptomatic. All patients underwent MR imaging and computed tomography (CT of the lumbar spine. The MR images at the mid-disc level were captured and enlarged 800% using a bilinear interpolation size conversion algorithm that allowed for enhanced image quality. Ligamentum flavum thickness was assessed using bilateral medial and lateral measurements. Disc height at each level was measured by the least-distance measurement method in three-dimensional models created by CT images taken of the same subject. Analysis of variance and t-tests were carried out to evaluate the relationship between ligamentum flavum thickness and patient variables.Ligamentum flavum thickness was found to significantly increase with older age, lower lumbar level, and chronic low back pain (p < 0.03. No difference in ligamentum flavum thickness was observed between right and left sided measurements, or between male and female subjects. Disc height and both ligamentum flavum thickness measurements showed low to moderate correlations that reached significance (p < 0.01. Additionally, a moderate and significant correlation between disc degeneration grade and ligamentum flavum thickness does exist (p <0.001.By measuring ligamentum flavum thickness on MR images at two different sites and comparing degrees of disc degeneration, we found that ligamentum flavum thickness may be closely related to the pathogenesis of pain processes in the spine.

  11. Easily Administered Patient-Reported Outcome Measures: Adolescents' Perceived Functional Changes After Completing an Intensive Chronic Pain Rehabilitation Program.

    Science.gov (United States)

    Kempert, Heidi; Benore, Ethan; Heines, Rachel

    2017-01-01

    To determine whether patient-reported measures would be clinically sensitive and useful for identifying functional change within an intensive chronic pain program setting by examining 2 patient-reported measures administered as part of physical and occupational therapy for chronic pain. A retrospective data analysis of children and adolescents with chronic pain treated over a single calendar year. Paired t tests evaluated change in perceived function measures and pain over time. Standardized residual change scores were used in subsequent regression to assess associations between change scores. An interdisciplinary pediatric pain rehabilitation program that supports children and adolescents with chronic pain by increasing strength, flexibility, and endurance; facilitating a return to daily life activities; and using appropriate self-directed coping and pain management skills. Children and adolescents (N=109; age range, 8-19y; 83% girls) with various chronic pain diagnoses who were admitted to a 3- to 4-week intensive pain rehabilitation program. Participants were involved in physical and occupational therapy for 3 hours daily, as well as recreation therapy, psychology, school, aquatics, art therapy, and music therapy for a total of 8 hours daily. Parents were involved in parent education with therapists from all disciplines in conjunction with their child's programming. Lower Extremity Functional Scale (LEFS), Upper Extremity Functional Index (UEFI), and self-reported pain severity rating on 0-to-10 numerical rating scale. Data demonstrated significant gains in LEFS and UEFI during the program. Improvement in perceived functioning was significantly correlated with a reduction in pain. The LEFS and UEFI provide a meaningful way to track progress in chronic pain rehabilitation. Using self-perceived measures, children and adolescents noted significant functional improvement, associated with less pain intensity. These findings increase our understanding of the

  12. Comparison of self-reported pain intensity, sleeping difficulty, and treatment outcomes of patients with myofascial temporomandibular disorders by age group: a prospective outcome study.

    Science.gov (United States)

    Karibe, Hiroyuki; Goddard, Greg; Shimazu, Kisaki; Kato, Yuichi; Warita-Naoi, Sachie; Kawakami, Tomomi

    2014-12-11

    Subjective symptoms of temporomandibular disorders (TMDs) have rarely been studied by age group. We aimed to compare self-reported pain intensity, sleeping difficulty, and treatment outcomes of patients with myofascial TMDs among three age groups. The study population included 179 consecutive patients (151 women and 28 men) who underwent comprehensive clinical examinations at a university-based orofacial pain center. They were classified into myofascial pain subgroups based on the Research Diagnostic Criteria for Temporomandibular Disorders. They were stratified by age group: M1, under 20 years; M2, 20-39 years; and M3, 40 years and older. The patients scored their pretreatment symptoms (first visit) and post-treatment symptoms (last visit) on a form composed of three items that assessed pain intensity and one item that assessed sleeping difficulty. Their treatment options (i.e., pharmacotherapy, physical therapy, and orthopedic appliances) and duration were recorded. All variables were compared between sexes in each group and between the age groups by using the Kruskal-Wallis test, the Mann-Whitney U test, the chi-square test, and analysis of variance (p < 0.05). No significant sex differences were found in any age group. Only sleeping difficulty was significantly different before treatment (p = 0.009). No significant differences were observed in the treatment options or treatment duration. After treatment, the intensity of jaw/face pain and headache and sleeping difficulty was significantly reduced in groups M2 and M3, but only the intensity of jaw/face pain was significantly decreased in group M1. The changes in the scores of pain intensity and sleeping difficulty were not different between the groups. Pain intensity does not differ by age group, but older patients with myofascial TMDs had greater sleeping difficulties. However, there were no differences between the age groups in the treatment outcomes. Clinicians should carefully consider the age

  13. Spino-pelvic-rhythm with forward trunk bending in normal subjects without low back pain.

    Science.gov (United States)

    Hasebe, Kiyotaka; Sairyo, Koichi; Hada, Yasushi; Dezawa, Akira; Okubo, Yu; Kaneoka, Koji; Nakamura, Yoshio

    2014-07-01

    A strong correlation between low back pain and tight hamstrings has been reported. However, the effect of tight hamstrings on spinal biomechanics remains unclear. The purpose of the study was to investigate spino-pelvic-rhythm during forward bending of the trunk and to clarify the rhythm features with regard to hamstrings tightness. Eighteen healthy male adults with no history of low back pain volunteered to participate. First, we measured the finger-to-floor distance (FFD) in the upright position and set this parameter to 100 %. Using a spinal mouse, spinal alignment was measured in the following four positions: (1) upright posture—100 % FFD; (2) forward bending—50 % FFD; (3) forward bending—25 % FFD; and (4) forward bending—0 % FFD (fingers in contact with the floor). Changes of the angle of the thoracic and lumbar spine as well as the pelvis were calculated. As an indicator of tight hamstrings, we measured straight leg raising (SLR) angle. From positions 1–2 (phase I), the entire spino-pelvic angle moved in 104°. During this phase, the lumbar spine mainly moved. In the second phase (positions 2–3), it moved in 16°. Interestingly, all but 2 subjects showed a negative angle in the thoracic motion, meaning that the thoracic spine extended 4° during trunk flexion, thus exhibiting paradoxical motion. During this phase, lumbopelvic rhythm showed 2 patterns. In 7 subjects, pelvic motion was greater than lumbar motion, while the remaining subjects showed the opposite. In subjects without tight hamstrings, 83 % showed a pelvis-dominant pattern. Only 7 subjects were capable of position 4. During this phase, only slight motion was noted in the spine, and the majority of the motion occurred in the pelvis. Lumbar and pelvic motion correlated negatively in all phases. SLR angle and pelvic motion correlated strongly during phase III, indicating dominant pelvic movement in flexible subjects. The lumbo-pelvic-rhythm comprises 2 patterns—lumbar dominant and

  14. Differential effects on pain intensity and unpleasantness of two meditation practices.

    Science.gov (United States)

    Perlman, David M; Salomons, Tim V; Davidson, Richard J; Lutz, Antoine

    2010-02-01

    Pain is an unpleasant sensory and emotional experience that can be regulated by many different cognitive mechanisms. We compared the regulatory qualities of two different meditation practices during noxious thermal stimuli: Focused Attention, directed at a fixation cross away from the stimulation, which could regulate negative affect through a sensory gating mechanism; and Open Monitoring, which could regulate negative affect through a mechanism of nonjudgmental, nonreactive awareness of sensory experience. Here, we report behavioral data from a comparison between novice and long-term meditation practitioners (long-term meditators, LTMs) using these techniques. LTMs, compared to novices, had a significant reduction of self-reported unpleasantness, but not intensity, of painful stimuli while practicing Open Monitoring. No significant effects were found for FA. This finding illuminates the possible regulatory mechanism of meditation-based clinical interventions like Mindfulness-Based Stress Reduction (MBSR). Implications are discussed in the broader context of training-induced changes in trait emotion regulation.

  15. The relative meaning of absolute numbers: the case of pain intensity scores as decision support systems for pain management of patients with dementia.

    Science.gov (United States)

    Lichtner, Valentina; Dowding, Dawn; Closs, S José

    2015-12-24

    Assessment and management of pain in patients with dementia is known to be challenging, due to patients' cognitive and/or communication difficulties. In the UK, pain in hospital is managed through regular assessments, with the use of pain intensity scores as triggers for action. The aim of this study was to understand current pain assessment practices, in order to later inform the development of a decision support tool designed to improve the management of pain for people with dementia in hospital. An exploratory study was conducted in four hospitals in the UK (11 wards), with observations of patients with dementia (n = 31), interviews of staff (n = 52) and patients' family members (n = 4) and documentary analysis. A thematic analysis was carried out, structured along dimensions of decision making. This paper focuses on the emergent themes related to the use of assessment tools and pain intensity scores. A variety of tools were used to record pain intensity, usually with numerical scales. None of the tools in actual use had been specifically designed for patients with cognitive impairment. With patients with more severe dementia, the patient's body language and other cues were studied to infer pain intensity and then a score entered on behalf of the patient. Information regarding the temporality of pain and changes in pain experience (rather than a score at a single point in time) seemed to be most useful to the assessment of pain. Given the inherent uncertainty of the meaning of pain scores for patients with dementia, numerical scales were used with caution. Numerical scores triggered action but their meaning was relative - to the patient, to the clinician, to the time of recording and to the purpose of documenting. There are implications for use of data and computerized decision support systems design. Decision support interventions should include personalized alerting cut-off scores for individual patients, display pain scores over time and integrate

  16. The effect of resisted inspiration during an active straight leg raise in pain-free subjects.

    Science.gov (United States)

    Beales, Darren John; O'Sullivan, Peter Bruce; Briffa, N Kathryn

    2010-04-01

    Alterations of respiratory patterns have been observed in pelvic girdle pain subjects during the active straight leg raise (ASLR). This study investigated how pain-free subjects coordinate motor control during an ASLR when this task is complicated by the addition of a respiratory challenge. Trunk muscle activation, intra-abdominal pressure, intra-thoracic pressure, pelvic floor motion, downward pressure of the non-lifted leg and respiratory rate were compared between resting supine, ASLR, breathing with inspiratory resistance (IR) and ASLR+IR. Subjects responded to ASLR+IR with an increase in the motor activation in the abdominal wall and chest wall compared to when ASLR and IR were performed in isolation. Activation of obliquus internus abdominis was greater on the side of the leg lift during the ASLR+IR, in comparison to symmetrical activation observed in the other abdominal wall muscles. The incremental increase of motor activity was associated with greater intra-abdominal pressure baseline shift when lifting the leg during ASLR+IR compared to ASLR. Individual variation was apparent in the form of the motor control patterns, mostly reflected in variable respiratory activation of the abdominal wall. The findings highlight the flexibility of the neuromuscular system in adapting to simultaneous respiratory and stability demands. 2009 Elsevier Ltd. All rights reserved.

  17. Physical and psychosocial disability in elderly subjects in relation to pain in the hip and/or knee

    NARCIS (Netherlands)

    Hopman-Rock, M.; Odding, E.; Hofman, A.; Kraaimaat, F. W.; Bijlsma, J. W.

    1996-01-01

    To determine physical and psychosocial disability in subjects aged 55 to 74 years living in the community, in relation to pain in the hip and/or knee, and to explore the relationships between pain, physical and psychosocial disability, and selected background variables. A subsample from a community

  18. Physical and psychosocial disability in elderly subjects in relation to pain in the hip and/or knee

    NARCIS (Netherlands)

    Hopman-Rock, M.; Odding, E.; Hofman, A.; Kraaimaat, F.W.; Bijlsma, J.W.J.

    1996-01-01

    Objective. To determine physical and psychosocial disability in subjects aged 55 to 74 years living in the community, in relation to pain in the hip and/or knee, and to explore the relationships between pain, physical and psychosocial disability, and selected background variables. Methods. A

  19. 2000 Volvo Award winner in clinical studies: Lumbar high-intensity zone and discography in subjects without low back problems.

    Science.gov (United States)

    Carragee, E J; Paragioudakis, S J; Khurana, S

    2000-12-01

    A prospective observational study of patients with low back pain and those without was performed. To investigate the prevalence and significance of a high-intensity zone in a group of patients asymptomatic for low back pain, but who had known risk factors for lumbar disc degeneration. This asymptomatic group was compared with a symptomatic group of patients with respect to the presence of anular high-intensity zone and the pain response with discography. Some authors have estimated the prevalence of a high-intensity zone in a group of symptomatic patients to be 86%. They have reported a strong correlation between a high-intensity zone and positive discography in patients with low back pain. Other investigators have reported evidence either supporting or discounting these findings. Patients with low back pain and those without underwent physical examination, psychometric testing, plain radiograph, magnetic resonance imaging, and discography. The presence of a high-intensity zone, anular disruption, and positive discographic pain then were compared between the two groups. There were strict inclusion criteria for both groups. A total of 109 discs in 42 patients were evaluated in the symptomatic group and compared with 143 discs in 54 patients in the asymptomatic group. The presence of a high-intensity zone was determined by a standardized criteria on T2-weighted magnetic resonance images. Psychometric testing also was administered to each patient before discography. Standard discography was performed on all the patients, and the pain response was recorded using a visual analog scale according to the Walsh et al criteria. The prevalence of a high-intensity zone in the patient populations was 59% in the symptomatic group and 24% in the asymptomatic group. In the symptomatic group, 33 (30.2%) of 109 discs were found to have a high-intensity zone. In the asymptomatic group, 13 of 143 discs were found to have a high-intensity zone. In the symptomatic group, 72.7% of the

  20. 6-day intensive treatment protocol for refractory chronic prostatitis/chronic pelvic pain syndrome using myofascial release and paradoxical relaxation training.

    Science.gov (United States)

    Anderson, Rodney U; Wise, David; Sawyer, Timothy; Glowe, Patricia; Orenberg, Elaine K

    2011-04-01

    Chronic prostatitis/chronic pelvic pain syndrome continues to elude conventional therapy. Evidence supports the concept that phenotypes of pelvic muscular tenderness and psychosocial distress respond to myofascial trigger point release and specific relaxation training. This case series reports long-term outcomes of a 6-day intensive combination of such therapies in refractory cases. A total of 200 men with pain for a median of 4.8 years referred themselves to Stanford University Urology for participation in an established protocol. Daily 3 to 5-hour sessions including intrapelvic/extrapelvic physiotherapy, self-treatment training and paradoxical relaxation training provided a solid introduction to facilitate self-management. Subjects answered baseline and followup questionnaires at variable intervals after initiation of therapy including the National Institutes of Health Chronic Prostatitis Symptom Index, global response assessment and a psychological query. We followed 116 men for a median of 6 months. Baseline total symptom index was 26 out of a maximum 43 points. Scores decreased by 30% (p pain, urinary dysfunction and quality of life showed significant improvement (p pelvic pain refractory to traditional treatment benefit from intensive myofascial trigger point therapy and concomitant paradoxical relaxation training. Education in techniques for self-administered trigger point release and continued pelvic muscle relaxation help patients reduce pain and dysfunction. Refinement of clinical phenotyping and selection of patients with pelvic muscle tenderness should enhance the success rate with this treatment modality. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  1. Threshold of musculoskeletal pain intensity for increased risk of long-term sickness absence among female healthcare workers in eldercare.

    Directory of Open Access Journals (Sweden)

    Lars L Andersen

    Full Text Available PURPOSE: Musculoskeletal disorders increase the risk for absenteeism and work disability. However, the threshold when musculoskeletal pain intensity significantly increases the risk of sickness absence among different occupations is unknown. This study estimates the risk for long-term sickness absence (LTSA from different pain intensities in the low back, neck/shoulder and knees among female healthcare workers in eldercare. METHODS: Prospective cohort study among 8,732 Danish female healthcare workers responding to a questionnaire in 2004-2005, and subsequently followed for one year in a national register of social transfer payments (DREAM. Using Cox regression hazard ratio (HR analysis we modeled risk estimates of pain intensities on a scale from 0-9 (reference 0, where 0 is no pain and 9 is worst imaginable pain in the low back, neck/shoulders and knees during the last three months for onset of LTSA (receiving sickness absence compensation for at least eight consecutive weeks during one-year follow-up. RESULTS: During follow-up, the 12-month prevalence of LTSA was 6.3%. With adjustment for age, BMI, smoking and leisure physical activity, the thresholds of pain intensities significantly increasing risk of LTSA for the low back (HR 1.44 [95%CI 1.07-1.93], neck/shoulders (HR 1.47 [95%CI 1.10-1.96] and knees (HR 1.43 [95%CI 1.06-1.93] were 5, 4 and 3 (scale 0-9, respectively, referencing pain intensity of 0. CONCLUSION: The threshold of pain intensity significantly increasing the risk for LTSA among female healthcare workers varies across body regions, with knee pain having the lowest threshold. This knowledge may be used in the prevention of LTSA among health care workers.

  2. EFFECTIVENESS OF DRY NEEDLING, STRETCHING, AND STRENGTHENING TO REDUCE PAIN AND IMPROVE FUNCTION IN SUBJECTS WITH CHRONIC LATERAL HIP AND THIGH PAIN: A RETROSPECTIVE CASE SERIES.

    Science.gov (United States)

    Pavkovich, Ron

    2015-08-01

    Chronic lateral hip and thigh pain is regularly treated by the physical therapist. Many issues can cause pain in this region, and trigger points may contribute to pain. Dry Needling (DN) is an intervention used by physical therapists where a monofilament needle is inserted into soft tissue to reduce pain thereby facilitating return to prior level of function. The purpose of this case series is to report the outcomes of DN and conventional physical therapy as a treatment intervention for subjects with chronic lateral hip and thigh pain. Four subjects with chronic lateral hip and thigh pain attended between four and eight sixty-minute sessions of dry needling and stretching/ strengthening activities over a four to eight week intervention course. Outcomes were tested at baseline and upon completion of therapy. A long-term follow up averaging 12.25 months (range 3 to 20 months) was also performed. The outcome measures included the Visual Analog Scale (VAS) and the Lower Extremity Functional Scale (LEFS). The LEFS and VAS indicated clinically meaningful improvements in disability and pain in the short term and upon long term follow up for each subject. The LEFS(mean) for the four subjects improved from 50.75 at baseline to 66.75 at the completion of treatment. At long-term follow-up, the LEFS(mean) was 65.50. Each subject met the minimal clinically important difference (MCID) and minimal detectable change (MDC) for the LEFS and the VAS. The VAS was broken down into best (VAS(B)), current (VAS(C)), and worst (VAS(W)) rated pain levels and averaged between the four subjects. The VAS(B) improved from 20 mm at the initial assessment to 0 mm upon completion of the intervention duration. The VAS(C) improved from 25.75 mm to 11.75 mm, and the VAS(W) improved from 85 mm to 32.5 mm. At the long-term follow up (average 12.25 months), the VAS(B), VAS(C), and VAS(W) scores were 0 mm, 14.58 mm, and 43.75 mm respectively. Clinically meaningful improvements in pain and disability were

  3. [Efficacy of modified auriculotherapy for post-operative pain control in patients subjected to laparoscopic cholecystectomy].

    Science.gov (United States)

    Toca-Villegas, Jiovanni; Esmer-Sánchez, David; García-Narváez, Jesús; Sánchez-Aguilar, Martín; Hernández-Sierra, Juan Francisco

    The high frequency of post-operative pain in the patients after laparoscopic cholecystectomy has led to the need to use multiple analgesic therapies. These include auriculotherapy, although not very good results have been obtained with the traditional techniques. To evaluate the effectiveness of modified auriculotherapy for post-operative pain control in laparoscopic cholecystectomy patients. Double-blind controlled clinical trial. Experimental group: Different points ear puncture with xylocaine without needles vs. placebo group. Post-operative visual analogue scale (VAS) at 6, 12, 18, 24, 36, and 48h and rescue doses of analgesics, were measured in both groups. At 6h post-operative, 87% of the auriculotherapy group had a VAS of<4 vs. 48% of placebo group (p = 0.004), and 96 vs. 74% (p = 0.008) at 18hours. At 24, 36 and 48h after surgery there were no differences, and as all of the patients in both groups had a VAS<4, they were discharged to the hospital. Modified auriculotherapy was better to the conventional analgesics for post-operative pain control in patients subjected to laparoscopic cholecystectomy. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  4. Associations of pain intensity and pain-related disability with psychological and socio-demographic factors in patients with temporomandibular disorders: a cross-sectional study at a specialised dental clinic.

    Science.gov (United States)

    Su, N; Lobbezoo, F; van Wijk, A; van der Heijden, G J M G; Visscher, C M

    2017-03-01

    The study assessed whether psychological and socio-demographic factors, including somatisation, depression, stress, anxiety, daytime sleepiness, optimism, gender and age, are associated with pain intensity and pain-related disability in patients with temporomandibular disorders (TMDs). In total, 320 TMD patients were involved in the study. The psychological status of each patient was assessed with questionnaires, including the Symptom Checklist-90 (SCL-90), Epworth Sleeping Scale (ESS), stress questionnaire and Life Orientation Test-Revised (LOT-R). TMD pain, including pain intensity and pain-related disability, was assessed with characteristic pain intensity (CPI) and disability points scales. The associations of psychological and socio-demographic factors with pain intensity and pain-related disability were assessed through logistic regression analyses. Higher pain intensity was significantly associated with more severe anxiety (P = 0·004), more severe somatisation (P associated with pain intensity (P pain-related disability was significantly associated with more severe anxiety (P associated with pain-related disability (P = 0·003). Among the psychological and socio-demographic factors in this study, somatisation was the best predictor of pain intensity, while depression was the best predictor of pain-related disability. © 2016 The Authors. Journal of Oral Rehabilitation Published by John Wiley & Sons Ltd.

  5. Efficacy of hijamat bila shurt (dry cupping) on intensity of pain in dysmenorrhoea-a preliminary study.

    Science.gov (United States)

    Sultana, Arshiya; Ur Rahman, Khaleeq; Farzana, Muzn; Lone, Azad

    2010-10-01

    Waje rehm (Dysmenorrhoea) means painful menstruation. Since ancient times, hijamat bila shurt (Dry cupping) is a method of treatment of for this disease. Therefore, objective of this preliminary study was to evaluate the efficacy of hijamat bila shurt on intensity of pain in waje rehm by using Visual Analogue Scale for pain. It was conducted from May 2009 to July 2010 on 25 patients in National Institute of Unani Medicine, Bangalore. Patients suffering from primary and secondary dysmenorrhoea with regular cycles, age group 12-37years were selected. For dry cupping, two glass cup of medium size were applied below the umbilicus for 15 minutes on day land/or day 2 of the menstrual phase for one cycle and pain intensity was assessed by Visual Analogue Scale score for pain before and after the treatment. The Mean and Standard Error Mean for pain intensity before and after the treatment was 6.48 (0.32) and 2.12 (0.32) respectively with P<0.001, considered significant. Thus, hijamat bila shurt was effective in reducing pain intensity in dysmenorrhoea.

  6. High intensity physical exercise and pain in the neck and upper limb among slaughterhouse workers: cross-sectional study.

    Science.gov (United States)

    Sundstrup, Emil; Jakobsen, Markus D; Jay, Kenneth; Brandt, Mikkel; Andersen, Lars L

    2014-01-01

    Slaughterhouse work involves a high degree of repetitive and forceful upper limb movements and thus implies an elevated risk of work-related musculoskeletal disorders. High intensity strength training effectively rehabilitates musculoskeletal disorders among sedentary employees, but less is known about the effect among workers with repetitive and forceful work demands. Before performing randomized controlled trials it may be beneficial to assess the cross-sectional connection between exercise and musculoskeletal pain. We investigated the association between high intensity physical exercise and pain among 595 slaughterhouse workers in Denmark, Europe. Using logistic regression analyses, odds ratios for pain and work disability as a function of physical exercise, gender, age, BMI, smoking, and job position were estimated. The prevalence of pain in the neck, shoulder, elbow, and hand/wrist was 48%, 60%, 40%, and 52%, respectively. The odds for experiencing neck pain were significantly lower among slaughterhouse workers performing physical exercise (OR = 0.70, CI: 0.49-0.997), whereas the odds for pain in the shoulders, elbow, or hand/wrist were not associated with exercise. The present study can be used as general reference of pain in the neck and upper extremity among slaughterhouse workers. Future studies should investigate the effect of high intensity physical exercise on neck and upper limb pain in slaughterhouse workers.

  7. High Intensity Physical Exercise and Pain in the Neck and Upper Limb among Slaughterhouse Workers: Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Emil Sundstrup

    2014-01-01

    Full Text Available Slaughterhouse work involves a high degree of repetitive and forceful upper limb movements and thus implies an elevated risk of work-related musculoskeletal disorders. High intensity strength training effectively rehabilitates musculoskeletal disorders among sedentary employees, but less is known about the effect among workers with repetitive and forceful work demands. Before performing randomized controlled trials it may be beneficial to assess the cross-sectional connection between exercise and musculoskeletal pain. We investigated the association between high intensity physical exercise and pain among 595 slaughterhouse workers in Denmark, Europe. Using logistic regression analyses, odds ratios for pain and work disability as a function of physical exercise, gender, age, BMI, smoking, and job position were estimated. The prevalence of pain in the neck, shoulder, elbow, and hand/wrist was 48%, 60%, 40%, and 52%, respectively. The odds for experiencing neck pain were significantly lower among slaughterhouse workers performing physical exercise (OR = 0.70, CI: 0.49–0.997, whereas the odds for pain in the shoulders, elbow, or hand/wrist were not associated with exercise. The present study can be used as general reference of pain in the neck and upper extremity among slaughterhouse workers. Future studies should investigate the effect of high intensity physical exercise on neck and upper limb pain in slaughterhouse workers.

  8. Description of signature scales in a floating wind turbine model wake subjected to varying turbulence intensity

    Science.gov (United States)

    Kadum, Hawwa; Rockel, Stanislav; Holling, Michael; Peinke, Joachim; Cal, Raul Bayon

    2017-11-01

    The wake behind a floating model horizontal axis wind turbine during pitch motion is investigated and compared to a fixed wind turbine wake. An experiment is conducted in an acoustic wind tunnel where hot-wire data are acquired at five downstream locations. At each downstream location, a rake of 16 hot-wires was used with placement of the probes increasing radially in the vertical, horizontal, and diagonally at 45 deg. In addition, the effect of turbulence intensity on the floating wake is examined by subjecting the wind turbine to different inflow conditions controlled through three settings in the wind tunnel grid, a passive and two active protocols, thus varying in intensity. The wakes are inspected by statistics of the point measurements, where the various length/time scales are considered. The wake characteristics for a floating wind turbine are compared to a fixed turbine, and uncovering its features; relevant as the demand for exploiting deep waters in wind energy is increasing.

  9. Experimental knee joint pain during strength training and muscle strength gain in healthy subjects

    DEFF Research Database (Denmark)

    Sørensen, T J; Langberg, Henning; Hodges, P W

    2012-01-01

    Knee joint pain and reduced quadriceps strength are cardinal symptoms in many knee pathologies. In people with painful knee pathologies, quadriceps exercise reduces pain, improves physical function, and increases muscle strength. A general assumption is that pain compromises muscle function and t...... and thus may prevent effective rehabilitation. This study evaluated the effects of experimental knee joint pain during quadriceps strength training on muscle strength gain in healthy individuals.......Knee joint pain and reduced quadriceps strength are cardinal symptoms in many knee pathologies. In people with painful knee pathologies, quadriceps exercise reduces pain, improves physical function, and increases muscle strength. A general assumption is that pain compromises muscle function...

  10. Complex regional pain syndrome (CRPS) or continuous unilateral distal experimental pain stimulation in healthy subjects does not bias visual attention towards one hemifield.

    Science.gov (United States)

    Filippopulos, Filipp M; Grafenstein, Jessica; Straube, Andreas; Eggert, Thomas

    2015-11-01

    In natural life pain automatically draws attention towards the painful body part suggesting that it interacts with different attentional mechanisms such as visual attention. Complex regional pain syndrome (CRPS) patients who typically report on chronic distally located pain of one extremity may suffer from so-called neglect-like symptoms, which have also been linked to attentional mechanisms. The purpose of the study was to further evaluate how continuous pain conditions influence visual attention. Saccade latencies were recorded in two experiments using a common visual attention paradigm whereby orientating saccades to cued or uncued lateral visual targets had to be performed. In the first experiment saccade latencies of healthy subjects were measured under two conditions: one in which continuous experimental pain stimulation was applied to the index finger to imitate a continuous pain situation, and one without pain stimulation. In the second experiment saccade latencies of patients suffering from CRPS were compared to controls. The results showed that neither the continuous experimental pain stimulation during the experiment nor the chronic pain in CRPS led to an unilateral increase of saccade latencies or to a unilateral increase of the cue effect on latency. The results show that unilateral, continuously applied pain stimuli or chronic pain have no or only very limited influence on visual attention. Differently from patients with visual neglect, patients with CRPS did not show strong side asymmetries of saccade latencies or of cue effects on saccade latencies. Thus, neglect-like clinical symptoms of CRPS patients do not involve the allocation of visual attention.

  11. Are reductions in pain intensity and pain-related distress necessary? An analysis of within-treatment change trajectories in relation to improved functioning following interdisciplinary acceptance and commitment therapy for adults with chronic pain.

    Science.gov (United States)

    Vowles, Kevin E; Witkiewitz, Katie; Levell, Jayne; Sowden, Gail; Ashworth, Julie

    2017-02-01

    A key issue in chronic pain treatment concerns the changes necessary for improved physical and emotional functioning. Traditionally, reducing pain intensity and pain-related distress have been viewed as a prerequisite for these improvements. Alternatively, acceptance and commitment therapy, a behavior change approach, theorizes that pain and distress reduction are not necessary for improvement, rather responses must change, such that functioning improves in clearly specified areas (e.g., engagement in valued activities, decreased disability in social activity) even when pain and distress persist. This study sought to directly examine aspects of change in pain and distress over the course of an interdisciplinary program of acceptance and commitment therapy in relation to functioning at treatment's conclusion and a 3-month follow-up in 174 treated patients. Latent change trajectories of pain intensity and pain-related distress were assessed weekly over 4 weeks of treatment and analyzed via latent growth curve and growth mixture modeling. A single latent trajectory with a decreasing quadratic slope was indicated for pain, while 2 separate trajectories were identified for pain-related distress 1 of linear decrease and the other an early increase followed by a decrease to initial level. Overall, and with only 3 exceptions across multiple tests, results indicated that trajectories of pain and distress during treatment were not significantly associated with improvements in functioning at treatment's conclusion and follow-up. This pattern of findings suggests that significant improvements in functioning may not require decreases in pain intensity and pain-related distress during treatment for chronic pain. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  12. Effect of Acupressure at the SP6 and LI4 Points on the Intensity of Labor Pain and Delivery Length

    Directory of Open Access Journals (Sweden)

    Rafat Kazemzadeh

    2014-06-01

    Full Text Available Background & Objectives: Delivery is one of the most important events in a woman's life, and pain is an inevitable part of childbirth. The non-controlled pain leads to prolonged labor and multiple injuries to mother and fetus. This research was done to determine the effect of acupressure at the SP6 and LI4 points on the duration and pain of the labor in nulliparous women.   Methods: This randomized controlled clinical trial was conducted on 84 nulliparous women who were attended hospital in Ardabil. The participants were divided into two intervention and control groups using randomized blocking. Pressure has been done on SP6- LI4 points in intervention group. Pain intensity was measured before and after the intervention using visual analog scales and length of active phase and second stage were recorded through vaginal exam in the checklist. Determination of the effect of pressure on the intensity of labor pain and delivery length performed using paired t-test, Student’s t-test and chi-square by SPSS v.16.   Results: After the intervention the mean level of pain intensity in the intervention group was decreased. Also, there was a significant decrease in mean intensity of pain after each intervention in the intervention group with different dilations (4, 6, 8, and 10 cm (p<0.001.The mean duration of active phase and second stage in intervention group was significantly less than the control group . (p<0.001, p=0.008.   Conclusion: Since acupressure at the SP6- LI4 point in different dilatations leads to the reduction in labor pain intensity and delivery duration, therefore, this method can be used to reduce the pain and duration of labor.

  13. A comparative investigation of flexion relaxation phenomenon in healthy and chronic neck pain subjects.

    Science.gov (United States)

    Maroufi, Nader; Ahmadi, Amir; Mousavi Khatir, Seyedeh Roghayeh

    2013-01-01

    The cervical flexion relaxation phenomenon (FRP) is a neck extensor myoelectric "silence" that occurs during complete cervical and lumbar flexion. In contrast to low back pain, the changes that occur during FRP in chronic neck pain (CNP) patients are still not clear. The aim of this study was to assess the characteristics of this phenomenon in the cervical region in CNP patients and controls. Twenty-two women (23 ± 2.62 years) with chronic non-specific neck pain and 21 healthy women (23.4 ± 1.68 years) participated in this study. They accomplished a cervical flexion and extension from neutral position. Neck angle and surface electromyographic activity of cervical erector spinae (CES) and upper trapezius muscles were recorded. Appearance, onset and offset angle of the FRP were analysed and compared between the two groups. There were significant differences in the appearance of FRP between the two groups (P ≤ 0.001). The FRP in the CES muscles was observed in 85.7 % of healthy subjects and in 36.3 % of CNP patients, and no FRP was observed in the upper trapezius. Results of this study show that the onset and offset of FRP parameters were significantly different between the two groups (P ≤ 0.001). The results of the present study indicate that FRP in CNP patients was seen less than the healthy subjects, and moreover the FRP period was reduced in CNP patients. Our results also suggest that the changes in FRP of CNP patients may be due to the increased CES activity in these patients.

  14. Effects of experimental muscle pain on shoulder-abduction force steadiness and muscle activity in healthy subjects

    DEFF Research Database (Denmark)

    Bandholm, Thomas Quaade; Rasmussen, Lars; Aagaard, Per

    2007-01-01

    We previously demonstrated that the steadiness of shoulder abduction is reduced in patients with subacromial impingement syndrome (SIS), which might be related to shoulder pain associated with the SIS. The aim of the present study was to examine the acute effects of experimental shoulder muscle...... pain on shoulder motor function in healthy subjects. The fluctuations in exerted force (force steadiness) and electromyographic (EMG) activity from eight shoulder muscles were determined during sub-maximal isometric and dynamic contractions with the shoulder abductors in nine healthy subjects (27.......7 +/- 4.2 years, mean +/- 1 SD) before, during and after experimental pain induction. Experimental pain was induced by bolus injections of 6% hypertonic saline into the supraspinatus muscle. Experimental muscle pain reduced shoulder-abduction force steadiness on average by 21% during isometric...

  15. PET/CT shows subjective pain in shoulder joints to be associated with uptake of (18)F-FDG.

    Science.gov (United States)

    Kamasaki, Toshihiko; Hayashida, Naomi; Miyamoto, Izumi; Usui, Toshiya; Chiba, Kenya; Kudo, Takashi; Takamura, Noboru

    2014-01-01

    The aim of the study was to evaluate the capability of fluorine-18-fluorodeoxyglucose (F-FDG)-positron emission tomography (PET)/computed tomography (CT) in the screening of musculoskeletal inflammation and injury of the shoulder region. The study included 122 participants (69 men and 53 women) who complained of shoulder pain at rest and 122 age-matched and sex-matched controls who did not experience pain at rest. Standardized uptake values (SUVs) were calculated for both the left and right shoulders and compared using a four-point visual analog scale of subjective shoulder pain. Correlations between SUVs and uric acid and C-reactive proteins were also evaluated. SUVs for shoulder joints with rest and/or motion pain were significantly higher than those for pain-free shoulder joints. SUVs associated with mild and severe pain at rest were significantly higher than those associated with absence of pain at rest, and SUVs associated with moderate and severe pain on motion were significantly higher than those associated with absence of motion pain. Furthermore, SUVs were significantly correlated with uric acid in men (β=0.21, P=0.02) and in all participants (β=0.22, Pshoulder region. As shoulder pain is common, especially among elderly individuals, we should carefully consider the necessity of further examination when identifying the uptake of F-FDG in shoulder joints.

  16. Effect of Spike Lavender Lakhlakhe on Pain Intensity Due to Phlebotomy Procedure in Premature Infants Hospitalized in Neonatal Intensive Care Unit: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Noushin Beheshtipoor

    2017-06-01

    Full Text Available Background: A Premature infants undergo multiple painful procedures during treatment; thus, it must be tried to limit complications caused by diagnostic and treatment procedures using simple and practical methods. This study was performed to evaluate the effect of spike lavender lakhlakhe on pain intensity due to phlebotomy in hospitalized premature infants.Methods: This single-arm, randomized clinical trial was performed on 30 infants chosen through convenience sampling method. Each newborn was considered as its own control. For the test group, one drop of pure (100% spike lavender lakhlakhe was taken by a standard dropper and diluted with 4 ml of warm distilled water by the research assistant. This mixture was stirred at 2-3 cm distance of the newborns’ nose from 60 minutes before until 2 minutes after phlebotomy, such that it could be smelled by the newborns. In both groups, heart rate and blood oxygen saturation were measured by a standard portable device, and the corresponding data was recorded in data collection sheets. Moreover, the infants’ facial expression changes were recorded by a camera and the intensity of pain was measured by Premature Infant Pain Profile before and after the procedure. Finally, the data was analyzed by paired comparison analysis test in SPSS, version 17.Results: Comparison of mean pain intensity caused by phlebotomy in the control and test groups showed a significant difference (7.667±0.311 vs. 4.882±0.311; P

  17. THE IMPACT OF LAVENDER AROMATHERAPY ON PAIN INTENSITY AND BETA-ENDORPHIN LEVELS IN POST-CAESAREAN MOTHERS

    Directory of Open Access Journals (Sweden)

    Yohana Putri Apryanti

    2017-10-01

    Full Text Available Background: Caesarean section is one of the most common interventions to overcome labor complications. However, pain cannot be avoided after the surgery. Lavender aromatherapy is considered as one of non-pharmacological therapy to reduce pain and increase beta-endorphin levels. Objective: To examine the effect of lavender aromatherapy on the intensity of pain and beta-endorphin levels in post-caesarean mothers. Methods: This was a quasy-experimental study with pretest and posttest with control group at Sembiring Delitua General Hospital on December 2016 to February 2017. There were 40 samples selected using purposive sampling, with 20 samples assigned in the experiment and control group. Numerical Rating Scale (NRS was used to measure pain and ELIZA methods to measure beta-endorphin levels. Independent t-test and paired t-test were used for data analysis Results: Results of this study showed that there was a significant difference in the mean value of pain intensity levels (p=0.000 and beta-endorphin levels (p=0.023 between experiment and control group. Conclusion: There was a significant effect of lavender aromatherapy on the decrease of pain intensity and the increase of beta-endorphin hormone in post-caesarean mothers. It is expected that lavender aromatherapy can be used as an alternative treatment to reduce pain and increase beta-endorphin levels in post-caesarean mothers.

  18. Exercise-induced hypoalgesia: Pain tolerance, preference and tolerance for exercise intensity, and physiological correlates following dynamic circuit resistance exercise.

    Science.gov (United States)

    Baiamonte, Brandon A; Kraemer, Robert R; Chabreck, Chelsea N; Reynolds, Matthew L; McCaleb, Kayla M; Shaheen, Georgia L; Hollander, Daniel B

    2017-09-01

    Previous research has demonstrated significant decreases in pain perception in healthy individuals following both aerobic and upper body resistance exercise, but research on circuit training has been limited. The purpose of the study was to determine the effects of a strenuous bout of dynamic circuit resistance exercise on pain threshold and pain tolerance in conjunction with changes in blood lactate levels, heart rate (HR), and perceived exertion. A sample of 24 college-age students participated in 2 sessions: (1) a maximal strength testing session and (2) a circuit training bout of exercise that consisted of 3 sets of 12 repetitions with a 1:1 work to rest ratio at 60% one-repetition maximum (1-RM) predicted from a three-repetition maximum (3-RM) for 9 exercises. Participants exhibited increases in pain tolerance, blood lactate levels, HR and perceived exertion following resistance exercise. Preference for exercise intensity was positively correlated with lactate post exercise and tolerance for exercise intensity was positively correlated with pain tolerance and lactate post exercise. In conclusion, this is the first study to demonstrate increases in pain tolerance following a dynamic circuit resistance exercise protocol and disposition for exercise intensity may influence lactate and pain responses to circuit resistance exercise.

  19. Results of implementing a pain management algorithm in intensive care unit patients: The impact on pain assessment, length of stay, and duration of ventilation.

    Science.gov (United States)

    Olsen, Brita F; Rustøen, Tone; Sandvik, Leiv; Jacobsen, Morten; Valeberg, Berit T

    2016-12-01

    This study aimed to measure the impact of implementing a pain management algorithm in adult intensive care unit (ICU) patients able to express pain. No controlled study has previously evaluated the impact of a pain management algorithm both at rest and during procedures, including both patients able to self-report and express pain behavior, intubated and nonintubated patients, throughout their ICU stay. The algorithm instructed nurses to assess pain, guided them in pain treatment, and was implemented in 3 units. A time period after implementing the algorithm (intervention group) was compared with a time period the previous year (control group) on the outcome variables: pain assessments, duration of ventilation, length of ICU stay, length of hospital stay, use of analgesic and sedative medications, and the incidence of agitation events. Totally, 650 patients were included. The number of pain assessments was higher in the intervention group compared with the control group. In addition, duration of ventilation and length of ICU stay decreased significantly in the intervention group compared with the control group. This difference remained significant after adjusting for patient characteristics. Several outcome variables were significantly improved after implementation of the algorithm compared with the control group. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Multisite peripheral joint pain: a cross-sectional study of prevalence and impact on general health, quality of life, pain intensity and consultation behaviour.

    Science.gov (United States)

    Finney, Andrew; Dziedzic, Krysia S; Lewis, Martyn; Healey, Emma

    2017-12-16

    Research into musculoskeletal conditions often focusses on pain at single sites, such as the knee, yet several studies have previously reported the high prevalence of multiple sites of musculoskeletal pain. The most common form of musculoskeletal condition is arthritis, with osteoarthritis (OA) the most common cause of joint pain in adults 45 years and over. However, there is limited recognition of the prevalence of multisite peripheral joint pain in those either living with or at risk of OA, therefore this study set out to estimate the prevalence of multisite peripheral joint pain in adults 45 years and older, and its impact on several dimensions of health. A cross-sectional population survey was mailed to adults (n = 28,443) aged 45 years and over from eight general practices in the North West Midlands, United Kingdom (UK). Prevalence rates were established for multisite peripheral joint pain (pain in two or more sites; hands, hips, knees, feet). Impact was measured for general health (SF-12 MCS & PCS), QoL (EQ-5D), pain intensity (0-10 numerical ratings scale) and the number of consultations with a range of health care professionals. Of 15,083 responders (53%), multisite peripheral joint pain was reported by 54%. Peripheral joint pain was present in n = 11,928, of which 68% reported pain in multiple sites. Multisite peripheral joint pain was shown to be significantly associated with reduced physical (Mean difference = -5.9 95% CI -6.3,-5.5) and mental (-2.8 95% CI -3.2,-2.4) components of the SF-12, reduced QoL (-0.14 95% CI -0.15, -0.13), increased pain (+0.70 95% CI 0.62, 0.79) and increased odds of consultations with GPs (OR 2.4 95% CI 2.2, 2.6) and practice nurses (OR 2.6 (95% CI 2.1, 3.2) when compared to single site pain. Multisite peripheral joint pain is prevalent in the population in adults 45 years and over and has a significant negative impact on several dimensions of health. Health care professionals should consider joint pain beyond

  1. Differences in performance on the functional movement screen between chronic low back pain patients and healthy control subjects.

    Science.gov (United States)

    Ko, Min-Joo; Noh, Kyung-Hee; Kang, Min-Hyeok; Oh, Jae-Seop

    2016-07-01

    [Purpose] Differences in scores on the Functional Movement Screen between patients with chronic lower back pain and healthy control subjects were investigated. [Subjects and Methods] In all, 20 chronic lower back pain patients and 20 healthy control subjects were recruited. Chronic lower back pain patients and healthy controls performed the Functional Movement Screen (deep squat, hurdle step, inline lunge, shoulder mobility, active straight leg raise, trunk stability pushup, and rotary stability). The Mann-Whitney test was used to analyze differences in Functional Movement Screen scores between the two groups. [Results] Chronic lower back pain patients scored lower on the Functional Movement Screen total composite compared with healthy control subjects. Chronic lower back pain patients scored lower on Functional Movement Screen subtests including the deep squat, hurdle step, active straight leg raise, and rotary stability tests. [Conclusion] The deep squat, hurdle step, active straight leg raise, and rotary stability tasks of the Functional Movement Screen can be recommended as a functional assessment tools to identify functional deficits in chronic lower back pain patients.

  2. Fine structural characterization of chondroitin sulfate in urine of bladder pain syndrome subjects.

    Science.gov (United States)

    Maccari, Francesca; Buzzega, Dania; Galeotti, Fabio; Volpi, Nicola

    2011-12-01

    Urothelial glycosaminoglycans (GAGs) are decreased in bladder pain syndrome (BPS), and urinary GAGs are thought to reflect this deficiency. In previous researches, urine GAG levels were found increased, decreased, or similar between BPS and controls. Additionally, no study is available on the structure characterization of urinary chondroitin sulfate (CS) in BPS patients. CS in the urine of BPS-affected patients and controls has been determined by specific electrophoresis, along with total GAGs and heparan sulfate (HS) percentage, and CS disaccharides have been quantified by high-performance liquid chromatography. No significant differences were obtained for total amount of GAGs, absolute content of CS and HS, and their relative percentages. Moreover, no differences were observed for CS structure confirming similar urine CS composition in BPS subjects and controls. This study found no significant differences of BPS and control urine GAG levels and CS structure to allow use of these parameters as diagnostic markers for BPS diagnosis.

  3. Randomized Trial of the Effect of Mindfulness-Based Stress Reduction on Pain-Related Disability, Pain Intensity, Health-Related Quality of Life, and A1C in Patients With Painful Diabetic Peripheral Neuropathy.

    Science.gov (United States)

    Nathan, Howard J; Poulin, Patricia; Wozny, Denise; Taljaard, Monica; Smyth, Cathy; Gilron, Ian; Sorisky, Alexander; Lochnan, Heather; Shergill, Yaad

    2017-12-01

    IN BRIEF Painful diabetic peripheral neuropathy (PDPN) has a large negative impact on patients' physical and mental functioning, and pharmacological therapies rarely provide more than partial relief. Mindfulness-based stress reduction (MBSR) is a group psychosocial intervention that was developed for patients with chronic illness who were not responding to existing medical treatments. This study tested the effects of community-based MBSR courses for patients with PDPN. Among patients whose PDPN pharmacotherapy had been optimized in a chronic pain clinic, those randomly assigned to treatment with MBSR experienced improved function, better health-related quality of life, and reduced pain intensity, pain catastrophizing, and depression compared to those receiving usual care.

  4. PROINFLAMMATORY CYTOKINE LEVELS AND INDEXES OF ENDOTHELIAL FUNCTION IN PATIENTS WITH OSTEOARTHRITIS IS DEPENDENT ON THE PAIN INTENSITY

    Directory of Open Access Journals (Sweden)

    E. Yu. Aleksenko

    2017-01-01

    Full Text Available Prevalence of hypertension in patients with osteoarthritis is rather high. According to published data, a combination of osteoarthritis and hypertension is registered in 45 to 80% of the patients, dependent on the age group. Pathogenesis of arterial hypertension developing in patients with osteoarthritis is of sufficient interest to the clinicians. We studied systolic and diastolic blood pressure, levels of some cytokines (IL-1β, IL-6, IL-18, TNFα and markers of endothelial function (EDN1, vWF activity in 83 patients (mean age 45.7±6.3 years with osteoarthritis of knee and hip joints (radiographic stage II-III accompanied by chronic pain. Local pain intensity over last month was evaluated by means of a visual analogue scale. According to the data obtained, the patients were divided into three groups. Group 1 consisted of 27 patients with mild pain (the pain index ≤ 3 points, the 2nd group included 34 persons with moderate pain (3 to 7 points, and the 3rd group consisted of 22 people with highest pain ratings (pain index ≥ 7. Increased pain intensity correlated with elevation of systolic and diastolic blood pressure. Meanwhile, higher levels of proinflammatory cytokines, and increased activity of EDN1 and vWF were observed in patients with moderate osteoarthritis and severe pain syndrome. Minimal values of cytokines were observed in patients with mild pain, whereas maximal levels, in the patients with severe pain and arterial hypertension. Inflammatory mediators are able to induce activation and injury of endothelium causing its dysfunction. vWF activity and EDN1 contents increased in all the studied groups, along with increased pain intensity. Higher EDN1 concentration and vWF activity may be considered objective signs of endotheliosis in the osteoarthritis patients. In turn, endothelial dysfunction is among major pathophysiological mechanisms of arterial hypertension. This may suggest a sufficient contribution of pain to occurrence and

  5. A comparison of change in the 0-10 numeric rating scale to a pain relief scale and global medication performance scale in a short-term clinical trial of breakthrough pain intensity.

    Science.gov (United States)

    Farrar, John T; Polomano, Rosemary C; Berlin, Jesse A; Strom, Brian L

    2010-06-01

    Pain intensity is commonly reported using a 0-10 Numeric Rating Scale in pain clinical trials. Analysis of the change on the Pain Intensity Numerical Rating Scale as a proportion has most consistently correlated with clinically important differences reported on the patient's global impression of change. The correlation of data from patients with breakthrough pain with a Pain Relief Scale and a different global outcome measures will extend our understanding of these measures. Data were obtained from the open titration phase of a multiple crossover, randomized, double-blind clinical trial comparing oral transmucosal fentanyl citrate with immediate-release oral morphine sulfate for the treatment of cancer-related breakthrough pain. Raw and percentage changes in the pain intensity scores from 1,307 episodes of pain in 134 oral transmucosal fentanyl citrate-naïve patients were correlated with the clinically relevant secondary outcomes of Pain Relief Verbal Response Scale and the global medication performance scale. The changes in raw and percentage change were assessed over time and compared with the ordinal Pain Relief Verbal Response Scale and Global Medication Performance Scale. The P value of the interaction between the raw pain intensity difference was significant (P = 0.034) for four 15-min time periods but not for the percentage pain intensity difference score (P = 0.26). We found similar results in comparison with the ordinal Pain Relief Verbal Response Scale (P = 0.0048 and P = 0.36 respectively) and global medication performance categories (P = 0.048 and P = 0.45, respectively). The change in pain intensity in breakthrough pain was more consistent over time and when compared with both the Pain Relief Verbal Response Scale and the Global Medication Performance Scale when the percentage change is used rather than raw pain intensity difference.

  6. Empathy for social exclusion involves the sensory-discriminative component of pain: a within-subject fMRI study.

    Science.gov (United States)

    Novembre, Giovanni; Zanon, Marco; Silani, Giorgia

    2015-02-01

    Recent research has shown that experiencing events that represent a significant threat to social bonds activates a network of brain areas associated with the sensory-discriminative aspects of pain. In the present study, we investigated whether the same brain areas are involved when witnessing social exclusion threats experienced by others. Using a within-subject design, we show that an ecologically valid experience of social exclusion recruits areas coding the somatosensory components of physical pain (posterior insular cortex and secondary somatosensory cortex). Furthermore, we show that this pattern of activation not only holds for directly experienced social pain, but also during empathy for social pain. Finally, we report that subgenual cingulate cortex is the only brain area conjointly active during empathy for physical and social pain. This supports recent theories that affective processing and homeostatic regulation are at the core of empathic responses. © The Author (2014). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  7. Effect of interferential current therapy on pain perception and disability level in subjects with chronic low back pain: a randomized controlled trial.

    Science.gov (United States)

    Albornoz-Cabello, Manuel; Maya-Martín, Julián; Domínguez-Maldonado, Gabriel; Espejo-Antúnez, Luis; Heredia-Rizo, Alberto Marcos

    2017-02-01

    To assess the short-term efficacy of transregional interferential current therapy on pain perception and disability level in chronic non-specific low back pain. A randomized, single-blinded (the assessor collecting the outcome data was blinded), controlled trial. A private physiotherapy research clinic. A total of 64 individuals, 20 men and 44 women, mean (SD) age was 51 years (11.93), with low back pain of more than three months, with or without pain radiating to the lower extremities above the knee, were distributed into a control ( n = 20) or an experimental group ( n = 44). A 2:1 randomization ratio was used in favour of the latter. A transregional interferential current electrotherapy protocol was performed for participants in the experimental group, while the control group underwent a 'usual care' treatment (massage, mobilization and soft-tissue techniques). All subjects received up to 10 treatment sessions of 25 minutes over a two-week period, and completed the intervention and follow-up evaluations. Self-perceived pain was assessed with a Visual Analogue Scale. Secondary measure included the Oswestry Low Back Disability Index. Evaluations were collected at baseline and after the intervention protocol. Significant between-group differences were found for interferential current therapy on pain perception ( p = 0.032) and disability level ( p = 0.002). The observed differences in the between-group mean changes were of 11.34 mm (1.77/20.91) and 13.38 points (4.97/21.78), respectively. A two-week transregional interferential current treatment has shown significant short-term efficacy, when compared with a 'usual care' protocol, on self-perceived pain and functionality in subjects with chronic low back pain.

  8. Nasal hyperresponders and atopic subjects report different symptom intensity to air quality: a climate chamber study

    DEFF Research Database (Denmark)

    Bodin, Lennart; Andersson, K.; Bønløkke, Jakob Hjort

    2009-01-01

    -atopic with nasal histamine hyperreactivity, 13 were non-atopic, and 12 were atopic. Subjective ratings of symptoms and general health were registered four times during four 6-h exposure sessions. Six symptom intensity indices were constructed. The nasal hyperreactive group had a high and time-dependent increase...... and Neurological Effects these were dependent on group affiliation, thus preventing a uniform statement of exposure effects for all three investigated groups. PRACTICAL IMPLICATIONS: Opportunities for identifying persons with high or low sensitivity to low-level exposures are important in preventive medicine...... of mucous membrane irritations, whereas the atopic group had a low and stable rate of irritations with exposure time, close to the reference group (P = 0.02 for differences between the groups with respect to time under exposure for Weak Inflammatory Responses and P = 0.05 for Irritative Body Perception...

  9. Effect of neuroscience education on subjects with chronic knee pain related to osteoarthritis: a randomized controlled trial

    OpenAIRE

    Lluch Girbés, Enrique Juan

    2017-01-01

    In this PhD study, the evidence for the role of central pain mechanisms in people with OA was investigated by means of a narrative and a systematic review of the existent literature. In addition, clinical criteria for recognizing central sensitization in subjects with knee OA are discussed as well as the rationale for a comprehensive integrative treatment program including pain neuroscience education and manual therapy for this population. Clinicians may find some practical problems when comb...

  10. Metformin improves performance in high-intensity exercise, but not anaerobic capacity in healthy male subjects.

    Science.gov (United States)

    Learsi, S K; Bastos-Silva, V J; Lima-Silva, A E; Bertuzzi, R; De Araujo, G G

    2015-10-01

    The aim of this study was to determine the ergogenic effects of metformin in high-intensity exercise, as well as its effects on anaerobic capacity, in healthy and physically active men. Ten subjects (mean (± standard deviation) maximal oxygen uptake (V˙O2max ) 38.6 ± 4.5 mL/kg per min) performed the following tests in a cycle ergometer: (i) an incremental test; (ii) six submaximal constant workload tests at 40%-90% (V˙O2max ); and (iii) two supramaximal tests (110% (V˙O2max ). Metformin (500 mg) or placebo was ingested 60 min before the supramaximal test. There were no significant differences between the placebo and metformin groups in terms of maximum accumulated oxygen deficit (2.8 ± 0.6 vs 3.0 ± 0.8 L, respectively; P = 0.08), lactate concentrations (7.8 ± 2.6 vs 7.5 ± 3.0 mmol/L, respectively; P = 0.75) or O2 consumed in either the last 30 s of exercise (40.4 ± 4.4 vs 39.9 ± 4.0 mL/kg per min, respectively; P = 0.35) or the first 110 s of exercise (29.0 ± 2.5 vs 29.5 ± 3.0 mL/kg per min, respectively; P = 0.42). Time to exhaustion was significantly higher after metformin than placebo ingestion (191 ± 33 vs 167 ± 32 s, respectively; P = 0.001). The fast component of V˙O2 recovery was higher in the metformin than placebo group (12.71 vs 12.18 mL/kg per min, respectively; P = 0.025). Metformin improved performance and anaerobic alactic contribution during high-intensity exercise, but had no effect on overall anaerobic capacity in healthy subjects. © 2015 Wiley Publishing Asia Pty Ltd.

  11. Mutual influence of intensity of pain syndrome and borderline mental disorders in patients with coxarthrosis

    Directory of Open Access Journals (Sweden)

    I. D. Spirina

    2017-02-01

    Full Text Available The objective of this study is to evaluate the mutual influence of pain syndrome and borderline psychiatric disorders depending on its intensity and tolerability in patients with coxarthrosis who need endoprosthetics. 76 patients with coxarthrosis aged from 25 to 68 who were hospitalized in the Department of Endoprosthetics at Mechnikov Regional Clinical Hospital in Dnipro City in the period from November 2015 to September 2016 were observed. For diagnosis of psychopathological disorders, and for evaluation of the effectiveness of therapeutic interventions, the following methods were used in our research: clinical and psychopathological (technique SCL-90-R, Tаylor anxiety scale, study of the type of attitude to the disease (LOBI, Dembo-Rubinstein self-esteem scale, Leonhard-Schmieschek questionnaire for assessment of accentuation of personality traits, the Luscher 8-colour test and the Toronto alexithymia scale (TAS. Severity of pain syndrome was assessed using a visual analogue scale of pain (VAS. Forms of borderline mental disorders were diagnosed in 51 patients with coxarthrosis, such as depressive disorder (F 32 – 19 (24.8%, neurasthenia (F 48 – 12 (16.2, anxiety and phobic disorders (F 40–41 – 14 (18.1%, and personality disorders (F 60.5, F 60.6, F 60.7 – 6 (7.6%. In 25 (33.3% patients clinically-defined forms of mental disorders were identified. Leading syndromes in these disorders were depression – 19 (24.8% patients, anxiety and phobic – 15 (20.0%, asthenic – 10 (12.4%, hypochondriacal – 7 (9.5% patients. According to the results of the correlation analysis, a close correlation between the severity of pain syndrome and borderline mental disorders (r = 0.779 was established for patients in the preoperative stage. The average level of pain syndrome on the VAS scale in patients with borderline mental disorders was twice as high as in patients without these disorders (63.4 vs. 32.4 points, but it does not depend on the

  12. Comparison of the Effects of Play Dough and Bubble Making Distraction Techniques on Venepuncture Pain Intensity in Children

    Directory of Open Access Journals (Sweden)

    Shahrokh Maghsoudi

    2015-12-01

    Full Text Available Background: Venepuncture is a minimally invasive procedure, which is commonly performed in hospitals; if the pain is inadequately managed, it can cause negative feelings in children. Distraction can reduce pain through affecting the central nervous system and releasing neurotransmitters that inhibit pain. Aim: In this study, we aimed to compare the effects of play-dough and bubble making as distraction techniques on the intensity of venepuncture pain in children. Method: In this randomized, controlled, clinical trial, 90 children aged three to six years old, were randomly allocated to the three groups of  play dough, bubble making, and control (n=30 for each group. This study was performed in Qaem, Imam Reza, and Dr. Sheikh hospitals of Mashhad, Iran, in 2015. The interventions consisted of using play dough and bubble making, which were started five minutes before venepuncture. Following the intervention, pain assessment was performed using Wong-Baker Faces Pain Rating Scale. Chi-square, Fisher’s exact, and One-way ANOVA tests were performed to analyze the data, using SPSS version 16. Results: The mean of pain intensity in the play dough, bubble making, and control groups was 5.1±1.8 6.2±1.4, and 8.2±1.5, respectively (out of ten. One-way ANOVA reflected a significant difference between the three groups (P

  13. High-frequency, high-intensity transcutaneous electrical nerve stimulation as treatment of pain after surgical abortion.

    Science.gov (United States)

    Platon, B; Andréll, P; Raner, C; Rudolph, M; Dvoretsky, A; Mannheimer, C

    2010-01-01

    The aim of the study was to compare the pain-relieving effect and the time spent in the recovery ward after treatment with high-frequency, high-intensity transcutaneous electrical nerve stimulation (TENS) or intravenous (IV) conventional pharmacological treatment after surgical abortion. Two-hundred women who underwent surgical abortion and postoperatively reported a visual analogue scale (VAS) pain score3 were included. The patients were randomised to TENS or conventional pharmacological treatment for their postoperative pain. The TENS treatment was given with a stimulus intensity between 20 and 60 mA during 1 min and repeated once if insufficient pain relief (VAS3). In the conventional pharmacological treatment group, a maximum dose of 100 microg fentanyl was given IV. There was no difference between the groups with regard to pain relief according to the VAS pain score (TENS=VAS 1.3 vs. IV opioids=VAS 1.6; p=0.09) upon discharge from the recovery ward. However, the patients in the TENS group spent shorter time (44 min) in the recovery ward than the conventional pharmacological treatment group (62 min; p<0.0001). The number of patients who needed additional analgesics in the recovery ward was comparable in both groups, as was the reported VAS pain score upon leaving the hospital (TENS=2.0 vs. conventional pharmacological treatment=1.8, NS). These results suggest that the pain-relieving effect of TENS seems to be comparable to conventional pharmacological treatment with IV opioids. Hence, TENS may be a suitable alternative to conventional pain management with IV opioids after surgical abortion. Copyright 2009 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  14. Three-dimensional Cervical Movement Characteristics in Healthy Subjects and Subgroups of Chronic Neck Pain Patients Based on Their Pain Location.

    Science.gov (United States)

    Waeyaert, Patirck; Jansen, Daniel; Bastiaansen, Marco; Scafoglieri, Aldo; Buyl, Ronald; Schmitt, Maarten; Cattrysse, Erik

    2016-08-01

    A cross-sectional observational study of three-dimensional (3D) cervical kinematics in 41 chronic neck pain (CNPs) patients and 156 asymptomatic controls. The objective was to investigate 3D cervical kinematics by analyzing and comparing quantitative and qualitative parameters in healthy subjects and CNPs. Furthermore, subgroups were formed to explore the influence of pain-location on cervical kinematics. The possible correlation of kinematic parameters with the degree of functional disability was examined as well. In patients with chronic neck pain, a clear pathological cause is frequently not identifiable. Therefore, the need to assess neck pain with a broader view than structure or anatomical-based divergences is desirable. Movements of the cervical spine were registered using an electromagnetic tracking system. Quantitative and qualitative kinematics were analyzed for active axial rotation, lateral bending, and flexion-extension motion components. During lateral bending, the range of the main motion demonstrated significant higher values (P = 0.001) in the controls (mean: 68.67° ± 15.17°) than patients (mean: 59.28° ± 15.41°). Significant differences were demonstrated between subgroups for several kinematic parameters (P pain group, some parameters also distinguished subgroups from controls. On average, the symmetrical group showed significant less harmonic movement patterns, expressed by qualitative parameters, in comparison with the "asymmetrical" group and controls. Furthermore, the "asymmetrical" group showed significant lower scores on quantitative parameters than the "symmetrical" group and controls. The degree of functional disability correlated moderately with changes in qualitative parameters. In this study, chronic neck pain patients with a symmetrical pain pattern showed significant poorer quality of movement, while those with asymmetrical pain showed a significant reduction in quantitative measures. Subgrouping of neck patients

  15. Pain anxiety differentially mediates the association of pain intensity with function depending on level of intolerance of uncertainty.

    Science.gov (United States)

    Fischerauer, Stefan F; Talaei-Khoei, Mojtaba; Vissers, Frederique L; Chen, Neal; Vranceanu, Ana-Maria

    2018-02-01

    Uncertainty about symptom duration, cause, prognosis and treatment is common in patients who seek medical care, yet individual ability to manage this uncertainty varies. Intolerance of uncertainty is considered an important factor in the etiology and persistence of negative emotions- in particular, depression and anxiety. We explored the contribution of intolerance of uncertainty to anxiety due to pain and physical function in patients seeking care at an orthopedic medical practice. Participants (N = 105, mean age of 51 ± 17, 63% male) were administered PROMIS Physical Function v1.2 Upper Extremity CAT, Numerical Rating Scale (NRS), Pain Anxiety Symptoms Scale-short form (PASS-20), and the Intolerance of Uncertainty Scale-short version (IUS-12). Results showed that the mediating role of pain anxiety is contingent upon the level of intolerance of uncertainty. Specifically, a minimum level of intolerance of uncertainty is required for the development of pain anxiety and its effect on function, and as intolerance of uncertainty rises from low to medium to high levels, the effect of pain on function goes from being independent of the anxiety to being more and more carried by and through anxiety about pain. These findings support the contention that intolerance of uncertainty plays a crucial role in the relationship between pain, pain anxiety, and physical function. Intolerance of uncertainty appears to be a trans-diagnostic target for coping skills training. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  16. A Comparison of Change in the 0–10 Numeric Rating Scale to a Pain Relief Scale and Global Medication Performance Scale in a Short-term Clinical Trial of Breakthrough Pain Intensity

    Science.gov (United States)

    Farrar, John T.; Polomano, Rosemary C.; Berlin, Jesse A.; Strom, Brian L.

    2010-01-01

    Background Pain intensity is commonly reported using a 0–10 numeric rating scale in breakthrough pain clinical trials. Analysis of the change on the Pain Intensity Numerical Rating Scale as a proportion as most consistently correlated with clinically important differences reported on the Patient Global Impression of Change. The analysis of data using a different global outcome measures and the pain relief scale will extend our understanding of these measures. Use of the pain relief scale is also explored in this study Methods Data came from the open titration phase of a multiple crossover, randomized, double-blind clinical trial comparing oral transmucosal fentanyl citrate to immediate-release oral morphine sulfate for treatment of cancer-related breakthrough pain. Raw and percent changes in the pain intensity scores on 1,307 from 134 oral transmucosal fentanyl citrate-naive patients were compared to the clinically relevant secondary outcomes of the pain relief verbal response scale and the global medication performance. The changes in raw and percent change were assessed over time and compared to the ordinal pain relief verbal response scale and global medication performance scales. Results The p-value of the interaction between the raw pain intensity difference was significant but not for the percent pain intensity difference score over 4 15 minute time periods (p = 0.034 and p = 0.26 respectively), in comparison with the ordinal pain relief verbal response scale (p = 0.0048 and p = 0.36 respectively), and global medication performance categories (p = 0.048 and p = 0.45 respectively). Conclusion The change in pain intensity in breakthrough pain was more consistent over time and when compared to both the pain relief verbal response scale and global medication performance scale when the percent change is used rather than raw pain intensity difference. PMID:20463579

  17. The Tampa Scale of Kinesiophobia: A Rasch analysis of its properties in subjects with low back and more widespread pain.

    Science.gov (United States)

    Damsgård, Elin; Fors, Terese; Anke, Audny; Røe, Cecilie

    2007-11-01

    The aim of this study was to investigate the psychometric properties of the Norwegian version of the Tampa Scale of Kinesiophobia in patients with low back pain and in patients with more widespread pain distribution including low back pain. A total of 120 subjects, 48 with isolated low back pain and 72 with more widespread pain distribution were included. The Norwegian translation of the Tampa Scale of Kinesiophobia, Hopkins Symptom Check List 25 question version and Fear Avoidance Behaviour Questionnaire were completed. The properties of the Norwegian translation of the Tampa Scale of Kinesiophobia were explored by a Rasch analysis. The Tampa Scale of Kinesiophobia fitted the Rasch model and passed the independent t-test for a unidimensional scale. The response categories for some of the items needed to be collapsed from 4 to 3 levels. Only the item "It's not really safe for a person with a condition like mine to be physically active" was significantly different in men and women. The Norwegian translation of Tampa Scale of Kinesiophobia seems to reflect a unidimensional construct of kinesiophobia. The scale seemed to be quite robust across age and gender, and the response patterns to the items were similar in patients with low back pain and widespread pain distribution including low back pain.

  18. Combination of haloperidol, dexamethasone, and ondansetron reduces nausea and pain intensity and morphine consumption after laparoscopic sleeve gastrectomy.

    Science.gov (United States)

    Benevides, Márcio Luiz; Oliveira, Sérgio de Souza; Aguilar-Nascimento, José Eduardo

    2013-01-01

    Postoperative nausea and vomiting (PONV) occur frequently after laparoscopic bariatric surgery. The combination of haloperidol, dexamethasone, and ondansetron may reduce these undesirable events. The aim of this study was to evaluate the intensity of nausea and pain, the number of vomiting episodes, and morphine consumption in postoperative (PO) obese patients undergoing laparoscopic sleeve gastrectomy (LSG). A clinical, randomized, controlled, double-blind study conducted with 90 patients with body mass index ≥ 35 kg.cm-2. Patients were divided into three groups of 30 individuals to receive ondansetron 8 mg (Group O); ondansetron 8 mg and dexamethasone 8 mg (Group OD); and ondansetron 8 mg, dexamethasone 8 mg, and haloperidol 2 mg (Group HDO). We evaluated the intensity of nausea and pain using the verbal numeric scale, cumulative number of vomiting episodes, and morphine consumption in the period of 0-2, 2-12, 12-24, and 24-36 hours postoperatively. Nausea intensity was lower in Group HDO compared to Group O (p = 0.001), pain intensity was lower in Group HDO compared to Group O (p = 0.046), and morphine consumption was lower in Group HDO compared to Group O (p = 0.037). There was no difference between groups regarding the number of vomiting episodes (p = 0.052). The combination of haloperidol, ondansetron, and dexamethasone reduced nausea and pain intensity and morphine consumption in postoperative obese patients undergoing LSG.

  19. An assessment of emotional pain among subjects with chronic dermatological problems in Lagos, Nigeria.

    Science.gov (United States)

    Owoeye, O A; Aina, O F; Omoluabi, P F; Olumide, Y M

    2007-01-01

    in each group the males scored slightly higher than their female counterparts. On assessment with PAS, the subjects had much higher mean score of 28.94 +/- 12.61 and the controls: 18.92 +/- 7.1 with "t" of 6.19*; and the difference was statistically significant at p compared to the healthy controls; the males had higher mean scores on PAS and SCL subscales, hence more likely to suffer emotional pain than their female counterparts. Finally, the need to have consultation-liaison psychiatry in the dermatology facilities in Nigeria was emphasized.

  20. Evaluation of the effects of patient-selected music therapy on the sleep quality and pain intensity of burn patients

    Directory of Open Access Journals (Sweden)

    Fatemeh Muhaddith Ardabili

    2016-02-01

    Full Text Available Background: Sleep disturbances and pain are some of the most common problems among burn patients, which have adverse effects on recovery process and patient comfort. Given the use of music as a non-pharmacological approach to alleviate pain and provide comfort, this study aimed to evaluate the effect of patient-selected music on sleep quality and pain intensity in burn patients. Methods: This clinical trial was conducted on burn patients hospitalized in one of the hospitals of Tehran, Iran in 2015. In total, 50 patients were selected using randomized convenience sampling and divided into two intervention (n=25 and control (n=25 groups. Intervention was carried out for the intervention group through playing instrumental music, selected by the patients, in three consecutive 45-minute sessions before sleep. Severity of pain in the participants was evaluated for three nights (before and five minutes after the intervention using visual analog scale (VAS. In addition, sleep quality of the samples was assessed three days before the intervention using Pittsburgh sleep quality index (PSQI and during the post-intervention days through interviews. The mentioned scales were applied for the control group as well. Data analysis was performed in SPSS version 18 using Chi-square, as well as paired and independent t-tests. Results: In this study, a significant improvement was observed in sleep quality (P<0.001 and pain intensity (P=0.012 in the participants of intervention group after listening to music. Moreover, a significant difference was observed between the study groups after the intervention in terms of mean sleep quality score (P<0.001 and pain intensity (P=0.046. Conclusion: According to the results of this study, application of patient-selected music therapy could be associated with a significant improve in sleep quality and decrease in pain intensity in burn patients. Therefore, it is recommended that this intervention approach be applied by

  1. Evaluation of the effect of patient-selected music on sleep quality and pain intensity in burn patients

    Directory of Open Access Journals (Sweden)

    Mohaddes Ardabili Fatemeh

    2016-08-01

    Full Text Available Background and Objective: Sleep disturbances and pain are some of the most common problems among burn patients, which have adverse effects on recovery process and patient comfort. Given the use of music as a non-pharmacological approach to alleviate pain and provide comfort, this study aimed to evaluate the effect of patient-selected music on sleep quality and pain intensity in burn patients. Materials and Method: This clinical trial was conducted on burn patients hospitalized in one of the hospitals of Tehran, Iran in 2015. In total, 50 patients were selected using randomized convenience sampling and divided into two intervention (n=25 and control (n=25 groups. Intervention was carried out for the intervention group through playing instrumental music, selected by the patients, in three consecutive 45-minute sessions before sleep. Severity of pain in the participants was evaluated for three nights (before and five minutes after the intervention using visual analog scale (VAS. In addition, sleep quality of the samples was assessed three days before the intervention using Pittsburgh sleep quality index (PSQI and during the post-intervention days through interviews. The mentioned scales were applied for the control group as well. Data analysis was performed in SPSS version 18 using Chi-square, as well as paired and independent t-tests. Results: In this study, a significant improvement was observed in sleep quality (P<0.001  and pain intensity (P=0.012 in the participants of intervention group after listening to music. Moreover, a significant difference was observed between the study groups after the intervention in terms of mean sleep quality score (P<0.001 and pain intensity (P=0.046. Conclusion: According to the results of this study, application of patient-selected music therapy could be associated with a significant improve in sleep quality and decrease in pain intensity in burn patients. Therefore, it is recommended that this intervention

  2. Resistance exercise improves muscle strength, health status and pain intensity in fibromyalgia--a randomized controlled trial.

    Science.gov (United States)

    Larsson, Anette; Palstam, Annie; Löfgren, Monika; Ernberg, Malin; Bjersing, Jan; Bileviciute-Ljungar, Indre; Gerdle, Björn; Kosek, Eva; Mannerkorpi, Kaisa

    2015-06-18

    Fibromyalgia (FM) is characterized by persistent widespread pain, increased pain sensitivity and tenderness. Muscle strength in women with FM is reduced compared to healthy women. The aim of this study was to examine the effects of a progressive resistance exercise program on muscle strength, health status, and current pain intensity in women with FM. A total of 130 women with FM (age 22-64 years, symptom duration 0-35 years) were included in this assessor-blinded randomized controlled multi-center trial examining the effects of progressive resistance group exercise compared with an active control group. A person-centred model of exercise was used to support the participants' self-confidence for management of exercise because of known risks of activity-induced pain in FM. The intervention was performed twice a week for 15 weeks and was supervised by experienced physiotherapists. Primary outcome measure was isometric knee-extension force (Steve Strong®), secondary outcome measures were health status (FIQ total score), current pain intensity (VAS), 6MWT, isometric elbow-flexion force, hand-grip force, health related quality of life, pain disability, pain acceptance, fear avoidance beliefs, and patient global impression of change (PGIC). Outcomes were assessed at baseline and immediately after the intervention. Long-term follow up comprised the self-reported questionnaires only and was conducted after 13-18 months. Between-group and within-group differences were calculated using non-parametric statistics. Significant improvements were found for isometric knee-extension force (p = 0.010), health status (p = 0.038), current pain intensity (p = 0.033), 6MWT (p = 0.003), isometric elbow flexion force (p = 0.02), pain disability (p = 0.005), and pain acceptance (p = 0.043) in the resistance exercise group (n = 56) when compared to the control group (n = 49). PGIC differed significantly (p = 0.001) in favor of the resistance exercise group at post-treatment examinations

  3. Gray matter changes following limb amputation with high and low intensities of phantom limb pain.

    Science.gov (United States)

    Preissler, Sandra; Feiler, Johanna; Dietrich, Caroline; Hofmann, Gunther O; Miltner, Wolfgang H R; Weiss, Thomas

    2013-05-01

    Limb amputation and chronic phantom limb pain (PLP) are both associated with neural alterations at all levels of the neuraxis. We investigated gray matter volume of 21 upper limb amputees and 14 healthy control subjects. Results demonstrate that amputation is associated with reduced gray matter in areas in the motor cortex representing the amputated limb. Additionally, patients show an increase in gray matter in brain regions that belong to the dorsal and ventral visual stream. We subdivided the patient group into patients with medium to high PLP (HPLP; N = 11) and those with slight PLP (SPLP; N = 10). HPLP patients showed reduced gray matter in brain areas involved in pain processing. SPLP patients showed a significant gray matter increase in regions of the visual stream. Results indicate that all patients may have an enhanced need for visual control to compensate the lack of sensory feedback of the missing limb. As we found these alterations primarily in the SPLP patient group, successful compensation may have an impact on PLP development. Therefore, we hypothesize that visual adaptation mechanisms may compensate for the lack of sensorimotor feedback and may therefore function as a protection mechanism against high PLP development.

  4. The Effect of Topical Anaesthesia on Pressure Pain Thresholds in symptom-free subjects

    OpenAIRE

    Axelsson, Anna; Carlsson, Elsa

    2014-01-01

    Palpation, a standard procedure in the diagnostic process of muscular pain conditions – myalgia, aims to provoke a muscular pain response. The origin of pain elicited by palpation is not fully understood. There is also a possibility that the pressure elicit response from mechanoreceptors in skin, sub mucosal tissue or periosteum, which may affect the validity of the method. The aim of this study was to evaluate the effect of topical anesthesia on pressure pain thresholds at masseter, temporal...

  5. Prevalence and intensity of chronic pain and self-perceived health among elderly people: a population-based study

    Directory of Open Access Journals (Sweden)

    Lilian Varanda Pereira

    2014-08-01

    Full Text Available OBJECTIVE: to identify the prevalence and intensity of chronic pain among elderly people of the community and to analyze associations with the self-perceived health status.METHOD: cross-sectional study with a populational sample (n=934, conducted through household interviews in the city of Goiânia, Brazil. The intensity of chronic pain (existing for 6 months or more was measured using a numerical scale (0-10 and the self-perceived health through a verbal scale (very good, good, fair, poor, very poor. For the statistical analysis, the absolute frequency and percentage, CI (95%, Chi-square test, Odds ratio, and regression analysis were used. Significance of 5%.RESULTS: The prevalence of chronic pain was 52.8% [CI (95%:49.4-56.1]; most frequently located in the lower limbs (34.5% and lumbar region (29.5%; with high or the worst possible intensity for 54.6% of the elderly people. The occurrence of chronic pain was associated with (p<0.0001 a worse self-perception of health (OR=4.2:2.5-7.0, a greater number of chronic diseases (OR=1.8:1.2-2.7, joint disease (OR=3.5:2.4-5.1 and the female gender (OR=2.3:1.7-3.0. A lower intensity of chronic pain was associated with a better self-perception of health (p<0.0001.CONCLUSION: the majority of the elderly people of the community reported chronic pain, of a severe intensity, and located in areas related to movement activities, thus influencing the morbidity and mortality of this population.

  6. Pen needle design influences ease of insertion, pain, and skin trauma in subjects with type 2 diabetes

    DEFF Research Database (Denmark)

    Præstmark, Kezia A; Jensen, Morten L; Berg Madsen, Nils

    2016-01-01

    of insertion, pain and skin trauma. RESEARCH DESIGN AND METHODS: 30 subjects with injection-treated type 2 diabetes and body mass index 25-35 kg/m(2) were included in the single-blinded study. Each subject received abdominal insertions with 18 different types of needles. All needles were tested twice per...... was dependent of SBP increase. CONCLUSIONS: The shape and design of a needle and the needle tip affect ease of insertion, pain and skin trauma. Relations are seen across different data acquisition methods and across species, enabling needle performance testing outside of clinical trials. TRIAL REGISTRATION...

  7. Can pain influence the proprioception and the motor behavior in subjects with mild and moderate knee osteoarthritis?

    Science.gov (United States)

    de Oliveira, Daniela C Silveira; Barboza, Saulo Delfino; da Costa, Franciele Dias; Cabral, Monnique Ponciano; Silva, Vanessa Martins Pereira; Dionisio, Valdeci Carlos

    2014-09-27

    Osteoarthritis (OA) is a chronic disease, usually characterized by pain, which is associated with reduced muscle strength, disability and progressive loss of function. However, the pain influence over proprioception and motor behaviour remains unclear. Thus, the purpose of the study was to identify the levels of pain, the proprioceptive acuity and the pattern of muscle recruitment during stair ascent and descent in elderly patients with mild and moderate osteoarthritis (OA) compared to healthy subjects. The study participants included 11 healthy elderly subjects (7 women and 4 men) and 31 elderly patients with knee OA (19 women and 12 men). The functional capacity was assessed by the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index; the pain was evaluated by Wong-Baker faces pain rating scale (WBS) and pressure pain threshold (PPT); the proprioceptive acuity was based on the joint position sense evaluated by electrogoniometer; and the electromyographic (EMG) activity of the major muscles of the lower limb were evaluated during a task of stair ascent and descent of 15 cm. For statistical analysis it was used Statistic for Windows software (StatSoft Inc., version 5.0). Data from the WOMAC index, WBS, the proprioceptive acuity and IEMG (for each muscle in each phase) were analyzed using the Mann-Whitney U test and data from PPT was used Kruskal-Wallis test. Higher scores were found in the WOMAC index and WBS whereas lower scores were seen in PPT in patients with knee OA compared to healthy subjects. In contrast, there were no significant differences in the proprioceptive acuity and EMG results of most muscles analyzed between the groups. The presence of pain does not influence the proprioception and the motor behavior of the thigh muscles during stair ascent and descent in subjects with mild and moderate knee OA.

  8. EFFECTS OF POSTEROANTERIOR LUMBAR SPINE MOBILIZATIONS ON PAIN, ROM AND FUNCTIONAL DISABILITY IN FEMALE SUBJECTS WITH CHRONIC NONSPECIFIC LOW BACK PAIN

    Directory of Open Access Journals (Sweden)

    C. Shanthi

    2014-12-01

    Full Text Available Background: Chronic nonspecific low back pain (CNSLBP i.e., low back pain of at least 12 weeks duration without a specific cause is a major cause of activity limitation, absenteeism , and high health care expenses. The prevalence of CNSLBP is estimated approximately 23% and activity limitation due to LBP have been found to be 11% to 12% of the population. Previous studies comparing the efficacy of postero-anterior mobilisation and prone-press ups were done and revealed statistically significant improvements in extension ranges but not clinical relevant improvements. This is possibly attributable to single session of interventions. So long term gains in pain reduction and lumbar extension cannot be assumed. Hence this study would be intending to prove the effect of postero-anterior mobilisation and prone press ups on chronic non-specific low back pain after 6 weeks and their clinical application. Method: 30 subjects who met the inclusion criteria were selected randomly from the department of physiotherapy, SVIMS and BIRRD, Tirupati. The study conducted for a period of 6 weeks.2 groups were formed with 15 in each group. PA lumbar glide and prone press up's was given to group I and only prone press up's was given to group II. Subjects were evaluated pre and post treatment for VAS, extension ROM of lumbar spine and functional disability. Result: Results showed that there exists a statistical significance between the groups in all the 3 parameters. Present randomized clinical trial provided evidence to support the use of postero-anterior mobilisation and prone press-ups in relieving pain, improving ROM and reducing disability in subjects with non-specific low back pain. In addition, results supported that postero-anterior mobilisation was more effective than prone press-ups.

  9. Long-term consequences of pain, anxiety and agitation for critically ill older patients after an intensive care unit stay.

    Science.gov (United States)

    Jeitziner, Marie-Madlen; Hamers, Jan P H; Bürgin, Reto; Hantikainen, Virpi; Zwakhalen, Sandra M G

    2015-09-01

    This study investigated whether an intensive care unit (ICU) stay is associated with persistent pain, anxiety and agitation in critically ill older patients. Patients hospitalised in the ICU are at risk for experiencing pain, anxiety and agitation, but long-term consequences for older patients have rarely been investigated. Prospective nonrandomised longitudinal study. Pain, anxiety and agitation, measured with a numeric rating scale (0-10), were assessed in older patients (≥65 years) hospitalised in the medical-surgical ICU of a university hospital. Agitation during the ICU was assessed with the Richmond Agitation-Sedation Scale. Data collection occurred during the ICU, one week after the stay and six and 12 months after hospital discharge. Data were collected from an age-matched community-based comparison group at recruitment and after six and 12 months. Study recruitment took place from December 2008-April 2011. This study included 145 older patients (ICU group) and 146 comparison group participants. Pain was higher in the ICU group one week after discharge, although pain levels in general were low. Both groups reported no or low levels of pain after six and 12 months. Anxiety levels in general were low, although higher in the ICU group one week after ICU discharge. After six and 12 months, anxiety in both groups was comparable. Throughout the study, levels of agitation were similar in both groups. Critically ill older patients did not experience increased pain, anxiety or agitation 12 months after an ICU stay. This study positively shows that an ICU stay is not associated with persistent pain, anxiety and agitation thus providing additional information to older patients and their families when making intensive care treatment decisions. Adequate management of pain during and after an ICU stay may minimise the suffering of older patients. © 2015 John Wiley & Sons Ltd.

  10. Seeing One's Own Painful Hand Positioned in the Contralateral Space Reduces Subjective Reports of Pain and Modulates Laser Evoked Potentials.

    Science.gov (United States)

    Valentini, Elia; Koch, Katharina; Aglioti, Salvatore Maria

    2015-06-01

    Studies report that viewing the body or keeping one's arms crossed while receiving painful stimuli may have an analgesic effect. Interestingly, changes in ratings of pain are accompanied by a reduction of brain metabolism or of laser evoked potentials amplitude. What remains unknown is the link between visual analgesia and crossed-arms related analgesia. Here, we investigated pain perception and laser evoked potentials in 3 visual contexts while participants kept their arms in a crossed or uncrossed position during vision of 1) one's own hand, 2) a neutral object in the same spatial location, and 3) a fixation cross placed in front of the participant. We found that having vision of the affected body part in the crossed-arms position was associated with a significant reduction in pain reports. However, no analgesic effect of having vision of the hand in an uncrossed position or of crossing the arms alone was found. The increase of the late vertex laser evoked potential P2 amplitude indexed a general effect of vision of the hand. Our results hint at a complex interaction between cross-modal input and body representation in different spatial frames of reference and at the same time question the effect of visual analgesia and crossed-arms analgesia alone. We found that nociceptive stimuli delivered to the hand in a crossed-arms position evoke less pain than in a canonical anatomic position. Yet we report no significant analgesic effect of vision or crossing the arms on their own. These findings foster the integration of visuospatial and proprioceptive information in rehabilitation protocols. Copyright © 2015 American Pain Society. Published by Elsevier Inc. All rights reserved.

  11. Effect of intraoperative lidocaine on anesthetic consumption, and bowel function, pain intensity, analgesic consumption and hospital stay after breast surgery.

    Science.gov (United States)

    Choi, Soo Joo; Kim, Myung Hee; Jeong, Hui Yeon; Lee, Jeong Jin

    2012-05-01

    Perioperative lidocaine infusion improves postoperative outcomes, mostly after abdominal and urologic surgeries. Knowledge of the effect of lidocaine on peripheral surgeries is limited. Presently, we investigated whether intraoperative lidocaine infusion reduced anesthetic consumption, duration of ileus, pain intensity, analgesic consumption and hospital stay after breast plastic surgeries. Sixty female patients, aged 20-60 years, enrolled in this prospective study were randomly and equally divided to two groups. One group (n = 30) received a 1.5 mg/kg bolus of lidocaine approximately 30 min before incision followed by continuous infusion of lidocaine (1.5 mg/kg/h) until skin closure (lidocaine group). The other group (n = 30) was untreated (control group). Balanced inhalation (sevoflurane) anesthesia and multimodal postoperative analgesia were standardized. End tidal sevoflurane concentration during surgery, time to the first flatus and defecation, visual analog pain scale (0-10), analgesic consumption and associated side effects at 24, 48, and 72 h after surgery, hospital stay, and patient's general satisfaction were assessed. Compared to the control group, intraoperative lidocaine infusion reduced by 5% the amount of sevoflurane required at similar bispectral index (P = 0.014). However, there were no significant effects of lidocaine regarding the return of bowel function, postoperative pain intensity, analgesic sparing and side effects at all time points, hospital stay, and level of patient's satisfaction for pain control. Low dose intraoperative lidocaine infusion offered no beneficial effects on return of bowel function, opioid sparing, pain intensity and hospital stay after various breast plastic surgeries.

  12. Immediate effect of nimmo receptor tonus technique on muscle elasticity, pain perception, and disability in subjects with chronic low back pain.

    Science.gov (United States)

    Koo, Terry K; Cohen, Jeffrey H; Zheng, Yongping

    2012-01-01

    Objectives of this study were to (1) quantify the immediate effect of Nimmo technique on muscle elasticity, pain perception, and disability and (2) evaluate comparative effectiveness of treating all primary and secondary trigger points (TrPs) vs primary TrP only. Fourteen chronic low back pain subjects recruited from a chiropractic college were tested in this within-day repeated-measures design study. Gluteus medius containing a prominent TrP was indented for 4 sessions using a mechanoacoustic indentor system. A finite element optimization method extracted hyperelastic material constants of the gluteus medius. Load-deformation response on a standardized block was simulated. Area under the load-deformation curve from 0% to 25% deformation (A(FE)) and force at 25% deformation (F(FE)) were determined. No treatment was applied between the first and second sessions. Only the primary TrP in gluteus medius was treated between the second and third sessions. Full Nimmo treatment was used between the third and fourth sessions requiring treatment of all primary and secondary TrPs. The A(FE), F(FE), tissue thickness, subjective pain, and Oswestry Disability Index were compared between sessions. After full Nimmo treatment, A(FE) and F(FE) were significantly smaller than baseline (P = .021 and .027, respectively) and focal TrP treatment only (P = .003 and .001, respectively). The changes accompanied concomitant improvement in subjective pain and disability. It appears that focal TrP treatment resolves TrP, but full Nimmo treatment further reduces electrogenic spasm. Immediate effect of a single full Nimmo treatment appears to reduce muscle tone, subjective pain, and disability and be more beneficial than focal TrP treatment. Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  13. Peak and end effects in patients' daily recall of pain and fatigue: a within-subjects analysis.

    Science.gov (United States)

    Schneider, Stefan; Stone, Arthur A; Schwartz, Joseph E; Broderick, Joan E

    2011-02-01

    Clinical research often relies on retrospective recall of symptom levels, but the information contained in these ratings is not well understood. The "peak-and-end rule" suggests that the most intense (peak) and final (end) moments of an experience disproportionately influence retrospective judgments, which may bias self-reports of somatic symptoms. This study examined the extent to which peak and end symptom levels systematically affect patients' day-to-day recall of pain and fatigue. Rheumatology patients (N = 97) completed 5 to 6 momentary ratings of pain and fatigue per day as well as a daily recall rating of these symptoms for 28 consecutive days. For pain, peak and end momentary ratings predicted daily recall of average pain beyond the actual average of momentary ratings. This effect was small, yet was confirmed in both between-person and within-person (repeated measures) analyses. For fatigue, neither peak nor end momentary symptoms significantly contributed to daily recall. Of note, the evidence for peak- and end-effects in recall of pain and fatigue varied significantly between individual patients. These findings suggest that peak- and end-effects create a small bias in recall reports of pain, but not fatigue. However, there are considerable individual differences in susceptibility to peak and end heuristics. The peak-end cognitive heuristic could bias end-of-day recall of pain and fatigue. An effect was shown for pain, but not for fatigue. The effects were small and were unlikely to substantially bias end-of-day assessments. Individuals were shown to differ in the degree that the heuristic was associated with recall. Copyright © 2011 American Pain Society. Published by Elsevier Inc. All rights reserved.

  14. A research regarding the relationship among intensive care nurses' self-esteem, job satisfaction and subjective well-being

    OpenAIRE

    Huihui Liu; Xiaohong Zhang; Rui Chang; Weining Wang

    2017-01-01

    Objective: The paper aims to explore the status of intensive care unit (ICU) nurses' self-esteem, job satisfaction, and subjective well-being and to investigate the relationship among the three elements. Methods: A cross-sectional survey of 224 nurses from five teaching hospitals in Tianjin, China, was conducted. Self-esteem scale, job satisfaction scale, and subjective well-being scale were used to explore the status of ICU nurses' self-esteem, job satisfaction, and subjective well-being....

  15. Association between preoperative magnetic resonance imaging, pain intensity and quantitative sensory testing in patients awaiting lumbar diskectomy.

    LENUS (Irish Health Repository)

    Hegarty, Dominic

    2011-02-01

    Magnetic resonance imaging (MRI) offers important information regarding the morphology, location and size of a herniated disc, which influences the decision to offer lumbar diskectomy (LD). This study aims to examine the association between clinical neurophysiologic indices including pain intensity and quantitative sensory testing (QST), and the degree of lumbar nerve root compromise depicted on magnetic resonance (MR) in patients awaiting LD.

  16. Prevalence of pain-free weeks in chiropractic subjects with low back pain - a longitudinal study using data gathered with text messages

    Directory of Open Access Journals (Sweden)

    Lemeunier Nadège

    2011-12-01

    Full Text Available Abstract Introduction The use of automated text messages has made it possible to identify different courses of low back pain (LBP, and it has been observed that pain often fluctuates and that absolute recovery is rather rare. The purpose of this study was to describe the prevalence of pain-free weeks and pain-free periods in subjects with non-specific LBP treated by chiropractors, and to compare subjects from two different countries in these aspects. Methods Data were obtained from two practice-based multicentre prospective outcome studies, one Danish and one Swedish, involving subjects being treated by chiropractors for non-specific LBP. Over 18 weeks, subjects answered a weekly automated text message question on the number of days in the past week that they had experienced bothersome LBP, i.e. a number between 0 and 7. The number of weeks in a row without any LBP at all ("zero weeks" as well as the maximum number of zero weeks in a row was determined for each individual. Comparisons were made between the two study samples. Estimates are presented as percentages with 95% confidence intervals. Results In the Danish and the Swedish populations respectively, 93/110 (85% and 233/262 (89% of the subjects were eligible for analysis. In both groups, zero weeks were rather rare and were most commonly (in 40% of the zero weeks reported as a single isolated week. The prevalence of pain free periods, i.e. reporting a maximum of 0, 1 or 2, or 3-6 zero weeks in a row, were similar in the two populations (20-31%. Smaller percentages were reported for ≥ 7 zero weeks in a row. There were no significant differences between the two study groups. Conclusion It was uncommon that chiropractic subjects treated for non-specific LBP experienced an entire week without any LBP at all over 18 weeks. When this occurred, it was most commonly reported for brief periods only. Hence, recovery in the sense that patients become absolutely pain free is rare, even in a primary

  17. Prevalence of pain-free weeks in chiropractic subjects with low back pain - a longitudinal study using data gathered with text messages.

    Science.gov (United States)

    Lemeunier, Nadège; Kongsted, Alice; Axén, Iben

    2011-12-14

    The use of automated text messages has made it possible to identify different courses of low back pain (LBP), and it has been observed that pain often fluctuates and that absolute recovery is rather rare. The purpose of this study was to describe the prevalence of pain-free weeks and pain-free periods in subjects with non-specific LBP treated by chiropractors, and to compare subjects from two different countries in these aspects. Data were obtained from two practice-based multicentre prospective outcome studies, one Danish and one Swedish, involving subjects being treated by chiropractors for non-specific LBP. Over 18 weeks, subjects answered a weekly automated text message question on the number of days in the past week that they had experienced bothersome LBP, i.e. a number between 0 and 7. The number of weeks in a row without any LBP at all ("zero weeks") as well as the maximum number of zero weeks in a row was determined for each individual. Comparisons were made between the two study samples. Estimates are presented as percentages with 95% confidence intervals. In the Danish and the Swedish populations respectively, 93/110 (85%) and 233/262 (89%) of the subjects were eligible for analysis. In both groups, zero weeks were rather rare and were most commonly (in 40% of the zero weeks) reported as a single isolated week. The prevalence of pain free periods, i.e. reporting a maximum of 0, 1 or 2, or 3-6 zero weeks in a row, were similar in the two populations (20-31%). Smaller percentages were reported for ≥ 7 zero weeks in a row. There were no significant differences between the two study groups. It was uncommon that chiropractic subjects treated for non-specific LBP experienced an entire week without any LBP at all over 18 weeks. When this occurred, it was most commonly reported for brief periods only. Hence, recovery in the sense that patients become absolutely pain free is rare, even in a primary care population.

  18. Prevalence of pain-free weeks in chiropractic subjects with low back pain - a longitudinal study using data gathered with text messages

    DEFF Research Database (Denmark)

    Lemeunier, Nadege; Kongsted, Alice; Axen, Iben

    2011-01-01

    ABSTRACT: INTRODUCTION: The use of automated text messages has made it possible to identify different courses of low back pain (LBP), and it has been observed that pain often fluctuates and that absolute recovery is rather rare. The purpose of this study was to describe the prevalence of pain...... treated by chiropractors for non-specific LBP. Over 18 weeks, subjects answered a weekly automated text message question on the number of days in the past week that they had experienced bothersome LBP, i.e. a number between 0 and 7. The number of weeks in a row without any LBP at all ("zero weeks......") as well as the maximum number of zero weeks in a row was determined for each individual. Comparisons were made between the two study samples. Estimates are presented as percentages with 95% confidence intervals. RESULTS: In the Danish and the Swedish populations respectively, 93/110 (85%) and 233/262 (89...

  19. Possible applications of Neuromuscular Taping in pain reduction in Multiple Sclerosis subject: a preliminary report

    Directory of Open Access Journals (Sweden)

    Carmine Berlingieri

    2016-12-01

    Full Text Available Pain is a common disabling symptom in patients with Multiple Sclerosis (MS. It has been indicated that pain prevalence in MS patients is between 29–86 %. It is evident that most MS patients requiring treatment will be also searching pain related treatments to assist in day to day activities. Neuropathic pain is a difficult symptom and is generally inadequately relieved even though different rehabilitative approaches may be used. Neuromuscular Taping inducing micro-movements by stimulating receptors in the skin has been described in literature as a possible intervention in neurological and orthopedic rehabilitation improving mobility and in pain reduction. The aim of this preliminary report was to analyze the effect and to evaluate the possible applications of Neuromuscular Taping (NMT in patients with MS in order to reduce pain in comparison to the Transcutaneous Electrical Nerve Stimulation (TENS and to physical rehabilitation treatment alone. We observed that NMT together with standard physical rehabilitation was able to reduce neuropathic pain to greater lengths, with statistically significant differences between pre and post treatment, compared to the other treatments evaluated. This study showed increased efficacy in pain reduction when NMT was applied to standard physical treatment in long standing pain conditions. Neuromuscular Taping may constitute a low cost treatment strategy for neuropathic pain conditions in MS.

  20. Increased objectively assessed vigorous-intensity exercise is associated with reduced stress, increased mental health and good objective and subjective sleep in young adults.

    Science.gov (United States)

    Gerber, Markus; Brand, Serge; Herrmann, Christian; Colledge, Flora; Holsboer-Trachsler, Edith; Pühse, Uwe

    2014-08-01

    The role of physical activity as a factor that protects against stress-related mental disorders is well documented. Nevertheless, there is still a dearth of research using objective measures of physical activity. The present study examines whether objectively assessed vigorous physical activity (VPA) is associated with mental health benefits beyond moderate physical activity (MPA). Particularly, this study examines whether young adults who accomplish the American College of Sports Medicine's (ACSM) vigorous-intensity exercise recommendations differ from peers below these standards with regard to their level of perceived stress, depressive symptoms, perceived pain, and subjective and objective sleep. A total of 42 undergraduate students (22 women, 20 men; M=21.24years, SD=2.20) volunteered to take part in the study. Stress, pain, depressive symptoms, and subjective sleep were assessed via questionnaire, objective sleep via sleep-EEG assessment, and VPA via actigraphy. Meeting VPA recommendations had mental health benefits beyond MPA. VPA was associated with less stress, pain, subjective sleep complaints and depressive symptoms. Moreover, vigorous exercisers had more favorable objective sleep pattern. Especially, they had increased total sleep time, more stage 4 and REM sleep, more slow wave sleep and a lower percentage of light sleep. Vigorous exercisers also reported fewer mental health problems if exposed to high stress. This study provides evidence that meeting the VPA standards of the ACSM is associated with improved mental health and more successful coping among young people, even compared to those who are meeting or exceeding the requirements for MPA. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. The use of dry needling for a subject with chronic lateral hip and thigh pain: a case report.

    Science.gov (United States)

    Pavkovich, Ron

    2015-04-01

    Lateral thigh pain, commonly referred to as greater trochanteric pain syndrome (GTPS) and/ or iliotibial band syndrome (ITBS) is commonly treated by the physical therapist. Lateral thigh pain is commonly treated by the physical therapist. The sources of lateral thigh pain are commonly attributed to GTPS and/ or ITBS though various pathologies may contribute to this pain, of which trigger points (TrPs) may be an etiology. Dry needling (DN) is an intervention utilized by physical therapists where a monofilament needle is inserted into soft tissue in order to reduce pain to improve range of motion/ motor control dysfunction. This can assist with facilitation of return to prior level of function. The purpose of this case report is to report the outcomes of a patient with lateral hip and thigh pain treated with DN as a primary intervention strategy. The subject was an active 78-year-old female recreational walker who was referred to physical therapy for chronic left lateral hip and thigh pain of greater than one-year duration without a clear mechanism of injury. She had a history of previous physical therapy treatment for the same condition, and previous therapeutic intervention strategies were effective for approximately two to three months duration prior to return of pain symptoms. Physical examination supported a diagnosis of GTPS/ ITBS. Subjective reports denoted sleep deficit due to pain lying on the left side at night and difficulty walking more than five minutes. Objective findings included decreased strength of the hip musculature and reproduction of pain symptoms upon flat palpation in specific locations throughout the lateral hip and thigh regions. She was treated for eight weeks using only DN to determine the effectiveness of DN as a primary intervention strategy, as previous physical therapy interventions were inconsistent and were only beneficial in the short-term. Clinically meaningful improvements were noted in disability and pain, as measured by the

  2. A comparison of lumbopelvic motion patterns and erector spinae behavior between asymptomatic subjects and patients with recurrent low back pain during pain-free periods.

    Science.gov (United States)

    Sánchez-Zuriaga, Daniel; López-Pascual, Juan; Garrido-Jaén, David; García-Mas, Maria Amparo

    2015-02-01

    The purpose of this study was to determine the patterns of lumbopelvic motion and erector spinae (ES) activity during trunk flexion-extension movements and to compare these patterns between patients with recurrent low back pain (LBP) in their pain-free periods and matched asymptomatic subjects. Thirty subjects participated (15 patients with disc herniation and recurrent LBP in their pain-free periods and 15 asymptomatic control subjects). A 3-dimensional videophotogrammetric system and surface electromyography (EMG) were used to record the angular displacements of the lumbar spine and hip in the sagittal plane and the EMG activity of the ES during standardized trunk flexion-extension cycles. Variables were maximum ranges of spine and hip flexion; percentages of maximum lumbar and hip flexion at the start and end of ES relaxation; average percentages of EMG activity during flexion, relaxation, and extension; and flexion-extension ratio of myoelectrical activity. Recurrent LBP patients during their pain-free period showed significantly greater ES activation both in flexion and extension, with a higher flexion-extension ratio than controls. Maximum ranges of lumbar and hip flexion showed no differences between controls and patients, although patients spent less time with their lumbar spine maximally flexed. This study showed that reduced maximum ranges of motion and absence of ES flexion-relaxation phenomenon were not useful to identify LBP patients in the absence of acute pain. However, these patients showed subtle alterations of their lumbopelvic motion and ES activity patterns, which may have important clinical implications. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  3. The effectiveness of lavender essence on strernotomy related pain intensity after coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Heidari Gorji

    2015-01-01

    Conclusion: The result indicated that aromatherapy can be used as a complementary method in postoperative pain reduction, as it reduced pain. The patients require two sedative drugs, and moreover, it avoids expenses of treatment.

  4. Bio-psychosocial factors are associated with pain intensity, physical functioning, and ability to work in female healthcare personnel with recurrent low back pain

    Directory of Open Access Journals (Sweden)

    Annika Taulaniemi

    2017-08-01

    Full Text Available Objective: To investigate associations of various bio-psychosocial factors with bodily pain, physical func-tioning, and ability to work in low back pain. Design: Cross-sectional study. Subjects: A total of 219 female healthcare workers with recurrent non-specific low back pain. Methods: Associations between several physical and psychosocial factors and: (i bodily pain, (ii physical functioning and (iii ability to work were studied. Variables with statistically significant associations (p < 0.05 in bivariate analysis were set within a generalized linear model to analyse their relationship with each dependent variable. Results: In generalized linear model analysis, perceived work-induced lumbar exertion (p < 0.001, multi-site pain (p< 0.001 and work-related fear-avoidance beliefs (FAB-W (p = 0.02 best explained bodily pain. Multi-site pain (p < 0.001, lumbar exertion (p = 0.005, FAB-W (p = 0.01 and physical performance in figure-of-eight running (p = 0.01 and modified push-ups (p = 0.05 best explained physical functioning; FAB-W (p< 0.001, lumbar exertion (p = 0.003, depression (p = 0.01 and recovery after work (p = 0.03 best explained work ability. In bivariate analysis lumbar exertion was associated with poor physical performance. Conclusion: FAB-W and work-induced lumbar exertion were associated with levels of pain, physical functioning and ability to work. Poor physical performance capacity was associated with work-induced lumbar exertion. Interventions that aim to reduce fear-avoidance and increase fitness capacity might be beneficial.

  5. Subjectivity

    Directory of Open Access Journals (Sweden)

    Jesús Vega Encabo

    2015-11-01

    Full Text Available In this paper, I claim that subjectivity is a way of being that is constituted through a set of practices in which the self is subject to the dangers of fictionalizing and plotting her life and self-image. I examine some ways of becoming subject through narratives and through theatrical performance before others. Through these practices, a real and active subjectivity is revealed, capable of self-knowledge and self-transformation. 

  6. Catecholamine-o-methyltransferase polymorphisms are associated with postoperative pain intensity.

    LENUS (Irish Health Repository)

    Lee, Peter J

    2011-02-01

    single nucleotide polymorphisms (SNPs) in the genes for catecholamine-O-methyltransferase (COMT), μ-opioid receptor and GTP cyclohydrolase (GCH1) have been linked to acute and chronic pain states. COMT polymorphisms are associated with experimental pain sensitivity and a chronic pain state. No such association has been identified perioperatively. We carried out a prospective observational clinical trial to examine associations between these parameters and the development of postoperative pain in patients undergoing third molar (M3) extraction.

  7. Exploring the relationship between analgesic event rate and pain intensity in kidney stone surgery: A Repeated Time to Event Pilot Study

    DEFF Research Database (Denmark)

    Juul, Rasmus Vestergaard; Pedersen, Katja Venborg; Christrup, Lona Louring

    III-60 Rasmus Juul Exploring the relationship between analgesic event rate and pain intensity in kidney stone surgery: A Repeated Time to Event Pilot Study RV Juul(1), KV Pedersen(2, 4), LL Christrup(1), AE Olesen(1, 3), AM Drewes(3), PJS Osther(4), TM Lund(1) 1) Department of Drug Design...... a relationship with pain intensity has not yet been established. The aim of this pilot study was to discuss how best to investigate the relationship between RTTE hazard of analgesic events and pain intensity in postoperative pain. Methods: Data was available from 44 patients undergoing kidney stone surgery...

  8. Reliability, construct and discriminative validity of clinical testing in subjects with and without chronic neck pain

    DEFF Research Database (Denmark)

    Jørgensen, René; Ris Hansen, Inge; Falla, Deborah

    2014-01-01

    -retest reliability in people with and without chronic neck pain. Moreover, construct and between-group discriminative validity of the tests were examined. METHODS: Twenty-one participants with chronic neck pain and 21 asymptomatic participants were included. Intra- and inter-reliability were evaluated for the Cranio......-Cervical Flexion Test (CCFT), Range of Movement (ROM), Joint Position Error (JPE), Gaze Stability (GS), Smooth Pursuit Neck Torsion Test (SPNTT), and neuromuscular control of the Deep Cervical Extensors (DCE). Test-retest reliability was assessed for Postural Control (SWAY) and Pressure Pain Threshold (PPT) over...... neck pain....

  9. Fear avoidance beliefs in back pain-free subjects are reflected by amygdala-cingulate responses.

    Science.gov (United States)

    Meier, Michael L; Stämpfli, Phillipp; Vrana, Andrea; Humphreys, Barry K; Seifritz, Erich; Hotz-Boendermaker, Sabina

    2015-01-01

    In most individuals suffering from chronic low back pain, psychosocial factors, specifically fear avoidance beliefs (FABs), play central roles in the absence of identifiable organic pathology. On a neurobiological level, encouraging research has shown brain system correlates of somatic and psychological factors during the transition from (sub) acute to chronic low back pain. The characterization of brain imaging signatures in pain-free individuals before any injury will be of high importance regarding the identification of relevant networks for low back pain (LBP) vulnerability. Fear-avoidance beliefs serve as strong predictors of disability and chronification in LBP and current research indicates that back pain related FABs already exist in the general and pain-free population. Therefore, we aimed at investigating possible differential neural functioning between high- and low fear-avoidant individuals in the general population using functional magnetic resonance imaging. Results revealed that pain-free individuals without a history of chronic pain episodes could be differentiated in amygdala activity and connectivity to the pregenual anterior cingulate cortex by their level of back pain related FABs. These results shed new light on brain networks underlying psychological factors that may become relevant for enhanced disability in a future LBP episode.

  10. Pain

    Science.gov (United States)

    ... Grant Funding for Pain Initiatives Current Funding Opportunities Research on the Impact of Creative Arts in Military Populations More Health Professional Information Earn CME More Related Topics Chronic Pain ( NINDS ) NIH Pain Seminar Series Pain: You Can Get Help ( NIA ) NIH ...

  11. Intensive care unit team perception of palliative care: the discourse of the collective subject.

    Science.gov (United States)

    Gulini, Juliana El Hage Meyer de Barros; Nascimento, Eliane Regina Pereira do; Moritz, Rachel Duarte; Rosa, Luciana Martins da; Silveira, Natyele Rippel; Vargas, Mara Ambrosina de Oliveira

    2017-05-25

    To learn the perception of health professionals in an intensive care unit towards palliative care. This was a descriptive and qualitative study based on the converging care approach conducted at an intensive care unit in the South of Brazil. Semi-structured interviews were used to investigate the understanding of the professionals about palliative care in this unit. The data were organized and analyzed using the discourse of the collective subject method with the help of Qualiquantisoft® software. Participants included 37 professionals (12 nurses, 11nursing technicians, 5 physical therapists and 9 doctors). The key ideas extracted from the interviews were: care in the end stage of life that avoids futile measures; comfort care; lack of standardized care and lack of team training. The professionals perceived palliative care as appropriate in the last stages of life, with no need for futile treatment or as comfort measures. However, they are aware of the lack of standardization and lack of capacity building in this area, which leads them to conceive palliative care as terminal care, and measures are recommended to break with this stigma. Conhecer a percepção dos profissionais de saúde de uma Unidade de Terapia Intensiva acerca do cuidado paliativo. Pesquisa descritiva, qualitativa do tipo Convergente Assistencial realizada em uma Unidade de Terapia Intensiva da região sul do Brasil. Utilizou-se de entrevista semiestruturada que investigou o entendimento e a compreensão sobre cuidado paliativo nesta unidade. Os dados foram organizados e analisados pela técnica do discurso do sujeito coletivo com auxílio do software Qualiquantisoft®. Participaram do estudo 37 profissionais (12 enfermeiros, 11 técnicos de enfermagem, cinco fisioterapeutas e nove médicos). As ideias centrais extraídas dos relatos: cuidado na fase terminal da vida sem medidas fúteis; cuidados de conforto; falta uniformizar a assistência e falta capacitação para a equipe. Os profissionais

  12. High intensity physical exercise and pain in the neck and upper limb among slaughterhouse workers

    DEFF Research Database (Denmark)

    Sundstrup, Emil; Jakobsen, Markus D.; Andersen, Kenneth Jay

    2014-01-01

    and pain among 595 slaughterhouse workers in Denmark, Europe. Using logistic regression analyses, odds ratios for pain and work disability as a function of physical exercise, gender, age, BMI, smoking, and job position were estimated. The prevalence of pain in the neck, shoulder, elbow, and hand....../wrist was 48%, 60%, 40%, and 52%, respectively. The odds for experiencing neck pain were significantly lower among slaughterhouse workers performing physical exercise (OR = 0.70, CI: 0.49-0.997), whereas the odds for pain in the shoulders, elbow, or hand/wrist were not associated with exercise. The present...

  13. A Controlled and Retrospective Study of 144 Chronic Low Back Pain Patients to Evaluate the Effectiveness of an Intensive Functional Restoration Program in France

    OpenAIRE

    Isabelle Caby; Nicolas Olivier; Frédérick Janik; Jacques Vanvelcenaher; Patrick Pelayo

    2016-01-01

    Study Design: A controlled and retrospective study of 144 chronic low back pain patients to evaluate the effectiveness of an intensive functional restoration program in France. Objective: Evaluating the efficiency of an intensive, dynamic and multidisciplinary functional restoration program in patients with chronic low back pain (LBP), during 6 and 12 months follow up. Summary of background data: Chronic low back pain disease has a multifactor nature, involving physical, psychological profess...

  14. Changes in Acceptance in a Low-Intensity, Group-Based Acceptance and Commitment Therapy (ACT) Chronic Pain Intervention.

    Science.gov (United States)

    Baranoff, John A; Hanrahan, Stephanie J; Burke, Anne L J; Connor, Jason P

    2016-02-01

    Acceptance and commitment therapy has shown to be effective in chronic pain rehabilitation, and acceptance has been shown to be a key process of change. The influence of treatment dose on acceptance is not clear, and in particular, the effectiveness of a non-intensive treatment (acceptance and commitment therapy (ACT) group program for chronic pain. The study sought to compare, at both groups and individual patient levels, changes in acceptance with changes observed in previous ACT studies. Seventy-one individuals with chronic pain commenced a 9-week ACT-based group program at an outpatient chronic pain service. In addition to acceptance, outcomes included the following: pain catastrophizing, depression, anxiety, quality of life, and pain-related anxiety. To compare the current findings with previous research, effect sizes from seven studies were aggregated using the random-effects model to calculate benchmarks. Reliable change indices (RCIs) were applied to assess change on an individual patient-level. The ACT intervention achieved a statistically significant increase in acceptance and medium effect size (d = 0.54) at a group level. Change in acceptance was of a similar magnitude to that found in previous ACT studies that examined interventions with similar treatment hours (acceptance occurred in approximately one-third (37.2, 90% CI) of patients. Approximately three-quarters (74.3, 90% CI) demonstrated reliable change in at least one of the outcome measures. The low-intensity, group-based ACT intervention was effective at a group level and showed a similar magnitude of change in acceptance to previous ACT studies employing low-intensity interventions. Three-quarters of patients reported reliable change on at least one outcome measure.

  15. Sex differences in lipolysis-regulating mechanisms in overweight subjects: effect of exercise intensity.

    Science.gov (United States)

    Moro, Cédric; Pillard, Fabien; de Glisezinski, Isabelle; Crampes, François; Thalamas, Claire; Harant, Isabelle; Marques, Marie-Adeline; Lafontan, Max; Berlan, Michel

    2007-09-01

    To explore sex differences in the regulation of lipolysis during exercise, the lipid-mobilizing mechanisms in the subcutaneous adipose tissue (SCAT) of overweight men and women were studied using microdialysis. Subjects matched for age, BMI, and physical fitness performed two 30-minute exercise bouts in a randomized fashion: the first test at 30% and 50% of their individual maximal oxygen uptake (Vo(2max)) and the second test at 30% and 70% of their Vo(2max). In both groups, an exercise-dependent increment in extracellular glycerol concentration (EGC) was observed. Whatever the intensity, phentolamine [alpha-adrenergic receptor (AR) antagonist] added to a dialysis probe potentiated exercise-induced lipolysis only in men. In a probe containing phentolamine plus propranolol (beta-AR antagonist), no changes in EGC occurred when compared with the control probe when exercise was performed at 30% and 50% Vo(2max). A significant reduction of EGC (when compared with the control probe) was observed in women at 70% Vo(2max). At each exercise power, the plasma non-esterified fatty acid and glycerol concentrations were higher in women. Exercise-induced increase in plasma catecholamine levels was lower in women compared with men. Plasma insulin decreased and atrial natriuretic peptide increased similarly in both groups. Overweight women mobilize more lipids (assessed by glycerol) than men during exercise. alpha(2)-Anti-lipolytic effect was functional in SCAT of men only. The major finding is that during low-to-moderate exercise periods (30% and 50% Vo(2max)), lipid mobilization in SCAT relies less on catecholamine-dependent stimulation of beta-ARs than on an increase in plasma atrial natriuretic peptide concentrations and the decrease in plasma insulin.

  16. Reliability and Validity of Standing Back Extension Test for Detecting Motor Control Impairment in Subjects with Low Back Pain.

    Science.gov (United States)

    Gondhalekar, Gauri A; Kumar, Senthil P; Eapen, Charu; Mahale, Ajit

    2016-01-01

    Low back pain is a chronic health problem with high socioeconomic impact. Specific diagnosis or treatment approach has not yet effectively established to treat chronic low back pain. Standing Back Extension Test is one of the clinical measures to detect the passive extension subgroup of Motor Control Impairment (MCI); which could have an impact on spinal stability leading to recurrent chronic low back pain. Reliability and validity of this test is not fully established. To determine the intra-rater and inter-rater reliability and concurrent validity of the Standing Back Extension Test for detecting MCI of the lumbar spine. A total of 50 subjects were included in the study, 25 patients with Non Specific Low Back Pain (NSLBP) (12 men, 13 women) and 25 healthy controls (12 men, 13 women) were recruited into the study. All subjects performed the test movement. Two raters blinded to the subjects rated the test performance as either 'Positive' or 'Negative' based on the predetermined rating protocol. The thickness of Transverse Abdominis (TrA) muscle was assessed using Rehabilitative Ultrasound Imaging (RUSI). For reliability, the kappa coefficient with percent agreement was calculated and for assessing the validity Receiver Operator Characteristic (ROC) curves and Area under the Curve (AUC) were constructed. The standing back extension test showed very good intra-rater (k=0.87 with an agreement of 96%) and good inter-rater (k=0.78 with an agreement of 94%) reliability and high AUC for TrA muscle. The standing back extension test was found to be a reliable and a valid measure to detect passive extension subgroup for MCI in subjects with low back pain.

  17. Intense focused ultrasound stimulation of the rotator cuff: evaluation of the source of pain in rotator cuff tears and tendinopathy.

    Science.gov (United States)

    Gellhorn, Alfred C; Gillenwater, Cody; Mourad, Pierre D

    2015-09-01

    The objective of this preliminary study was to evaluate the ability of individual 0.1-s long pulses of intense focused ultrasound (iFU) emitted with a carrier frequency of 2 MHz to evoke diagnostic sensations when applied to patients whose shoulders have rotator cuff tears or tendinopathy. Patients were adults with painful shoulders and clinical and imaging findings consistent with rotator cuff disease. iFU stimulation of the shoulder was performed using B-mode ultrasound coupled with a focused ultrasound transducer that allowed image-guided delivery of precisely localized pulses of energy to different anatomic areas around the rotator cuff. The main outcome measure was iFU spatial average-temporal average intensity (I_SATA), and location required to elicit sensation. In control patients, iFU produced no sensation throughout the range of stimulation intensities (≤2000 W/cm(2) I_SATA). In patients with rotator cuff disease, iFU was able to induce sensation in the tendons of the rotator cuff, the subacromial bursa, and the subchondral bone in patients with chronic shoulder pain and rotator cuff disease, with an average ± standard deviation intensity equaling 680 ± 281 W/cm(2) I_SATA. This result suggests a primary role for these tissues in the pathogenesis of shoulder pain related to rotator cuff tendinopathy. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  18. The immediate reduction in low back pain intensity following lumbar joint mobilization and prone press-ups is associated with increased diffusion of water in the L5-S1 intervertebral disc.

    Science.gov (United States)

    Beattie, Paul F; Arnot, Cathy F; Donley, Jonathan W; Noda, Harmony; Bailey, Lane

    2010-05-01

    Single-group, prospective, repeated-measures design. To determine differences in the changes of diffusion of water in the L5-S1 intervertebral disc between subjects with nonspecific low back pain (LBP) who reported an immediate reduction in pain intensity of 2 or greater on an 11-point (0-10) numeric rating scale after a 10-minute session of lumbar joint mobilization, followed by prone press-up exercises, compared to those who did not report an immediate reduction in pain intensity of 2 or greater on the pain scale. Combining lumbar joint mobilization and prone press-up exercises is a common intervention for patients with LBP; however, there is conflicting evidence regarding the effectiveness and efficacy of this approach. Increased knowledge of the physiologic effects of the combined use of these treatments, and the relationship to pain reports, can lead to refinement of their clinical application. Twenty adults, aged 22 to 54, participated in this study. All subjects reported LBP of at least 2 on an 11-point (0-10) verbally administered numeric rating scale at the time of enrollment in the study and were classified as being candidates for the combination of joint mobilization and prone press-ups. Subjects underwent T2- and diffusion-weighted lumbar magnetic resonance imaging scans before and immediately after receiving a 10-minute session of lumbar pressures in a posterior-to-anterior direction and prone press-up exercises. Subjects who reported a decrease in current pain intensity of 2 or greater immediately following treatment were classified as immediate responders, while the remainder were classified as not-immediate responders. The apparent diffusion coefficient, representing the diffusion of water in the nucleus pulposis, was calculated from the midsagittal diffusion-weighted images. Following treatment, immediate responders (n = 10) had a mean increase in the apparent diffusion coefficient in the middle portion of the L5-S1 intervertebral disc of 4

  19. The Effect of Lavender Aaromatherapy on the Pain Intensity Perception and Intarapartum Outcomes in Primipare

    Directory of Open Access Journals (Sweden)

    N Alavi

    2010-04-01

    14.Golian tehrani SH, Vasegh rahim Pour F, Mehran A. The Effect of Relaxation by Meditation on the Severity of Pain on the Length of Active Phase in Nulliparous Women. Hayat J 1385 3(12: 51-61. 15.Kim JT, Wajda M, Cuff G, Serota D, Schlame M, Axelrod DM, et al. Evaluation of aromatherapy in treating postoperative pain: pilot study. Pain Practice 2006 6: 273-7.

  20. Comparison of the different kinematic patterns during lateral bending between subjects with and without recurrent low back pain.

    Science.gov (United States)

    Sung, Paul S; Danial, Pamela; Lee, Dongchul C

    2016-10-01

    Lateral bending is a prerequisite for various functional activities of daily life, which require combined three-dimensional motion. Even though a number of studies have evaluated spinal kinematic changes during lateral bending, the literature reveals a lack of data based on limb dominance. The purpose of this study was to compare kinematic angular displacement of the spinal regions for dominant and non-dominant lateral bending in subjects with and without recurrent low back pain. Forty-four right hand dominant individuals with recurrent low back pain (43.1 [17.4] years) and without low back pain (39.7 [18.7] years) participated in this study. All participants were asked to perform trunk lateral bending to the dominant and non-dominant sides with a bar, three times repeatedly. The outcome measures included three-dimensional angular displacements for the three regions of the spine (upper thorax, lower thorax, and lumbar spine). Lumbar rotation (degrees) increased to the dominant side in the low back pain group (9.29 [1.06]) compared to the control group (6.20 [1.02]) with increased rotation in the upper thorax as well (t=-2.09, p=0.04). However, the upper thorax rotation increased in the low back pain group to the non-dominant side (t=2.08, p=0.03) and to the dominant side (t=-2.35, p=0.02). There was a group interaction with planes (F=5.82, p=0.02) during lateral bending. Although lower thorax motion was not different between groups, increased lumbar spine and upper thorax rotations to the dominant side in the low back pain group were evident during lateral bending. This directional asymmetry should be carefully monitored to understand increased lumbar rotation to the dominant side in subjects with recurrent low back pain. The interactions between group and plane explain compensation strategies through increased lumbar rotation to the dominant side with decreased lateral bending of the upper thorax in subjects with recurrent low back pain. Copyright © 2016 Elsevier

  1. Increased medial foot loading during drop jump in subjects with patellofemoral pain

    DEFF Research Database (Denmark)

    Rathleff, Michael S; Richter, Camilla; Brushøj, Christoffer

    2014-01-01

    PURPOSE: To compare medial-to-lateral plantar forces during drop jump and single leg squat in individuals with and without patellofemoral pain. METHODS: This cross-sectional study compared 23 young adults with patellofemoral pain to 20 age- and sex-matched controls without knee pain. The plantar...... pressure distribution was collected during drop jump and single leg squat using pressure-sensitive Pedar insoles, inserted into a standard flat shoe. The primary outcome was the medial-to-lateral force, quantified as the peak force under the medial forefoot as the percentage of force under the total...... forefoot during drop jump. Secondary outcomes included peak medial-to-lateral force during single leg squat and mean forces during drop jump and single leg squat. RESULTS: The primary outcome showed that individuals with patellofemoral pain had a 22 % higher medial-to-lateral peak force during drop jump...

  2. A comparison between the effects of simple and traction splints on pain intensity in patients with femur fractures.

    Science.gov (United States)

    Irajpour, Alireza; Kaji, Nariman Sadeghi; Nazari, Fatemeh; Azizkhani, Reza; Zadeh, Akbar Hassan

    2012-11-01

    Fractures of femur are among the most important causes of mortality in musculoskeletal injuries. Owning to lack of adequate research to compare various techniques of fracture stabilization, there has not yet been an agreement over a protocol to utilize a specific type of splint for femoral fracture immobilization. This study was thus conducted to compare the effects of simple and traction splints on pain intensityimmediately after and at the 1(st), 6(th), and 12(th)h after splinting among patients with femur fracture in the centers affiliated to Isfahan University of Medical Sciences (Isfahan, Iran). This quasi-experimental study was performed on 32 patients with femur fractures. Prehospital emergency ambulances were divided into two groups of simple and traction splints using a table of random numbers. Continuous convenient sampling was employed in each group to use either a simple or a traction splint for the patients with femur fractures. Pain intensity of the patients was then measured by a visual analogue scale (VAS) immediately, 1 h, 6 h, and 12 h after splinting. The effects of the two techniques were finally compared. After splinting, pain intensity decreased significantly in both groups (P = 0.0001 in both groups). The reductions were significantly more in the traction splint group at the 1(st), 6(th)(P = 0.0001), and 12(th)h after splinting (P = 0.02) compared with the simple splint group. There was no significant difference in pain intensity immediately after splintingbetween the two groups (P = 0.441). The significant difference in pain reduction between the simple and traction splint groups at the 1(st), 6(th), and 12(th)h after splinting emphasizes the superiority of traction splints.

  3. Efficacy of pulsed high-intensity laser therapy on pain, functional capacity, and gait in children with haemophilic arthropathy.

    Science.gov (United States)

    El-Shamy, Shamekh Mohamed; Abdelaal, Ashraf Abdelaal Mohamed

    2016-12-15

    The aim of this study was to evaluate the effects of pulsed high-intensity laser therapy (HILT) on pain, functional capacity, and gait in children with haemophilia. Thirty children with haemophilia type A with ages ranging from 9 to 13 years were selected for this study. They were assigned randomly, into two equal treatment groups. The laser group received the traditional physical therapy programme plus active laser (total energy of 1500 J through three phases/3 sessions/week), whereas the placebo group received the same physical therapy programme plus placebo laser over three consecutive months. Baseline and post-treatment assessments used the visual analogue scale (VAS) to evaluate pain, a 6-min walk test (6MWT) to evaluate functional capacity, and the GAITRite(®) system to evaluate gait parameters. Children in the laser group showed significant improvement in pain, functional capacity, and gait parameters compared to those in the placebo group (p capacity for the laser and placebo groups were 316.6 ± 35.27 and 288 ± 43.3 m, respectively. HILT is an effective modality in reducing pain, increasing functional capacity, and improving gait performance in children with haemophilic arthropathy. Implications for Rehabilitation Haemophilic arthropathy due to recurrent joint bleeding leads to physical, psychological, and socioeconomic problems in children with haemophilia and reduces their quality of life. Early physiotherapeutic interventions help to prevent and treat the sequelae of recurrent haemarthrosis. High-intensity laser therapy has been introduced as non-invasive and an effective physiotherapy modality for rapid pain control, with consequent improvement in children's quality of life. High-intensity laser therapy should be used as an adjunct to exercise programme in the rehabilitation of children with haemophilic arthropathy.

  4. γ-Aminobutyric acid (GABA) oral rinse reduces capsaicin-induced burning mouth pain sensation: An experimental quantitative sensory testing study in healthy subjects.

    Science.gov (United States)

    Zhang, Y; Wang, K; Arendt-Nielsen, L; Cairns, B E

    2018-02-01

    In burning mouth patients, analgesia after oral administration of clonazepam may result from modulation of peripheral γ-aminobutyric acid (GABA) receptors. The effect of oral administration of test solutions (water, 0.5 mol/L or 0.05 mol/L GABA, 1% lidocaine) was investigated for the amelioration of pain and sensitivity induced by application of capsaicin (1%, 2 min) to the tongue of thirty healthy male and female subjects in this four-session, randomized, placebo-controlled, double-blinded, cross-over study. Intra-oral quantitative sensory testing was used to assess cold (CDT), warm (WDT) and mechanical (MDT) detection thresholds as well as mechanical (MPT) and heat (HPT) pain thresholds. Capsaicin-induced pain intensity was continuously rated on a 0-10 electronic visual analogue scale (VAS). The area under the VAS curve (VASAUC) after rinsing was calculated for each solution. Capsaicin application on the tongue evoked burning pain with a peak of 4.8/10, and significantly increased CDT and MDT while significantly decreasing WDT, HPT, and MPT. The VASAUC was significantly smaller after oral rinse with 0.05 mol/L GABA, 0.5 mol/L GABA, and 1% lidocaine than after oral rinse with water. Rinse with 0.5 mol/L or 0.05 mol/L GABA were similarly effective in decreasing VASAUC. Rinsing with either 1% lidocaine, 0.5 mol/L or 0.05 mol/L GABA also significantly attenuated the effects of capsaicin on WDT and HPT in a treatment independent manner. There were no sex-related differences in these effects of GABA. Capsaicin-induced burning tongue pain and decreases in WDT and HPT can be ameliorated by rinsing the mouth with lidocaine and GABA solutions. Rinsing the mouth with an oral GABA containing solution ameliorated burning pain and increased heat sensitivity produced by application of capsaicin to the tongue. This finding suggests that GABA can act as a local analgesic agent in the oral cavity. © 2017 European Pain Federation - EFIC®.

  5. Single-subject independent component analysis-based intensity normalization in non-quantitative multi-modal structural MRI.

    Science.gov (United States)

    Papazoglou, Sebastian; Würfel, Jens; Paul, Friedemann; Brandt, Alexander U; Scheel, Michael

    2017-04-22

    Non-quantitative MRI is prone to intersubject intensity variation rendering signal intensity level based analyses limited. Here, we propose a method that fuses non-quantitative routine T1-weighted (T1w), T2w, and T2w fluid-saturated inversion recovery sequences using independent component analysis and validate it on age and sex matched healthy controls. The proposed method leads to consistent and independent components with a significantly reduced coefficient-of-variation across subjects, suggesting potential to serve as automatic intensity normalization and thus to enhance the power of intensity based statistical analyses. To exemplify this, we show that voxelwise statistical testing on single-subject independent components reveals in particular a widespread sex difference in white matter, which was previously shown using, for example, diffusion tensor imaging but unobservable in the native MRI contrasts. In conclusion, our study shows that single-subject independent component analysis can be applied to routine sequences, thereby enhancing comparability in-between subjects. Unlike quantitative MRI, which requires specific sequences during acquisition, our method is applicable to existing MRI data. Hum Brain Mapp, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  6. Empathy for social exclusion involves the sensory-discriminative component of pain: a within-subject fMRI study

    OpenAIRE

    Novembre, Giovanni; Zanon, Marco; Silani, Giorgia

    2014-01-01

    Recent research has shown that experiencing events that represent a significant threat to social bonds activates a network of brain areas associated with the sensory-discriminative aspects of pain. In the present study, we investigated whether the same brain areas are involved when witnessing social exclusion threats experienced by others. Using a within-subject design, we show that an ecologically valid experience of social exclusion recruits areas coding the somatosensory components of phys...

  7. Stress-intensity factor equations for cracks in three-dimensional finite bodies subjected to tension and bending loads

    Science.gov (United States)

    Newman, J. C., Jr.; Raju, I. S.

    1984-01-01

    Stress intensity factor equations are presented for an embedded elliptical crack, a semielliptical surface crack, a quarter elliptical corner crack, a semielliptical surface crack along the bore of a circular hole, and a quarter elliptical corner crack at the edge of a circular hole in finite plates. The plates were subjected to either remote tension or bending loads. The stress intensity factors used to develop these equations were obtained from previous three dimensional finite element analyses of these crack configurations. The equations give stress intensity factors as a function of parametric angle, crack depth, crack length, plate thickness, and, where applicable, hole radius. The ratio of crack depth to plate thickness ranged from 0 to 1, the ratio of crack depth to crack length ranged from 0.2 to 2, and the ratio of hole radius to plate thickness ranged from 0.5 to 2. The effects of plate width on stress intensity variation along the crack front were also included.

  8. Comparison of pain, disorder, back performance, and psychological factors in patients with low back pain and radicular pain.

    Science.gov (United States)

    Kim, Seunghwan; Kim, Jung Hyun; Kim, You Lim; Lee, Suk Min

    2018-01-01

    [Purpose] This study investigated the relationship between pain intensity, lumber disability, and psychological factors in patients with low back pain. [Subjects and Methods] A total of 166 outpatients (116 female, 50 male) with chronic low back pain presenting for physical therapy participated in this study. Patients were divided into two groups: those with low back pain alone and those with both low back pain and radicular pain. Pain intensity and lumbar disability were measured using a visual analogue scale and the Roland-Morris Disability Questionnaire. Psychological factors, such as self-efficiency, fear avoidance, and depression were measured using the Chronic Pain Self-efficacy Scale, Fear-Avoidance Beliefs Questionnaire, and Beck Depression Index, respectively. [Results] Patients with low back pain with radicular pain had greater pain and lumber disability and lower psychological factors compared with patients with chronic low back pain alone. [Conclusion] Our findings indicate the presence of low back pain with radicular pain is more related to pain, LBP disability index, Back performance, Self-efficiency (Pain, Function, Symptom), Fear-avoidance (body, work) and depression factors than low back pain. Considering the relationships between in pain, LBP disability index, Back performance, Self-efficiency (Pain, Function, Symptom), Fear-avoidance (body, work) and depression factors in patients with low back pain, therapeutic intervention for not only pain and dysfunction, but also psychological factors is needed.

  9. The Comparison of Ginkgo biloba and Cinnarizine effectiveness in tinnitus intensity of patients with subjective tinnitus

    OpenAIRE

    Hamidreza Khazraei; Nasim khodami; Soroush Amani; Mina Shahtoosi; Alireza Khodami

    2015-01-01

    Background and Aim: Subjective Tinnitus is one of the common problems in the world whose prevalence is estimated to be 7-20 percent in the community. In the present study, effectiveness of Ginkgo biloba with that of cinnarizine on subjective tinnitus were compared and assessed in order to determine the effective dose of Ginko on .patients. Materials and Methods: This clinical trial study conducted on 61 patients with subjective tinnitus who had been referred or had come to Shahrekord ENT c...

  10. Beneficial effect of amantadine on postoperative pain reduction and consumption of morphine in patients subjected to elective spine surgery.

    Science.gov (United States)

    Bujak-Giżycka, Beata; Kącka, Katarzyna; Suski, Maciej; Olszanecki, Rafał; Madej, Józef; Dobrogowski, Jan; Korbut, Ryszard

    2012-03-01

    To analyze the effect of coadministration of morphine and amantadine on postoperative pain reduction and morphine consumption in patients after elective spine surgery. In double-blinded study, 60 patients (ASA physical status I-II) were randomized into two groups. Group A was given oral amantadine 50 or 100 mg 1 hour before surgery and 8, 20, 32 hours after operation. Group P received placebo at identical times. Pain was assessed using numerical rating scale before first administration of morphine and in 2, 3, 4, 6, 24, and 48 hours after operation. The amounts of morphine consumed were recorded up to 48 hours after surgery. Blood samples were taken twice in 2 hours after surgery and plasma levels of morphine and its main metabolites were measured. As compared with placebo, amantadine significantly reduced intra-operative Fentanyl use and sensation of postoperative pain. Up to 48 hours after operation, the cumulative consumption of morphine was 25% lower in the amantadine group. Moreover, intensity of nausea and vomiting tended to be lower in A group. Starting from 12th hour after surgery, the level of postoperative sedation was lower in patients who received amantadine, as compared with placebo group. No significant differences in plasma levels of morphine ant its metabolites were observed between A and P groups. Pre- and postoperative administration of amantadine significantly reduced fentanyl use during operation, as well as reduced the postoperative pain and decreased morphine consumption in young patients undergoing orthopedic surgery. Wiley Periodicals, Inc.

  11. Central projection of pain arising from delayed onset muscle soreness (DOMS in human subjects.

    Directory of Open Access Journals (Sweden)

    Katharina Zimmermann

    Full Text Available Delayed onset muscle soreness (DOMS is a subacute pain state arising 24-48 hours after a bout of unaccustomed eccentric muscle contractions. Functional magnetic resonance imaging (fMRI was used to examine the patterns of cortical activation arising during DOMS-related pain in the quadriceps muscle of healthy volunteers evoked by either voluntary contraction or physical stimulation. The painful movement or physical stimulation of the DOMS-affected thigh disclosed widespread activation in the primary somatosensory and motor (S1, M1 cortices, stretching far beyond the corresponding areas somatotopically related to contraction or physical stimulation of the thigh; activation also included a large area within the cingulate cortex encompassing posteroanterior regions and the cingulate motor area. Pain-related activations were also found in premotor (M2 areas, bilateral in the insular cortex and the thalamic nuclei. In contrast, movement of a DOMS-affected limb led also to activation in the ipsilateral anterior cerebellum, while DOMS-related pain evoked by physical stimulation devoid of limb movement did not.

  12. Pilates-based therapeutic exercise: effect on subjects with nonspecific chronic low back pain and functional disability: a randomized controlled trial.

    Science.gov (United States)

    Rydeard, Rochenda; Leger, Andrew; Smith, Drew

    2006-07-01

    A randomized controlled trial, prestest-posttest design, with a 3-, 6-, and 12-month follow-up. To investigate the efficacy of a therapeutic exercise approach in a population with chronic low back pain (LBP). Therapeutic approaches developed from the Pilates method are becoming increasingly popular; however, there have been no reports on their efficacy. Thirty-nine physically active subjects between 20 and 55 years old with chronic LBP were randomly assigned to 1 of 2 groups. The specific-exercise-training group participated in a 4-week program consisting of training on specialized (Pilates) exercise equipment, while the control group received the usual care, defined as consultation with a physician and other specialists and healthcare professionals, as necessary. Treatment sessions were designed to train the activation of specific muscles thought to stabilize the lumbar-pelvic region. Functional disability outcomes were measured with The Roland Morris Disability Questionnaire (RMQ/RMDQ-HK) and average pain intensity using a 101-point numerical rating scale. There was a significantly lower level of functional disability (P = .023) and average pain intensity (P = .002) in the specific-exercise-training group than in the control group following the treatment intervention period. The posttest adjusted mean in functional disability level in the specific-exercise-training group was 2.0 (95% CI, 1.3 to 2.7) RMQ/RMDQ-HK points compared to a posttest adjusted mean in the control group of 3.2 (95% CI, 2.5 to 4.0) RMQ/RMDQ-HK points. The posttest adjusted mean in pain intensity in the specific-exercise-training group was 18.3 (95% CI, 11.8 to 24.8), as compared to 33.9 (95% CI, 26.9 to 41.0) in the control group. Improved disability scores in the specific-exercise-training group were maintained for up to 12 months following treatment intervention. The individuals in the specific-exercise-training group reported a significant decrease in LBP and disability, which was

  13. Effects of Lavender Inhalant on the Pain during Endotracheal Suctioning in Intensive Care Unit Patients

    Directory of Open Access Journals (Sweden)

    M. Taheri Rezgh Abadi

    2017-09-01

    Full Text Available Aims: Patients undergoing artificial ventilation require tracheal tube suction because of inability to clear their effective airways, which is usually a painful process for the patients. The aim of this study was to investigate the effect of spike lavender’s inhalant on pain during tracheal tube suctioning in ICU intubated patients. Materials & Methods: In this double-blinded randomized clinical trial, 60 intubated patients hospitalized in ICU of Shahid Modarres Hospital of Kashmar City, Iran, in 2017 were selected by available and simple sampling method, and were randomly divided into 2 control and case groups (each 30 individuals. Before the standard suctioning process, the test group patients received inhalant of 2% spike lavender for 5 minutes and the control group received inhalant of distilled water. The level of pain was recorded before and during tracheal tube suctioning. Data were analyzed by SPSS 16 software using independent T, paired T, Fisher and Mann-Whitney U tests. Findings: There was no significant difference in pain score before tracheal tube suction between 2 groups (p>0.05. However, there were significant differences between the level of pain during tracheal tube suctioning and the pain was increased in both groups, but this increase was significantly higher in the control group (p<0.001. Conclusion: Spike lavender’s inhalant is effective on pain reduction during suctioning process of ICU intubated patients.

  14. The use of dry needling for a subject with acute onset of neck pain: a case report.

    Science.gov (United States)

    Pavkovich, Ron

    2015-02-01

    Neck pain is a common complaint treated by the physical therapist. Trigger points (TrPs) have been studied as a source of neuromusculoskeletal pain, though the ability of clinicians to accurately locate a TrP is not well supported. Dry needling (DN) is an intervention utilized by physical therapists where a monofilament needle is inserted into soft tissue in order to reduce pain thereby facilitating return to prior level of function. The purpose of this case report is to report the outcomes of DN as a primary treatment intervention for acute, non-specific cervical region pain. The subject was an active 64-year-old female who self- referred for cervical pain following lifting heavy boxes while moving into a new home. She had a history of multi-level cervical fusion and recurrent cervical pain that physical therapy helped to control over the past few years. Physical examination supported a diagnosis of acute cervical region strain. Objective findings included decreased cervical active range of motion (AROM) and upper extremity strength, as well as, reproduction of pain symptoms upon palpation indicating the likelihood of TrPs in the right upper trapezius, levator scapula, supraspinatus, and infraspinatus musculature. She was treated using DN to the aforementioned muscles for two sessions, and no other interventions were performed in order to determine the effectiveness of DN as a primary intervention strategy without other interventions masking the effects of DN. Clinically meaningful improvements were noted in pain and disability, as measured by the Neck Disability Index and Quadruple Visual Analog Scale. Physical examination denoted minimal to no change in cervical AROM (likely associated with multi-level fusion), except for right lateral flexion, and no change in shoulder flexion/ abduction MMT. The patient was able to return to daily and work activities without further functional limitations caused by pain. This case report shows promising outcomes for the use of

  15. FACTORS ASSOCIATED WITH THE PREVALENCE AND INTENSITY OF DENTAL PAIN IN CHILDREN IN THE MUNICIPALITIES OF THE CAMPINAS REGION, SÃO PAULO.

    Science.gov (United States)

    Guskuma, Renata Cristina; Lages, Vinícius Aguiar; Hafner, Maylu Botta; Rando-Meirelles, Maria Paula Maciel; Cypriano, Silvia; Sousa, Maria da Luz Rosário de; Batista, Marília Jesus

    2017-01-01

    The aim of this study was to evaluate the prevalence and intensity of dental pain in children according to size of municipality, associated factors and absenteeism. The sample consisted of children aged 12 years old from public and private schools drawn from eight cities in the region of Campinas (SP). A questionnaire was applied to obtain dental pain, demographic, socioeconomic data, and a clinical examination was carried out to evaluate the experience of having a cavity. The outcome for the logistic regression analysis was having pain and the outcome for the negative log-binomial regression was the intensity of pain. The significance level was 5%. The sample consisted of 1,233 children, and 16.7% reported pain in the last six months. Dental pain was the cause of 46.4% of school absenteeism during this period. The prevalence of pain was lower among households with high income (p=0.023) and higher among nonwhites (p=0.027). Pain intensity was lower in medium-sized cities (p=0.02) and small cities (p=0.004), and higher in children whose parents had a lower educational level (p=0.003), children who sought out a dentist for the pain (p=0.04) and who had untreated cavities (p=0.04). The prevalence and intensity of dental pain in children aged under 12 are related to socioeconomic aspects of the family, such as low-income and parents with a low level of education, which impact daily activities as seen through school absenteeism. Pain intensity was lower in medium and small cities. Oral health promotion strategies in this age group should be encouraged to avoid dental pain.

  16. Self-report and subjective history in the diagnosis of painful neck conditions: A systematic review of diagnostic accuracy studies.

    Science.gov (United States)

    Mizer, Adam; Bachmann, Alexa; Gibson, Jessie; Donaldson, Megan Burrowbridge

    2017-10-01

    Rising healthcare costs and inherent risks with over-utilizing diagnostic imaging require a quality subjective examination to improve effectiveness and time management of physical examinations. This systematic review investigates the diagnostic accuracy of subjective history and self-report items to determine if there is significant alteration in the probability of identifying specific painful neck conditions. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. 1) Written in the English language 2) Cervical pain with/without referred upper extremity or head pain 3) Subjective history or self-report items 4) Study designs that reported diagnostic statistics or allowed calculation of sensitivities, specificities, diagnostic odds ratios, and likelihood ratios 5) used a reference standard that has a sensitivity or specificity ≥75% or a diagnostic tool that is strongly supported in the literature where this data is not available. Quality Assessment of Studies of Diagnostic Accuracy II was performed to evaluate risk of bias. Five studies with 830 total patients met the inclusion criteria. Conditions commonly reported in the literature included: cervical radiculopathy, cervical myelopathy, degenerative joint disease, and cervicogenic headache. Individual history questions show minimal diagnostic value in identifying cervical conditions without the physical examination. The value of the subjective history report is important and requires further investigation for specific neck conditions. Clustering symptoms may provide more insight than individual history items in future studies. The diagnostic value of history for neck conditions may be underrepresented due to the lack of studies that isolate subjective examination from the physical examination. 3a. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Development of the Italian Version of the Pain Vigilance and Awareness Questionnaire in Subjects with Chronic Low Back Pain: Cross-cultural Adaptation, Confirmatory Factor Analysis, Reliability and Validity.

    Science.gov (United States)

    Monticone, Marco; Ambrosini, Emilia; Rocca, Barbara; Nava, Tiziana; Terragni, Erica; Cerri, Cesare; McCracken, Lance M

    2016-04-01

    Growing attention is being given to cognitive-behavioural measures to improve interventions for spinal disorders. The Pain Vigilance and Awareness Questionnaire (PVAQ) has never been validated in Italian subjects with chronic low back pain (LBP). The purpose of this study is translating, culturally adapting and validating the Italian version of PVAQ (PVAQ-I). A cross-sectional evaluation of the psychometric properties of the PVAQ-I on patients with chronic LBP was conducted. The questionnaire was culturally adapted in accordance with international standards. The psychometric testing included confirmatory factor analysis, reliability by internal consistency (Cronbach's alpha) and test-retest reliability (intra-class correlation coefficient, ICC); construct validity by comparing the PVAQ-I with the Pain Catastrophising Scale (PCS), the Tampa Scale of Kinesiophobia (TSK), the Hospital Anxiety and Depression Score (HADS), the Chronic Pain Acceptance Questionnaire (CPAQ), a Numerical Rating Scale of pain intensity (NRS) and the Oswestry Disability Questionnaire (ODI); and sensitivity to change by calculating the smallest detectable change. The PVAQ-I was administered to 131 subjects with chronic LBP (77 females, mean age of 48 ± 16 years, median symptoms duration of 12 months). Factor analysis confirmed a two-factor (passive awareness and active vigilance), 13-item solution, which led to an acceptable data-model fit. Internal consistency (α = 0.91) and test-retest reliability (ICC = 0.92) were good. As a priori hypothesized, construct validity showed moderate correlations between the PVAQ-I and PCS (r = 0.60), TSK (r = 0.44) and HADS-Anxiety (r = 0.53) and low correlations with HADS-Depression (r = 0.28), NRS (r = 0.28), ODI (r = 0.23) and CPAQ (r = -0.12). The smallest detectable change was 9. The PVAQ was successfully translated into Italian and proved to have satisfactory psychometric properties. Its use is recommended for

  18. Guidelines for Premeal Insulin Dose Reduction for Postprandial Exercise of Different Intensities and Durations in Type 1 Diabetic Subjects Treated Intensively With a Basal-Bolus Insulin Regimen (Ultralente-Lispro)

    National Research Council Canada - National Science Library

    Rémi Rabasa-Lhoret; Josée Bourque; Francine Ducros; Jean-Louis Chiasson

    2001-01-01

    Guidelines for Premeal Insulin Dose Reduction for Postprandial Exercise of Different Intensities and Durations in Type 1 Diabetic Subjects Treated Intensively With a Basal-Bolus Insulin Regimen (Ultralente-Lispro...

  19. The impact of premature ejaculation on the subjective perception of orgasmic intensity: validation and standardisation of the 'Orgasmometer'.

    Science.gov (United States)

    Limoncin, E; Lotti, F; Rossi, M; Maseroli, E; Gravina, G L; Ciocca, G; Mollaioli, D; Di Sante, S; Maggi, M; Lenzi, A; Jannini, E A

    2016-09-01

    To the best of our knowledge, no psychometric tools have been specifically developed to measure if premature ejaculation (PE) is related to low sexual pleasure in terms of perception of orgasmic intensity. Hence, the aim of this study was to evaluate if men with PE suffer from a low perception of orgasmic intensity using a new tool, the 'Orgasmometer', to quantitatively measure the intensity of orgasmic pleasure. Among 329 subjects attending our andrological unit for suspected PE, 257 men fulfilled the inclusion criteria. Of these, 156 (60.7%; 156/257) were affected by PE (PE group) and 101 (39.3%; 101/257) did not have any sexual dysfunction (Control group). Men were requested to fill out the Premature Ejaculation Diagnostic Tool (PEDT) and the Orgasmometer, a new visual tool recording orgasm intensity on a Likert scale. Interestingly, MANCOVA analysis revealed a statistically significant difference between the two groups (p = 0.044) in the subjective perception of orgasm intensity with the PE group scoring lower on the Orgasmometer (mean 5.8; 95% CI 5.191-6.409) than the Control group (mean 7.95; 95% CI 7.033-8.87). In addition, multiple linear regression revealed an inverse correlation between the PEDT and the Orgasmometer scores (p < 0.0001). Hence, higher PEDT scores were associated with a lower subjective perception of orgasmic intensity. The Orgasmometer was well understood, had good test-retest reliability and a high AUC in differentiating between men with high and low orgasmic pleasure intensity. The ROC curve analysis showed that a cut-off ≤6 had 87.7% sensitivity (95% CI 79.6-92.6), 95% specificity (95% CI 88.7-98.4), 95.3% positive predictive value (PPV) and 86.4% negative predictive value (NPV). Men affected by premature ejaculation perceived significantly lower orgasmic intensity than sexually healthy men. The Orgasmometer is an easy-to-perform, user-friendly tool for measuring orgasmic intensity. © 2016 American Society of Andrology and

  20. Lung sound intensity in patients with emphysema and in normal subjects at standardised airflows

    NARCIS (Netherlands)

    Schreur, H. J.; Sterk, P. J.; Vanderschoot, J.; van Klink, H. C.; van Vollenhoven, E.; Dijkman, J. H.

    1992-01-01

    A common auscultatory finding in pulmonary emphysema is a reduction of lung sounds. This might be due to a reduction in the generation of sounds due to the accompanying airflow limitation or to poor transmission of sounds due to destruction of parenchyma. Lung sound intensity was investigated in

  1. Reliability and minimal detectable change of a modified passive neck flexion test in patients with chronic nonspecific neck pain and asymptomatic subjects.

    Science.gov (United States)

    López-de-Uralde-Villanueva, Ibai; Acuyo-Osorio, Mario; Prieto-Aldana, María; La Touche, Roy

    2017-04-01

    The Passive Neck Flexion Test (PNFT) can diagnose meningitis and potential spinal disorders. Little evidence is available concerning the use of a modified version of the PNFT (mPNFT) in patients with chronic nonspecific neck pain (CNSNP). To assess the reliability of the mPNFT in subjects with and without CNSNP. The secondary objective was to assess the differences in the symptoms provoked by the mPNFT between these two populations. We used repeated measures concordance design for the main objective and cross-sectional design for the secondary objective. A total of 30 asymptomatic subjects and 34 patients with CNSNP were recruited. The following measures were recorded: the range of motion at the onset of symptoms (OS-mPNFT), the range of motion at the submaximal pain (SP-mPNFT), and evoked pain intensity on the mPNFT (VAS-mPNFT). Good to excellent reliability was observed for OS-mPNFT and SP-mPNFT in the asymptomatic group (intra-examiner reliability: 0.95-0.97; inter-examiner reliability: 0.86-0.90; intra-examiner test-retest reliability: 0.84-0.87). In the CNSNP group, a good to excellent reliability was obtained for the OS-mPNFT (intra-examiner reliability: 0.89-0.96; inter-examiner reliability: 0.83-0.86; intra-examiner test-retest reliability: 0.83-0.85) and the SP-PNFT (intra-examiner reliability: 0.94-0.98; inter-examiner reliability: 0.80-0.82; intra-examiner test-retest reliability: 0.88-0.91). The CNSNP group showed statistically significant differences in OS-mPNFT (t = 4.92; P < 0.001), SP-mPNFT (t = 2.79; P = 0.007) and in VAS-mPNFT (t = -10.39; P < 0.001) versus the asymptomatic group. The mPNFT is a reliable tool regardless of the examiner and the time factor. Patients with CNSNP have a decrease range of motion and more pain than asymptomatic subjects in the mPNFT. This exceeds the minimal detectable changes for OS-mPNFT and VAS-mPNFT. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Pelvic joint fusion in patients with severe pelvic girdle pain - a prospective single-subject research design study.

    Science.gov (United States)

    Kibsgård, Thomas J; Røise, Olav; Stuge, Britt

    2014-03-15

    The fusion of the pelvic joints in patients with severe pelvic girdle pain (PGP) is a controversial and insufficiently studied procedure. The aims of this study were to evaluate physical function and pain after sacroiliac joint (SIJ) fusion. A single-subject research design study with repeated measurements was conducted; pre-operatively and at 3, 6 and 12 months post-operatively. The outcome measures considered were the Oswestry disability index (ODI), visual analogue scale (VAS), and SF-36. Eight patients with severe PGP received open-accessed unilateral anterior SIJ fusion and fusion of the pubic symphysis. Seven patients reported positive results from the surgery. At 1 year post-operation, significant (p < 0.001) reductions in ODI (54 to 37) and VAS (82 to 57) were reported. The physical functioning, bodily pain, and social functioning scores in the SF-36 were also improved. Positive and significant changes in disability and pain at 1 year after SIJ fusion were observed. Despite these positive results, open accessed anterior fusion of the SIJ was associated with adverse events and complications such as infection and nerve damage.

  3. Pelvic joint fusion in patients with severe pelvic girdle pain – a prospective single-subject research design study

    Science.gov (United States)

    2014-01-01

    Background The fusion of the pelvic joints in patients with severe pelvic girdle pain (PGP) is a controversial and insufficiently studied procedure. The aims of this study were to evaluate physical function and pain after sacroiliac joint (SIJ) fusion. Methods A single-subject research design study with repeated measurements was conducted; pre-operatively and at 3, 6 and 12 months post-operatively. The outcome measures considered were the Oswestry disability index (ODI), visual analogue scale (VAS), and SF-36. Eight patients with severe PGP received open-accessed unilateral anterior SIJ fusion and fusion of the pubic symphysis. Results Seven patients reported positive results from the surgery. At 1 year post-operation, significant (p < 0.001) reductions in ODI (54 to 37) and VAS (82 to 57) were reported. The physical functioning, bodily pain, and social functioning scores in the SF-36 were also improved. Conclusion Positive and significant changes in disability and pain at 1 year after SIJ fusion were observed. Despite these positive results, open accessed anterior fusion of the SIJ was associated with adverse events and complications such as infection and nerve damage. PMID:24629145

  4. Lower inhibitory control interacts with greater pain catastrophizing to predict greater pain intensity in women with migraine and overweight/obesity.

    Science.gov (United States)

    Galioto, Rachel; O'Leary, Kevin C; Thomas, J Graham; Demos, Kathryn; Lipton, Richard B; Gunstad, John; Pavlović, Jelena M; Roth, Julie; Rathier, Lucille; Bond, Dale S

    2017-12-01

    Pain catastrophizing (PC) is associated with more severe and disabling migraine attacks. However, factors that moderate this relationship are unknown. Failure of inhibitory control (IC), or the ability to suppress automatic or inappropriate responses, may be one such factor given previous research showing a relationship between higher PC and lower IC in non-migraine samples, and research showing reduced IC in migraine. Therefore, we examined whether lower IC interacts with increased PC to predict greater migraine severity as measured by pain intensity, attack frequency, and duration. Women (n = 105) aged 18-50 years old (M = 38.0 ± 1.2) with overweight/obesity and migraine who were seeking behavioral treatment for weight loss and migraine reduction completed a 28-day smartphone-based headache diary assessing migraine headache severity. Participants then completed a modified computerized Stroop task as a measure of IC and self-report measures of PC (Pain Catastrophizing Scale [PCS]), anxiety, and depression. Linear regression was used to examine independent and joint associations of PC and IC with indices of migraine severity after controlling for age, body mass index (BMI) depression, and anxiety. Participants on average had BMI of 35.1 ± 6.5 kg/m2and reported 5.3 ± 2.6 migraine attacks (8.3 ± 4.4 migraine days) over 28 days that produced moderate pain intensity (5.9 ± 1.4 out of 10) with duration of 20.0 ± 14.2 h. After adjusting for covariates, higher PCS total (β = .241, SE = .14, p = .03) and magnification subscale (β = .311, SE = .51, p migraine attacks. Future studies are needed to determine whether interventions to improve IC could lead to less painful migraine attacks via improvements in PC.

  5. Cross friction algometry (CFA): Comparison of pressure pain thresholds between patients with chronic non-specific low back pain and healthy subjects.

    Science.gov (United States)

    Farasyn, Andre; Lassat, Bert

    2016-04-01

    Palpation is widely used to assess muscular sensitivity in clinical settings but still remains a subjective evaluation. This cross-sectional study assessed a newly developed cross-friction algometry making palpation measurable. The objective was to investigate the reliability of pressure pain thresholds obtained using Cross-Friction Algometry (CFA-PPTs) measured at the level of Erector spinae and Gluteus maximus central muscle parts, and to compare the CFA-PPTs between patients with chronic nonspecific low back pain (nCLBP) and matching healthy subjects. Patients presenting nCLBP to GP's and send into a Pain Center and healthy subjects recruited via university ad valvas & flyers distribution. 30 patients with nCLBP were measured for cross-friction algometry. Other evaluations consisted of the Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI). The inter- and intra-reliability were tested and found to be sufficient. The mean CFA-PPT values of the Erector spinae at levels T8, T10, L1 & L3 and the Gluteus maximus of the nCLBP group were significantly lower (p ≤ 0.001) when compared to the CFA-PPT values of the healthy group. The greatest difference (-58%) was found at L1 Erector spinae level and at the superior part of the Gluteus maximus measuring point (-59%). Within the group of patients with nCLBP it was surprising to notice that there was no significant correlation between all the reference points measured using CFA-PPTs and the outcomes of the VAS and ODI scores. With the aid of CFA, the importance of local muscular disorder in the lumbar part of the Erector spinae and Gluteus maximus in patients with nCLBP is obviously demonstrated, but also reveals the very large inter-individual differences in muscular fibrosis sensitivity and/or pain behavior in daily life. This possibly re-opens the debate on which influences can be put forward as the most important: the central or the peripheral sensitization system. Copyright © 2015 Elsevier Ltd. All

  6. Virtual Visual Effect of Hospital Waiting Room on Pain Modulation in Healthy Subjects and Patients with Chronic Migraine

    Directory of Open Access Journals (Sweden)

    Marina de Tommaso

    2013-01-01

    Full Text Available Environmental context has an important impact on health and well being. We aimed to test the effects of a visual distraction induced by classical hospital waiting room (RH versus an ideal room with a sea view (IH, both represented in virtual reality (VR, on subjective sensation and cortical responses induced by painful laser stimuli (LEPs in healthy volunteers and patients with chronic migraine (CM. Sixteen CM and 16 controls underwent 62 channels LEPs from the right hand, during a fully immersive VR experience, where two types of waiting rooms were simulated. The RH simulated a classical hospital waiting room while the IH represented a room with sea viewing. CM patients showed a reduction of laser pain rating and vertex LEPs during the IH vision. The sLORETA analysis confirmed that in CM patients the two VR simulations induced a different modulation of bilateral parietal cortical areas (precuneus and superior parietal lobe, and superior frontal and cingulate girus, in respect to controls. The architectural context may interfere with pain perception, depending upon the status of subject. Many variables may change patients’ outcome and support the use of VR technology to test the best conditions for their management.

  7. Clinical Use of High-Intensity Focused Ultrasound (HIFU) for Tumor and Pain Reduction in Advanced Pancreatic Cancer.

    Science.gov (United States)

    Strunk, H M; Henseler, J; Rauch, M; Mücke, M; Kukuk, G; Cuhls, H; Radbruch, L; Zhang, L; Schild, H H; Marinova, M

    2016-07-01

    Evaluation of ultrasound-guided high-intensity focused ultrasound (HIFU) used for the first time in Germany in patients with inoperable pancreatic cancer for reduction of tumor volume and relief of tumor-associated pain. 15 patients with locally advanced inoperable pancreatic cancer and tumor-related pain symptoms were treated by HIFU (n = 6 UICC stage III, n = 9 UICC stage IV). 13 patients underwent simultaneous standard chemotherapy. Ablation was performed using the JC HIFU system (Chongqing, China HAIFU Company) with an ultrasonic device for real-time imaging. Imaging follow-up (US, CT, MRI) and clinical assessment using validated questionnaires (NRS, BPI) was performed before and up to 15 months after HIFU. Despite biliary or duodenal stents (4/15) and encasement of visceral vessels (15/15), HIFU treatment was performed successfully in all patients. Treatment time and sonication time were 111 min and 1103 s, respectively. The applied total energy was 386 768 J. After HIFU ablation, contrast-enhanced imaging showed devascularization of treated tumor regions with a significant average volume reduction of 63.8 % after 3 months. Considerable pain relief was achieved in 12 patients after HIFU (complete or partial pain reduction in 6 patients). US-guided HIFU with a suitable acoustic pathway can be used for local tumor control and relief of tumor-associated pain in patients with locally advanced pancreatic cancer. • US-guided HIFU allows an additive treatment of unresectable pancreatic cancer.• HIFU can be used for tumor volume reduction.• Using HIFU, a significant reduction of cancer-related pain was achieved.• HIFU provides clinical benefit in patients with pancreatic cancer. Citation Format: • Strunk HM, Henseler J, Rauch M et al. Clinical Use of High-Intensity Focused Ultrasound (HIFU) for Tumor and Pain Reduction in Advanced Pancreatic Cancer. Fortschr Röntgenstr 2016; 188: 662 - 670. © Georg Thieme Verlag KG

  8. High-intensity stepwise conditioning programme for improved exercise responses and agility performance of a badminton player with knee pain.

    Science.gov (United States)

    Chen, Bob; Mok, Damon; Lee, Winson C C; Lam, Wing Kai

    2015-02-01

    To examine the effect of a high-intensity stepwise conditioning programme combined with multiple recovery measures on physical fitness, agility, and knee pain symptoms of an injured player. A single case study. University-based conditioning training laboratory. One 26-year-old male world-class badminton player (height, 190.0 cm; weight, 79.3 kg; left dominant hand; playing experience, 16 years; former world champion) with patellar tendinosis and calcification of his left knee. The player received seven conditioning sessions over three weeks. During the programme, there was a gradual increase in training duration and load across sessions while cold therapy, manual stretches and massage were administered after each session to minimise inflammation. The training outcome was evaluated with three different testing methods: standard step test, badminton-specific agility test, and tension-pain rating. The conditioning programme reduced knee pain symptoms and improved actual performance and cardiopulmonary fitness during the agility task. The player was able to return to sport and compete within a month. A high-intensity stepwise conditioning programme improved the physical fitness while sufficient recovery measures minimised any possible undesirable effects and promoted faster return to elite level competition. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Clinical efficacy of Trigonella foenum graecum (Fenugreek) and dry cupping therapy on intensity of pain in patients with primary dysmenorrhea.

    Science.gov (United States)

    Inanmdar, Wajida; Sultana, Arshiya; Mubeen, Umraz; Rahman, Khaleequr

    2016-05-25

    To determine the effificacy and safety of fenugreek seed and dry cupping on intensity of pain in primary dysmenorrhea. Sixty patients with primary dysmenorrhea were enrolled in this prospective, open-labeled, randomized, standard-controlled study, conducted in the National Institute of Unani Medicine Hospital between February 2010 and April 2011. In group A (20 cases), 3 g powder of fenugreek seed (3 capsules, 1 g each) was given orally twice daily from day 1 to 3 of menstrual cycle. Group B (20 cases) received the same dose of fenugreek seed as group A along with dry cupping therapy [two 4.2-cm and one 2.5-cm cups (internal diameter)], which was applied below the umbilicus for 15 min on day 1 and day 3 of menstrual cycle for 3 consecutive months. The control group C (20 cases) was given mefenamic acid, 500 mg twice daily, on the same protocol. The reduction in menstrual pain intensity was measured with well validated Visual Analogue Scale and safety of fenugreek seed was evaluated by clinical examination and laboratory investigations. Baseline characteristics and biochemical parameters were comparable and homogenous among all groups (P>0.05). The percentage reduction in lower abdominal pain was 66.89%, 66.49%, and 62.88% in A, B and C groups respectively at the end of the treatment. No adverse drug effects were noticed. The fenugreek seed and dry cupping are effificacious, safe, cost effective, and well tolerated.

  10. The influence of psychological factors on pre-operative levels of pain intensity, disability and health-related quality of life in lumbar spinal fusion surgery patients.

    Science.gov (United States)

    Abbott, Allan D; Tyni-Lenné, Raija; Hedlund, Rune

    2010-09-01

    To assess the extent to which perceived pain and psychological factors explain levels of disability and health-related quality of life (HRQOL) in patients scheduled for lumbar fusion surgery, and to test the hypothesis that relationships between pain intensity, mental health, fear of movement/(re)injury, disability and HRQOL are mediated by cognitive beliefs and appraisals. Cross-sectional, correlation study. Orthopaedic outpatient setting in a tertiary hospital. One hundred and seven chronic back pain patients scheduled for lumbar fusion surgery. Visual analogue scale for pain intensity, Short Form 36 mental health subscale, Tampa Scale for Kinesiophobia, Back Beliefs Questionnaire, Self-efficacy Scale, Coping Strategy Questionnaire, Oswestry Disability Index and European Quality of Life Questionnaire. The group effect of multiple mediators significantly influenced the relationships between pain intensity and mental health, fear of movement/(re)injury, functional disability and HRQOL. Pain catastrophising significantly mediated the relationship between pain intensity and mental health, control over pain significantly mediated the relationship between mental health and functional disability, self-efficacy and pain outcome expectancy significantly mediated the relationship between mental health and HRQOL, and self-efficacy also significantly mediated the relationship between pain intensity, fear of movement/(re)jury and functional disability. The model explained 28, 30, 52 and 42% of the variation in mental health, fear of movement/(re)injury, functional disability and HRQOL, respectively. This study highlights the strong influence and mediation roles of psychological factors on pain, mental health, fear of movement/(re)injury, disability and HRQOL in patients scheduled for lumber fusion. Future research should focus on screening as well as pre- and post-operative interventions based on these psychological factors for the potential improvement of lumber fusion

  11. Evaluation of pelvic floor muscles activity with and without abdominal maneuvers in subjects with and without low back pain.

    Science.gov (United States)

    Ehsani, Fatemeh; Arab, Amir Massoud; Assadi, Hamed; Karimi, Noureddin; Shanbehzadeh, Sanaz

    2016-04-27

    There was controversy in finding of studies related pelvic floor muscle (PFM) rehabilitation of subjects with low back pain (LBP), while this issue is very important for treatment of subjects with LBP. The purpose of this study was to evaluate PFM contraction in three conditions of alone and with abdominal hollowing (AH) or abdominal bracing (AB) maneuvers in subjects with and without chronic LBP. Subjects were divided into two groups: subjects with LBP (N = 25) and without LBP (N = 27). PFM contraction alone and during contraction with AH or AB maneuvers was measured. The amount of bladder base movement was measured as an indicator of PFM activity. There were no differences in PFM activity between subjects with and without chronic LBP, when PFM contracted alone (P = 0.60), contracted with AH (P= 0.12) and AB maneuver (P = 0.54). Our data revealed that contraction of the PFM alone produce greater displacement of the bladder base than contraction of the PFM with AH (P = 0.005) or AB maneuver (P = 0.001) in both groups. However, no significant difference was found between contraction of the PFM with AH and AB maneuver in individuals with LBP (P = 0.31). It seems that PFM contraction alone is more effective than PFM contraction with AH or AB maneuvers in lifting the pelvic floor in subjects with and without LBP.

  12. Collapse and coalescence of spherical voids subject to intense shearing: studied in full 3D

    DEFF Research Database (Denmark)

    Nielsen, Kim Lau; Dahl, Jonas; Tvergaard, Viggo

    2012-01-01

    Micro-mechanical 2D cell model studies have revealed ductile failure during intense shearing to be governed by the interaction of neighbouring voids, which collapse to micro-cracks and continuously rotate and elongate until coalescence occurs. For a three-dimensional void structure, this implies...... significant straining of the matrix material located on the axis of rotation. In particular, the void surface material is severely deformed during shearing and void surface contact is established early in the deformation process. This 3D effect intensifies with decreasing stress triaxiality and complicates...... shape, void orientation etc. The objective of this work is to expand the range of stress triaxiality usually faced in 3D cell model studies, such that intense shearing is covered, and to bring forward details on the porosity and void shape evolution. The overall material response is presented...

  13. The effect of inhalation aromatherapy with damask rose (Rosa damascena) essence on the pain intensity after dressing in patients with burns: A clinical randomized trial.

    Science.gov (United States)

    Bikmoradi, Ali; Harorani, Mehdi; Roshanaei, Ghodratollah; Moradkhani, Shirin; Falahinia, Golam Hossein

    2016-01-01

    Pain is one of the common problems encountered by patients with burns, which increases after each dressing. This study aimed to investigate the effect of inhalation aromatherapy with damask rose essence on the pain of patients with burns that is caused after dressing. A randomized clinical trial was conducted on 50 patients with second- and third-degree burn wounds. The baseline pain of the patients was assessed 30 min before they entered into the dressing room on the first and second days of intervention. The patients in the experimental group inhaled five drops of damask rose essence 40% in distilled water, while those in the control group inhaled five drops of distilled water as placebo. The pain intensity was assessed using Visual Analogue Scale at 15 and 30 min after the patients exited from the dressing room. Data were analyzed by SPSS (version 18) using descriptive and inferential statistics. There was significant difference between the mean of pain intensity before and after intervention at 15 and 30 min after dressing (P < 0.001). Moreover, there was significant difference in reduction of pain intensity before and after aromatherapy in the experimental group (P < 0.05). Also, there was a significant reduction in severity of pain after dressing in the experimental group compared with the control group (P < 0.05). Inhalation aromatherapy with damask rose could be effective for relieving the pain caused after dressing in patients with burns. Therefore, it could be suggested as a complementary therapy in burn patients for pain relief.

  14. The Effect Dry Cupping Therapy at Acupoint BL23 on the Intensity of Postpartum Low Back Pain in Primiparous Women Based on Two Types of Questionnaires, 2012; A Randomized Clinical Trial.

    Science.gov (United States)

    Akbarzadeh, Marzieh; Ghaemmaghami, Mehrnoush; Yazdanpanahi, Zahra; Zare, Najaf; Azizi, Amir; Mohagheghzadeh, Abdolali

    2014-04-01

    Continuous low back pain is associated with the symptoms of the pregnancy period. In spite of the improvement of low back pain within 6 months after the delivery, some women may develop chronic problems. This study aimed to investigate the effect of dry cupping therapy at BL23 point on the intensity of low back pain in primiparous women.  In the present randomized clinical trial, 100 samples were randomly allocated to either the cupping therapy or the control group (each containing 50 subjects). Cupping therapy was performed for 15-20 minutes every day up to 4 consecutive times. Visual Analogue Scale (VAS) and short-form McGill pain questionnaire were completed by the two groups before the intervention and immediately, 24 hours, and 2 weeks after that. Then, the data were entered into the SPSS statistical software (v. 16) and analyzed using chi-square test and repeated measures ANOVA. According to VAS, the mean intensity of low back pain in the cupping therapy group decreased from 7.8±2.7 before the intervention to 3.7±1.8, 2.5±1.7, and 1.4±1.4 immediately, 24 hours, and 2 weeks after the intervention, respectively. Besides, these measures were respectively obtained as 31.8±10.8, 9.0±6.7, 7.5±6.6, and 3.6±4.1 in the short-form McGill pain questionnaire. According to repeated measures ANOVA, a significant difference was observed among the various stages of follow-up (P=0.01). The study results showed cupping therapy to be effective in sedation of pain. Thus, it can be used as an effective treatment for reducing the low back pain. 2013072611944N3.

  15. The Effect Dry Cupping Therapy at Acupoint BL23 on the Intensity of Postpartum Low Back Pain in Primiparous Women Based on Two Types of Questionnaires, 2012; A Randomized Clinical Trial

    Science.gov (United States)

    Akbarzadeh, Marzieh; Ghaemmaghami, Mehrnoush; Yazdanpanahi, Zahra; Zare, Najaf; Azizi, Amir; Mohagheghzadeh, Abdolali

    2014-01-01

    Background: Continuous low back pain is associated with the symptoms of the pregnancy period. In spite of the improvement of low back pain within 6 months after the delivery, some women may develop chronic problems. This study aimed to investigate the effect of dry cupping therapy at BL23 point on the intensity of low back pain in primiparous women.  Methods: In the present randomized clinical trial, 100 samples were randomly allocated to either the cupping therapy or the control group (each containing 50 subjects). Cupping therapy was performed for 15-20 minutes every day up to 4 consecutive times. Visual Analogue Scale (VAS) and short-form McGill pain questionnaire were completed by the two groups before the intervention and immediately, 24 hours, and 2 weeks after that. Then, the data were entered into the SPSS statistical software (v. 16) and analyzed using chi-square test and repeated measures ANOVA. Results: According to VAS, the mean intensity of low back pain in the cupping therapy group decreased from 7.8±2.7 before the intervention to 3.7±1.8, 2.5±1.7, and 1.4±1.4 immediately, 24 hours, and 2 weeks after the intervention, respectively. Besides, these measures were respectively obtained as 31.8±10.8, 9.0±6.7, 7.5±6.6, and 3.6±4.1 in the short-form McGill pain questionnaire. According to repeated measures ANOVA, a significant difference was observed among the various stages of follow-up (P=0.01). Conclusion: The study results showed cupping therapy to be effective in sedation of pain. Thus, it can be used as an effective treatment for reducing the low back pain. Trial Registration Number: 2013072611944N3 PMID:25349852

  16. Heel blood sampling in European neonatal intensive care units: compliance with pain management guidelines

    DEFF Research Database (Denmark)

    Losacco, Valentina; Cuttini, Marina; Greisen, Gorm

    2011-01-01

    of heel blood sampling and associated procedures (oral sweet solutions, non-nutritive sucking, swaddling or positioning, topical anaesthetics and heel warming) were collected through a structured mail questionnaire. 284 NICUs (78% response rate) participated, but only 175 with >/=50 very low birth weight...... and France were the most likely, and Belgium and Spain the least likely to employ recommended combinations of evidence-based pain management measures. Conclusions Heel puncture is a common procedure in preterm neonates, but pain appears inadequately treated in many units and countries. Better compliance...

  17. Energy absorption and emission of harmonics by clusters subject to intense short laser pulses

    Science.gov (United States)

    Popruzhenko, S. V.; Zaretsky, D. F.; Bauer, D.

    2008-09-01

    Experimental and theoretical achievements in studies of atomic and metal clusters interacting with short intense infrared laser pulses are reviewed. The focus is made on the theoretical concepts describing the energy transfer from the laser field to the cluster nanoplasma and emission of laser harmonics from it. Both effects are considered assuming the collisionless regime, where the interaction of nanoplasma electrons with the self-consistent field dominates the individual collisions. The pivotal role of nonlinear resonances is underlined and described in detail. Possible ways for a further development of the theory and experimental perspectives are briefly discussed.

  18. MOSI: Multimodal Corpus of Sentiment Intensity and Subjectivity Analysis in Online Opinion Videos

    OpenAIRE

    Zadeh, Amir; Zellers, Rowan; Pincus, Eli; Morency, Louis-Philippe

    2016-01-01

    People are sharing their opinions, stories and reviews through online video sharing websites every day. Studying sentiment and subjectivity in these opinion videos is experiencing a growing attention from academia and industry. While sentiment analysis has been successful for text, it is an understudied research question for videos and multimedia content. The biggest setbacks for studies in this direction are lack of a proper dataset, methodology, baselines and statistical analysis of how inf...

  19. Changes in symptoms and pain intensity of cancer patients after enrollment in palliative care at home

    NARCIS (Netherlands)

    Dumitrescu, Luminita; van den Heuvel-Olaroiu, Marinela; van den Heuvel, Wim J. A.

    2007-01-01

    This study describes the activities and interventions carried out by an at-home palliative care team treating cancer patients who died within two years of being enrolled in a palliative care program. It analyzes which changes in symptoms and pain occurred and which sociodemographic and medical

  20. Age-related cutoffs for cervical movement behaviour to distinguish chronic idiopathic neck pain patients from unimpaired subjects.

    Science.gov (United States)

    Niederer, Daniel; Vogt, Lutz; Wilke, Jan; Rickert, Marcus; Banzer, Winfried

    2015-03-01

    The present study aims to develop age-dependent cutoff values in a quasi-experimental, cross-sectional diagnostic test study. One hundred and twenty (120) asymptomatic subjects (n = 100, 36♀, 18 75 years, for normative values; n = 20, 23-75 years, 15♀, for selectivity analyses) and 20 patients suffering from idiopathic neck pain (selectivity analyses, 22-71 years, 15♀) were included. Subjects performed five repetitive maximal cervical flexion/extension movements in an upright sitting position. Cervical kinematic characteristics (maximal range of motion (ROM), coefficient of variation (CV) and mean conjunct movements in rotation and flexion (CM)) were calculated from raw 3D ultrasonic data. Regression analyses were conducted to reveal associations between kinematic characteristics and age and gender and thus to determine normative values for healthy subjects. Age explains 53 % of the variance in ROM (decrease 10.2° per decade), 13 % in CV (increase 0.003 per decade) and 9 % in CM (increase 0.57° per decade). Receivers operating characteristic (ROC) analyses were conducted for differences between individual values of the kinematic characteristics and normative values to optimise cutoff values for distinguishing patients from unimpaired subjects (20 patients and 20 healthy). Cutoff values distinguished asymptomatic subjects' and chronic nonspecific neck patient's movement characteristics with sufficient quality (sensitivity 70-80 %, specificity 65-70 %). By including such classifications, the present findings expand actual research stating an age-related decrease in kinematic behaviour only using categorising span widths across decades. Future study is warranted to reveal our results' potential applicability for intervention onset decision making for idiopathic neck pain patients.

  1. Faster Improvement in Migraine Pain Intensity and Migraine-Related Disability at Early Time Points with AVP-825 (Sumatriptan Nasal Powder Delivery System) versus Oral Sumatriptan: A Comparative Randomized Clinical Trial Across Multiple Attacks from the COMPASS Study.

    Science.gov (United States)

    Lipton, Richard B; McGinley, James S; Shulman, Kenneth J; Wirth, R J; Buse, Dawn C

    2017-11-01

    in migraine pain intensity and migraine-related disability. A typical individual showed significantly faster reductions in migraine pain over the first 30 minutes and migraine-related disability over the first 45 minutes when treating with AVP-825 compared with oral sumatriptan. Overall levels of pain and disability also favored AVP-825 over 2 h following treatment. Model-based odds ratios (OR) comparing AVP-825 to oral sumatriptan ranged from 0.38 to 0.76 for pain and 0.37 to 0.65 for disability, with OR disability in the AVP-825 condition. Compared with 100 mg oral sumatriptan, treatment with AVP-825 was associated with faster reductions in migraine pain intensity and migraine-related disability starting at 10 minutes postdose and continuing through the first 30 minutes for migraine pain intensity and the first 45 minutes for migraine-related disability, resulting in lower overall pain intensity and disability that lasted through the first 2 h following treatment. Both migraine pain intensity and disability varied substantially both across subjects and within subjects across attacks. © 2017 American Headache Society.

  2. Effects of transcutaneous electrical nerve stimulation on pain intensity during application of carboxytherapy in patients with cellulite: A randomized placebo-controlled trial.

    Science.gov (United States)

    Sadala, Adria Y; Machado, Aline F P; Liebano, Richard E

    2018-01-16

    Carboxytherapy may generate local pain that is considered the main limiting factor in clinical practice. Transcutaneous electric nerve stimulation (TENS) is widely used in the control of acute pain; however, the effect of TENS on pain relief during carboxytherapy has not been studied to date. To assess the effect of TENS on pain intensity during carboxytherapy in patients with cellulite in the gluteal region. This randomized clinical trial was conducted with 84 patients, 18-44 years of age, who had moderate cellulite in the gluteal region, according to Cellulite Severity Scale, but never received carboxytherapy. Patients were randomized into 3 groups: active TENS, placebo TENS, and control group. For the intervention, skin depressions with cellulite were outlined, and the gluteal area to be treated was defined. The subcutaneous injection of CO 2 was performed using 0.30 × 13 mm-needles at a 45° angle, with a controlled flow rate of 100 mL/min maintained for 1 minute at each puncture site. The parameters for TENS were as follows: frequency of 100 Hz and pulse duration of 200 μs; TENS intensity was adjusted until the patient reported strong paresthesia. The visual numeric pain rating scale was used to assess pain intensity after each puncture. The active TENS group reported lower pain intensity compared to the placebo TENS (P cellulite in the gluteal region. © 2018 Wiley Periodicals, Inc.

  3. Agreement and correlation between the self-report leeds assessment of neuropathic symptoms and signs and Douleur Neuropathique 4 Questions neuropathic pain screening tools in subjects with low back-related leg pain.

    Science.gov (United States)

    Walsh, Jeremy; Rabey, Martin I; Hall, Toby M

    2012-01-01

    The self-report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) and Douleur Neuropathique 4 Questions (DN4) neuropathic pain screening tools have been shown to be reliable, valid, and able to differentiate neuropathic pain from inflammatory or mixed pain syndromes. However, no studies have compared these tools to determine whether their outcomes are similar. This study evaluated agreement and correlation between the S-LANSS and DN4 in the identification of neuropathic pain in subjects with low back-related leg pain. This observational study compared S-LANSS and DN4 scores in 45 patients with low back-related leg pain. The S-LANSS and DN4 cutoff scores of 12 and 4, respectively, were used to classify subjects as positive or negative for the presence of neuropathic pain for each screening tool. The κ statistic was used to determine whether there was agreement in classification of neuropathic pain between the 2 screening tools. Pearson correlation coefficient was used to determine correlation between scores of the 2 screening tools. Neuropathic pain was identified in 15 subjects (33%) using the S-LANSS and in 19 subjects (42%) using the DN4. Agreement on neuropathic pain classification was fair, with a κ value of 0.34. There was moderate to good correlation (r = 0.62; P < .001) between scores obtained from the 2 tools. The finding of fair agreement suggests that despite the moderate to good correlation between scores, the cutoff points for the classification of neuropathic pain of the 2 tools may not be congruent. Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  4. Response of pain intensity to soft tissue mobilization and neurodynamic technique: a series of 18 patients with chronic carpal tunnel syndrome.

    Science.gov (United States)

    De-la-Llave-Rincon, Ana I; Ortega-Santiago, Ricardo; Ambite-Quesada, Silvia; Gil-Crujera, Antonio; Puentedura, Emilio J; Valenza, Marie C; Fernández-de-las-Peñas, César

    2012-07-01

    The purpose of this prospective case series was to examine the combined effects of soft tissue mobilization and nerve slider neurodynamic technique on pain and pressure sensitivity in women with chronic carpal tunnel syndrome (CTS). Eighteen women with a clinical and electromyographic diagnosis of CTS participated. Patients completed the numerical pain rating scale (NPRS) for current, worst, and lowest pain intensity and underwent pain pressure threshold (PPT) testing over the median, radial, and ulnar nerves; the C5-C6 zygapophyseal joint; the carpal tunnel; and the tibialis anterior muscle. Pain was assessed at baseline and 1-week follow-up, whereas PPT were assessed at baseline and immediately after and 1-week after intervention. Each received soft tissue mobilization and nerve slider neurodynamic technique directed at different anatomical sites of potential entrapment of the median nerve. A decrease in the mean current intensity and worst level of hand pain (P.195). The application of soft tissue mobilization and neurodynamic technique decreased the intensity of pain but did not change pressure pain sensitivity in this group of women with chronic CTS. Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  5. Effects of vision and cognitive load on static postural control in subjects with and without patellofemoral pain syndrome.

    Science.gov (United States)

    Zeinalzadeh, Afsaneh; Talebian, Saeed; Naghdi, Soofia; Salavati, Mahyar; Nazary-Moghadam, Salman; Zeynalzadeh Ghoochani, Bahareh

    2018-04-01

    To compare the effects of vision and cognitive load on static postural control in subjects with and without patellofemoral pain syndrome (PFPS). Twenty-eight PFPS patients and 28 controls participated in the study. Postural control was assessed in isolation as well as with visual manipulation and cognitive loading on symptomatic limb. The outcome measures of postural control were quantified in terms of area, anterior-posterior (AP), medial-lateral (ML), and mean velocity (MV) of the displacements of center of pressure (COP). In addition, cognitive performance (auditory Stroop task) was measured in the forms of average reaction time and error ratio in baseline (sitting) and different postural conditions. PFPS subjects showed greater increases in area (p = 0.01), AP (p = 0.01), and ML (p = 0.05) displacements of COP in the blindfolded tasks as compared to control group. However, cognitive load did not differently affect postural control in the two groups. Although PFPS and control group had similar reaction times in the sitting position (p = 0.29), PFPS subjects had longer reaction times than healthy subjects in dual task conditions (p = 0.04). Visual inputs seem to be essential for discriminating postural control between PFPS and healthy individuals. PFPS patients biased toward decreasing cognitive performance more than healthy subjects when they perform the single leg stance and cognitive task concurrently.

  6. Bedtime uncooked cornstarch supplement prevents nocturnal hypoglycaemia in intensively treated type 1 diabetes subjects.

    Science.gov (United States)

    Axelsen, M; Wesslau, C; Lönnroth, P; Arvidsson Lenner, R; Smith, U

    1999-03-01

    The present study tests two interrelated hypotheses: (1) that bedtime ingestion of uncooked cornstarch exerts a lower and delayed nocturnal blood glucose peak compared with a conventional snack; (2) that bedtime carbohydrate supplement, administered as uncooked cornstarch, prevents nocturnal hypoglycaemia without altering metabolic control in intensively treated type 1 diabetes (IDDM) patients. The above hypotheses were tested separately (1) by pooling and analysing data from two overnight studies of comparable groups of patients with non-insulin dependent diabetes mellitus (NIDDM) (14 and 10 patients, respectively), and (2) by a double-blind, randomized 4-week cross-over study in 12 intensively treated IDDM patients. Sahlgrenska University Hospital, Göteborg. Sweden. (1) Ingestion of uncooked cornstarch and wholemeal bread (0.6 g of carbohydrates kg-1 body weight) and carbohydrate-free placebo at 22.00 h. (2) Intake of uncooked cornstarch (0.3 g kg-1 body weight) and carbohydrate-free placebo at 23.00 h. (1) Nocturnal glucose and insulin levels; (2) frequency of self-estimated hypoglycaemia (blood glucose [BG] levels Bedtime uncooked cornstarch ingestion led to a lower (2.9 +/- 0.5 vs. 5.2 +/- 0.6 mM, P = 0.01) and delayed (4.3 +/- 0.6 vs. 2.0 +/- 0.0 h, P bedtime uncooked cornstarch supplement, as compared with placebo, led to a 70% reduction in the frequency of self-estimated hypoglycaemia at 03.00 h (P bedtime, mimicked the nocturnal glucose utilization profile following insulin replacement, with a peak in blood glucose after 4 h. In IDDM patients, bedtime uncooked cornstarch supplement diminished the number of self-estimated hypoglycaemic episodes, without adversely affecting HbA1c and lipid levels. Hence, bedtime uncooked cornstarch ingestion may be feasible to prevent a mid-nocturnal glycaemic decline following insulin replacement in IDDM and, based on the nocturnal blood glucose profile, may also be preferable compared with conventional snacks.

  7. Investigating the effect of Eye Movement Desensitization and Reprocessing (EMDR) on postoperative pain intensity in adolescents undergoing surgery: a randomized controlled trial.

    Science.gov (United States)

    Maroufi, Mohsen; Zamani, Shahla; Izadikhah, Zahra; Marofi, Maryam; O'Connor, Peter

    2016-09-01

    To investigate the efficacy of Eye Movement Desensitization and Reprocessing for postoperative pain management in adolescents. Eye Movement Desensitization and Reprocessing is an inexpensive, non-pharmacological intervention that has successfully been used to treat chronic pain. It holds promise in the treatment of acute, postsurgical pain based on its purported effects on the brain and nervous system. A randomized controlled trial was used. Fifty-six adolescent surgical patients aged between 12-18 years were allocated to gender-balanced Eye Movement Desensitization and Reprocessing (treatment) or non-Eye Movement Desensitization and Reprocessing (control) groups. Pain was measured using the Wong-Baker FACES(®) Pain Rating Scale (WBFS) before and after the intervention (or non-intervention for the control group). A Wilcoxon signed-rank test demonstrated that the Eye Movement Desensitization and Reprocessing group experienced a significant reduction in pain intensity after treatment intervention, whereas the control group did not. Additionally, a Mann-Whitney U-test showed that, while there was no significant difference between the two groups at time 1, there was a significant difference in pain intensity between the two groups at time 2, with the Eye Movement Desensitization and Reprocessing group experiencing lower levels of pain. These results suggest that Eye Movement Desensitization and Reprocessing may be an effective treatment modality for postoperative pain. © 2016 John Wiley & Sons Ltd.

  8. Pain assessment.

    Science.gov (United States)

    Haefeli, Mathias; Elfering, Achim

    2006-01-01

    Pain usually is the major complaint of patients with problems of the back, thus making pain evaluation a fundamental requisite in the outcome assessment in spinal surgery. Pain intensity, pain-related disability, pain duration and pain affect are the aspects that define pain and its effects. For each of these aspects, different assessment instruments exist and are discussed in terms of advantages and disadvantages. Risk factors for the development of chronic pain have been a major topic in pain research in the past two decades. Now, it has been realised that psychological and psychosocial factors may substantially influence pain perception in patients with chronic pain and thus may influence the surgical outcome. With this background, pain acceptance, pain tolerance and pain-related anxiety as factors influencing coping strategies are discussed. Finally, a recommendation for a minimum as well as for a more comprehensive pain assessment is given.

  9. The Effect of Lavender Aaromatherapy on the Pain Intensity Perception and Intarapartum Outcomes in Primipare

    OpenAIRE

    N Alavi; M Nemati; M Kaviani; MH Tabaie

    2010-01-01

    1.Borli S, Diana SK. Easy Labour by Lamas Method, translation: Zein Ali Bagha E. 1st ed. Tehran: Babazadeh 1382:2. 2.Hadi N. Mother & Child Health . 1st ed. Shiraz: Navid13849. 3.Hosseinpour N. Acupuncture & tens on severity primiparous women's labour pain reffers to zeinabieh hospital of shiraz . MS thesis of nursing & midwifery college of shiraz university of medical sciences, Shiraz,1386. 4.Shariat MA, Mohammadian Mohamad A, Mahmodi M. The effect of request of pregnant women ...

  10. Interexaminer reliability of the electromagnetic radiation receiver for determining lumbar spinal joint dysfunction in subjects with low back pain

    Energy Technology Data Exchange (ETDEWEB)

    Gemmell, H.A.; Jacobson, B.H.; Edwards, S.W.; Heng, B.J.

    1990-03-01

    Twenty subjects (6 male, 14 female) with low back pain were examined by two experienced and licensed chiropractic doctors (E1 and E2). Both examiners examined the patients using a Toftness Electromagnetic Radiation Receiver (EMRR) and by manual palpation (MP) of the spinous processes. Interexaminer reliability was calculated at three sites (L3, L4, L5) for the following combinations: (a) E1,MP--E2,MP; (b) E1,EMRR--E2,EMRR; (c) E1,MP--E2,EMRR; and (d) E2,MP--E1,EMRR, and intraexaminer reliability was calculated for the following variables: (e) E1,MP--E1,EMRR; and (f) E2,MP--E2,EMRR. Results of a Kappa coefficient analysis for interexaminer reliability of the stated combinations and at the specific sites were: (a) -0.071, 0.400, 0.200; (b) -0.013, 0.100, -0.120; (c) 0.286, 0.300, 0.200; (d) -0.081, 0.000, 0.048. These results predominantly indicate a poor to fair interexaminer reliability. The results of a Kappa coefficient analysis for intraexaminer reliability of the stated combinations were: (e) 0.111, 0.400, 0.737; (f) 0.000, 0.100, 0.368. These results indicate a poor to fair reliability. It was concluded that in subjects with low back pain the EMRR may not be a reliable indicator of spinal joint dysfunction.

  11. Immediate effects of hamstring muscle stretching on pressure pain sensitivity and active mouth opening in healthy subjects.

    Science.gov (United States)

    Bretischwerdt, Cristina; Rivas-Cano, Luis; Palomeque-del-Cerro, Luis; Fernández-de-las-Peñas, César; Alburquerque-Sendín, Francisco

    2010-01-01

    This study analyzed the immediate effect of hamstring muscle stretching on pressure pain sensitivity over the masseter and the upper trapezius muscles and maximum active mouth opening in healthy subjects. One hundred twenty volunteers, 70 males and 50 females, between the ages of 22 and 47, were randomly divided into 3 groups: group 1 (control group) that did not receive any intervention, group 2 where a unilateral hamstring muscle stretching was applied, and group 3 where a bilateral stretching was applied. Pressure pain thresholds (PPTs) were bilaterally assessed over the masseter and upper trapezius muscles pre- and 5 minutes posttreatment by an assessor blinded to group assignment. Maximum mouth opening was also assessed pre- and 5 minutes posttreatment. Mixed-model analyses of variance (ANOVAs) were used to examine the effects of the intervention. The primary analysis was the group x time interaction. The ANOVA revealed significant group x time interaction for changes in PPTs over the upper trapezius (F = 4.5; P = .01) and masseter (F = 6.3; P = .002) muscles. Pre-post effect sizes were moderate (0.5 >d > 0.7) for both stretching groups and negative (d 0.7) for both stretching groups and negative (d stretching of the hamstring musculature produced an immediate increase in PPTs over both masseter and upper trapezius muscles in healthy subjects. Copyright 2010 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  12. Population Pharmacokinetic Modeling of Tapentadol Extended Release (ER) in Healthy Subjects and Patients with Moderate or Severe Chronic Pain.

    Science.gov (United States)

    Huntjens, Dymphy R; Liefaard, Lia C; Nandy, Partha; Drenth, Henk-Jan; Vermeulen, An

    2016-03-01

    Tapentadol is a centrally acting analgesic with two mechanisms of action, µ-opioid receptor agonism and noradrenaline reuptake inhibition. The objectives were to describe the pharmacokinetic behavior of tapentadol after oral administration of an extended-release (ER) formulation in healthy subjects and patients with chronic pain and to evaluate covariate effects. Data were obtained from 2276 subjects enrolled in five phase I and nine phase II and III studies. Nonlinear mixed-effects modeling was conducted using NONMEM. The population estimates of apparent oral clearance and apparent central volume of distribution were 257 L/h and 1870 L, respectively. The complex absorption was described with a transit compartment for the first input. The second input function embraces saturable "binding" in the "absorption compartment", and a time-varying rate constant. Covariate evaluation demonstrated that age, aspartate aminotransferase, and health (painful diabetic neuropathy or not) had a statistically significant effect on apparent clearance, and bioavailability appeared to be dependent on body weight. The pcVPC indicted that the model provided a robust and unbiased fit to the data. A one-compartment disposition model with two input functions and first-order elimination adequately described the pharmacokinetics of tapentadol ER. The dose-dependency in the pharmacokinetics of tapentadol ER is adequately described by the absorption model. None of the covariates were considered as clinically relevant factors that warrant dose adjustments.

  13. Duration of mechanical ventilation in an adult intensive care unit after introduction of sedation and pain scales.

    Science.gov (United States)

    Williams, Teresa Ann; Martin, Suzanne; Leslie, Gavin; Thomas, Linda; Leen, Timothy; Tamaliunas, Sheralee; Lee, K Y; Dobb, Geoffrey

    2008-07-01

    Sedation and analgesia scales promote a less-distressing experience in the intensive care unit and minimize complications for patients receiving mechanical ventilation. To evaluate outcomes before and after introduction of scales for sedation and analgesia in a general intensive care unit. A before-and-after design was used to evaluate introduction of the Richmond Agitation-Sedation Scale and the Behavioral Pain Scale for patients receiving mechanical ventilation. Data were collected for 6 months before and 6 months after training in and introduction of the scales. A total of 769 patients received mechanical ventilation for at least 6 hours (369 patients before and 400 patients after implementation). Age, scores on the Acute Physiology and Chronic Health Evaluation (APACHE) II, and diagnostic groups were similar in the 2 groups, but the after group had more men than did the before group. Duration of mechanical ventilation did not change significantly after the scales were introduced (median, 24 vs 28 hours). For patients who received mechanical ventilation for 96 hours or longer (24%), mechanical ventilation lasted longer after implementation of the scales (P=.03). Length of stay in the intensive care unit was similar in the 2 groups (P= .18), but patients received sedatives for longer after implementation (P=.01). By logistic regression analysis, APACHE II score (Pmechanical ventilation lasting 96 hours or longer. Sedation and analgesia scales did not reduce duration of ventilation in an Australian intensive care unit.

  14. Lesson from performing SCORADs in children with atopic dermatitis: subjective symptoms do not correlate well with disease extent or intensity.

    Science.gov (United States)

    Hon, K L E; Leung, T F; Wong, Y; Fok, T F

    2006-06-01

    Atopic dermatitis (AD) is a distressing disease associated with pruritus and sleep disturbance. It is not known how well these symptoms correlate with the extent and intensity of eczematous involvement. We evaluated whether: (i) the level of sleep loss correlates with pruritus and (ii) the level of pruritus correlates with the extent or severity of AD in children according to the SCORing Atopic Dermatitis (SCORAD) index. Patients with AD younger than 18 years old were recruited from the pediatric dermatology clinic of a university teaching hospital, and AD severity was evaluated by the SCORAD index. One hundred and eighty-two Chinese children with AD (107 boys and 75 girls) [mean (SD) age of 9.6 (4.2) years] were recruited. Their mean (SD) overall SCORAD was 30.1 (19.2). Sleep loss was strongly correlated with pruritus (r = 0.57, P < 0.001). However, the two subjective symptoms were only weakly correlated with the objective signs (extent and intensity) of AD. The correlations between pruritus and extent and intensity were 0.42 (P < 0.001) and 0.38 (P < 0.001), respectively, and the correlations between sleep loss and extent and intensity were 0.38 (P < 0.001) and 0.34 (P < 0.001), respectively. We speculate that the lack of a better correlation was either because pruritus and sleep loss as reported by parents were imprecise, or that mechanisms other than disease extent or severity are responsible for the pathogenesis of these subjective symptoms.

  15. Multidisciplinary intensive functional restoration versus outpatient active physiotherapy in chronic low back pain: a randomized controlled trial.

    Science.gov (United States)

    Roche-Leboucher, Ghislaine; Petit-Lemanac'h, Audrey; Bontoux, Luc; Dubus-Bausière, Valérie; Parot-Shinkel, Elsa; Fanello, Serge; Penneau-Fontbonne, Dominique; Fouquet, Natacha; Legrand, Erick; Roquelaure, Yves; Richard, Isabelle

    2011-12-15

    Randomized parallel group comparative trial with a 1-year follow-up period. To compare in a population of patients with chronic low back pain, the effectiveness of a functional restoration program (FRP), including intensive physical training and a multidisciplinary approach, with an outpatient active physiotherapy program at 1-year follow-up. Controlled studies conducted in the United States and in Northern Europe showed a benefit of FRPs, especially on return to work. Randomized studies have compared these programs with standard care. A previously reported study presented the effectiveness at 6 months of both functional restoration and active physiotherapy, with a significantly greater reduction of sick-leave days for functional restoration. A total of 132 patients with low back pain were randomized to either FRP (68 patients) or active individual therapy (64 patients). One patient did not complete the FRP; 19 patients were lost to follow-up (4 in the FRP group and 15 in the active individual treatment group). The number of sick-leave days in 2 years before the program was similar in both groups (180 ± 135.1 days in active individual treatment vs. 185 ± 149.8 days in FRP, P = 0.847). In both groups, at 1-year follow-up, intensity of pain, flexibility, trunk muscle endurance, Dallas daily activities and work and leisure scores, and number of sick-leave days were significantly improved compared with baseline. The number of sick-leave days was significantly lower in the FRP group. Both programs are efficient in reducing disability and sick-leave days. The FRP is significantly more effective in reducing sick-leave days. Further analysis is required to determine if this overweighs the difference in costs of both programs.

  16. Glucosamine-containing supplement improves locomotor functions in subjects with knee pain – a pilot study of gait analysis

    Directory of Open Access Journals (Sweden)

    Kanzaki N

    2016-06-01

    Full Text Available Noriyuki Kanzaki,1 Yuta Otsuka,1 Takayuki Izumo,1 Hiroshi Shibata,1 Hideyuki Nagao,2 Keita Ogawara,3 Hiroshi Yamada,3 Seiji Miyazaki,3 Yutaka Nakamura3 1Institute for Health Care Science, Suntory Wellness Ltd, Seika-cho, Soraku-gun, Kyoto, Japan; 2Research Institute of Sports Medical Science, Tokai University, Hiratsuka, Kanagawa, Japan; 3School of Physical Education, Tokai University, Hiratsuka, Kanagawa, Japan Background: Previously, we demonstrated that glucosamine-containing supplementation was effective for improving locomotor functions, especially walking speed. However, the biomechanical mechanism of efficacy has not been elucidated. This study aimed to address this challenge in subjects with knee pain, using a motion capture system. Methods: An open label study was conducted in 30 Japanese subjects with knee pain. The subjects were administered a daily supplement containing 1,200 mg of glucosamine hydrochloride, 60 mg of chondroitin sulfate, 45 mg of type II collagen peptides, 90 mg of quercetin glycosides, 10 mg of imidazole peptides, 1 mg of proteoglycan, and 5 µg of vitamin D (GCQID. The intervention continued for 16 weeks. Efficacy for locomotor functions involving the knee joint was evaluated mainly using the Japanese Knee Osteoarthritis Measure (JKOM and the 5-question Geriatric Locomotive Function Scale (GLFS-5. To examine the biomechanical mechanism of efficacy for locomotor functions, motions of subjects in a normal walking state were captured. Gait analysis was conducted and efficacy for gait parameters such as normal walking speed, stride length, cadence, and angle of soles was evaluated. Results: GCQID significantly improved total scores on the JKOM and GLFS-5. In gait analysis, normal walking speed, stride length, and angle of soles at the end of the stance phase were all significantly increased, but cadence did not change significantly during the intervention period. There were significant intercorrelations of changes in

  17. Lumbar and abdominal muscle activity during walking in subjects with chronic low back pain: support of the "guarding" hypothesis?

    Science.gov (United States)

    van der Hulst, Marije; Vollenbroek-Hutten, Miriam M; Rietman, Johan S; Hermens, Hermanus J

    2010-02-01

    It has been hypothesized that changes in trunk muscle activity in chronic low back pain (CLBP) reflect an underlying "guarding" mechanism, which will manifest itself as increased superficial abdominal - and lumbar muscle activity. During a functional task like walking, it may be further provoked at higher walking velocities. The purpose of this cross sectional study was to investigate whether subjects with CLBP show increased co-activation of superficial abdominal - and lumbar muscles during walking on a treadmill, when compared to asymptomatic controls. Sixty-three subjects with CLBP and 33 asymptomatic controls walked on a treadmill at different velocities. Surface electromyography data of the erector spinae, rectus abdominis and obliquus abdominis externus muscles were obtained and averaged per stride. Results show that, compared to asymptomatic controls, subjects with CLBP have increased muscle activity of the erector spinae and rectus abdominis, but not of the obliquus abdominis externus. These differences in trunk muscle activity between groups do not increase with higher walking velocities. In conclusion, the observed increased trunk muscle activity in subjects with CLBP during walking supports the guarding hypothesis.

  18. Low intensity laser therapy and functional orthopedics contribution in pain and temporo mandibular dysfunction treatment; Contribuicao do laser em baixa intensidade e da ortopedia funcional dos maxilares no tratamento da dor e disfuncao tempora-mandibular

    Energy Technology Data Exchange (ETDEWEB)

    Lollato, Renata Fronzaglia

    2003-07-01

    Temporo Mandibular Dysfunction (TMD) is a term used to describe disorders which involve temporomandibular joint (TMJ), masticatory muscles, and associated structures, isolatedly or not, whose most frequent symptoms pain. Its etiology involve controversies, and among risk factors is Class 11 malocclusion. A lot of techniques are used for TMD treatment, and the most recent are Low Intensity Laser Therapy (LILT) and Functional Orthopedics (FO). The aim of this study was to evaluate pain and buccal mobility in subjects with Class II malocclusion and TMD symptoms, treated with LILT and FO associated or not. Eighteen subjects were selected and divided in three groups. Group 1 was treated with LILT, {lambda} = 780 nm, 70 mW, 15 J/cm{sup 2} per point, in six sessions during two weeks. The application was in three points around the TMJ and in masticatory muscles: masseter, temporalis, sternomastoid and trapezius, on both sides when there was pain. Palpation was made before and five minutes after application and subjects answered a questionnaire with a score for pain evaluation. Group 2 received functional orthopedics aparatology Planas Indirect Composed Plates, and was evaluated once a week during two weeks, after palpation and following the same score as group 1. Group 3 received both therapies at the same time, and the first application coincided with the aparatology installation. The evaluation followed the parameters of group 1. The results were statically analyzed , and in general form did not show significant differences. There was remission of pain symptoms in ali of the groups, and group 3 showed more rapidly results. This fact leaded us to a conclusion that the association of the LILT with FO was the best treatment for the pain symptoms remission in TMD. (author)

  19. Electron emission from conductors subjected to intense, short-pulse electric fields

    Science.gov (United States)

    Scarpetti, R. D.; Goerz, D. A.; Bowen, P. R.; Hodgin, R. L.; Wong, K. C.; Champney, P. D'a.

    1987-06-01

    We studied electron emission from metal electrodes subjected to electric fields ranging from 0.5 to 2.5 MV/cm for pulse durations of 3 to 10 ns. We used two high-voltage pulsers for these tests; a 500 to 700 kV, 72 ohm pulser that generated a 3 ns Gaussian pulse; and a 2 MV, 60 ohm pulser that generated a 10 ns flat-top pulse with a 1-ns risetime. The high voltage levels allowed emission studies using electrode spacings of several millimeters to several centimeters. Our studies emphasized bare and anodized aluminum surface shaving surface finishes that ranged from rolled stock to machined finishes of 2 to 400 micron-in roughness. We also investigated polished stainless steel and brass. Emphasis was on first-shot performance with subsequent pulses applied to check for possible conditioning. The background pressure was typically .00005 Torr. Our studies showed that for 10 ns pulse lengths, anodized aluminum surfaces could hold off more than twice the electric field strength of bare aluminum surfaces without appreciable electron emission. Anodized surfaces performed well at 1.0 to 1.5 MV/cm, while bare surfaces emitted at 0.5 to 0.7 MV/cm. For the shorter, 3 ns pulse lengths, anodizing was less effective at improving suppression of electron emission, while surface finish became the important factor. Electrodes with surface finishes of 40 micro-in or better roughness performed well at field strengths of up to 2.4 MV/cm. The behavior of velvet cloth as an emitter was also investigated using the 3 ns pulser. We found that velvet would emit within 3 ns at field strengths approaching 100 kV/cm.

  20. One-footed and externally disturbed two-footed postural control in patients with chronic low back pain and healthy control subjects. A controlled study with follow-up.

    Science.gov (United States)

    Luoto, S; Aalto, H; Taimela, S; Hurri, H; Pyykkö, I; Alaranta, H

    1998-10-01

    A study of postural control during one-footed and externally disturbed two-footed stance among healthy control subjects and patients with chronic low back pain at the beginning of a functional back restoration program and 6 months later at follow-up examination. To study postural control cross-sectionally among control subjects and patients with low back pain, and to evaluate the effects of functional restoration on the postural control parameters in a follow-up examination. Deficits of motor skills and coordination have been reported in association with musculoskeletal disorders. It has been found that patients with chronic low back pain have impaired psychomotor control, but the impairment is reversible with successful low back rehabilitation. It is insufficiently known how functional activation and intensive physical training affect postural control. Sixty-one healthy volunteers (32 men, 29 women) and altogether 99 patients with low back pain participated in the study. Sixty-eight patients (33 men, 35 women) had moderate and 31 (18 men, 13 women) had severe low back pain. Postural stability was measured with a force platform. In two-footed stance, vibration stimulation on calf and back muscles was used to disturb the balance. Center point of force-velocity (cm/sec), average position shift in anteroposterior direction (cm), and maximal position shift in lateral direction (cm) were used as the parameters. Reliability of all tests was acceptable. Center point of force-velocity was the most sensitive parameter and the one-footed measurement the most sensitivetest for evaluating postu