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Sample records for subjective pain ratings

  1. 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...

  2. 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.

  3. Serotonin transporter binding in the hypothalamus correlates negatively with tonic heat pain ratings in healthy subjects: A [11C]DASB PET study

    DEFF Research Database (Denmark)

    Kupers, Ron; Frokjaer, Vibe G.; Erritzoe, David

    2010-01-01

    ) tonic noxious heat stimulus. PET data were analyzed using both volume-of-interest (VOI) and voxel-based approaches. VOI analysis revealed a significant negative correlation between tonic pain ratings and SERT binding in the hypothalamus (r = −0.59; p = 0.008), a finding confirmed by the parametric...... analysis revealed a positive correlation between pain tolerance and SERT binding in the hypothalamus (r = 0.53; p = 0.02) although this was not seen in the parametric analysis. These data extend our earlier observation that cortical 5-HT receptors co-determine responses to tonic but not to phasic pain....... The negative correlation between SERT binding in the hypothalamus and insula with tonic pain ratings suggests a possible serotonergic control of the role of these areas in the modulation or in the affective appreciation of pain....

  4. 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.

  5. 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.

  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. 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.

  8. 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

  9. Sex Differences in Parent and Child Pain Ratings during an Experimental Child Pain Task

    Directory of Open Access Journals (Sweden)

    Erin C Moon

    2008-01-01

    Full Text Available Research in the field of pediatric pain has largely ignored the role of fathers in their children’s pain experiences. The first objective of the present study was to examine the effect of the presence of mothers versus fathers on children’s subjective ratings, facial expressions and physiological responses to acute pain. The second objective was to examine whether child and parent sex influence parents’ proxy ratings of their children’s pain. The final objective was to compare levels of agreement between mothers’ and fathers’ assessments of their children’s pain. Participants included 73 children (37 boys, 36 girls, four to 12 years of age, along with 32 fathers and 41 mothers. Children undertook the cold pressor pain task while observed by one of their parents. During the task, the children’s heart rates and facial expressions were recorded. Children provided self-reports and parents provided proxy reports of child pain intensity using the seven-point Faces Pain Scale. Neither child nor parent sex had a significant impact on children’s subjective reports, facial expressions or heart rates in response to acute pain. Fathers gave their sons higher pain ratings than their daughters, whereas mothers’ ratings of their sons’ and daughters’ pain did not differ. Kappa statistics and t tests revealed that fathers tended to be more accurate judges of their children’s pain than mothers. Overall, this research highlights the importance of examining both parent and child sex differences in pediatric pain research.

  10. Pain rating schema: three distinct subgroups of individuals emerge when rating mild, moderate, and severe pain

    Directory of Open Access Journals (Sweden)

    Frey-Law LA

    2013-12-01

    Full Text Available Laura A Frey-Law,1 Jennifer E Lee,2,3 Alex M Wittry,4 Myles Melyon5 1Department of Physical Therapy and Rehabilitation Science, The University of Iowa, Iowa City, IA, USA; 2Mount Mercy University, Department of Psychology, Cedar Rapids, IA, USA; ³College of Nursing, The University of Iowa, 4Department of Emergency Medicine, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA; 5Midwestern University, Glendale, AZ, USA Background: While the validity of pain assessment has been well documented, the underlying schema (ie, organized, preconceived ideas of how individuals interpret numerical pain ratings is not well understood. This study's objectives were to examine numerical pain intensity ratings, from (0 to 10 cm on the visual analog scale [VAS] across multiple severities of commonly experienced acute pain conditions to determine whether the ratings differed between these pain conditions and/or between individuals. Methods: A community sample (N=365, 66% female rated their anticipated pain intensity (VAS for threshold, mild, moderate, severe, and tolerance level, using several common pain conditions: headache, toothache, joint injury, delayed-onset muscle soreness, burns, and “general pain.” Results: Cluster analysis revealed three subgroups of individuals, suggesting three types of underlying pain rating schema: 1 Low Rating subgroup (low VAS pain intensity ratings across all the pain severity categories; 2 Low/High Rating subgroup (low VAS pain intensity rating for mild, but high VAS pain intensity rating for severe pain; and 3 High Rating subgroup (high VAS pain intensity ratings across all the pain severity categories. Overall, differences between pain conditions were small: muscle soreness pain intensity was consistently rated lower than the other pain types across severities. The highest pain ratings varied between joint injury and general pain, depending on severity level. No effects of sex or current experience of pain

  11. 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...

  12. Altering gender role expectations: effects on pain tolerance, pain threshold, and pain ratings.

    Science.gov (United States)

    Robinson, Michael E; Gagnon, Christine M; Riley, Joseph L; Price, Donald D

    2003-06-01

    The literature demonstrating sex differences in pain is sizable. Most explanations for these differences have focused on biologic mechanisms, and only a few studies have examined social learning. The purpose of this study was to examine the contribution of gender-role stereotypes to sex differences in pain. This study used experimental manipulation of gender-role expectations for men and women. One hundred twenty students participated in the cold pressor task. Before the pain task, participants were given 1 of 3 instructional sets: no expectation, 30-second performance expectation, or a 90-second performance expectation. Pain ratings, threshold, and tolerance were recorded. Significant sex differences in the "no expectation" condition for pain tolerance (t = 2.32, df = 38, P gender-specific tolerance expectations, men and women did not differ in their pain tolerance, pain threshold, or pain ratings. This is the first empirical study to show that manipulation of expectations alters sex differences in laboratory pain.

  13. [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.

  14. Comparison of numerical and verbal rating scales to measure pain exacerbations in patients with chronic cancer pain

    National Research Council Canada - National Science Library

    Brunelli, Cinzia; Zecca, Ernesto; Martini, Cinzia; Campa, Tiziana; Fagnoni, Elena; Bagnasco, Michela; Lanata, Luigi; Caraceni, Augusto

    2010-01-01

    Numerical rating scales (NRS), and verbal rating scales (VRS) showed to be reliable and valid tools for subjective cancer pain measurement, but no one of them consistently proved to be superior to the other...

  15. 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

  16. 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.

  17. 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.

  18. Postoperative patients' perspectives on rating pain : A qualitative study

    NARCIS (Netherlands)

    van Dijk, J.F.M.; Vervoort, Sigrid; van Wijck, Albert J.M.; Kalkman, CJ; Schuurmans, Marieke

    Background: In postoperative pain treatment patients are asked to rate their pain experience on a single uni-dimensional pain scale. Such pain scores are also used as indicator to assess the quality of pain treatment. However, patients may differ in how they interpret the Numeric Rating Scale (NRS)

  19. Postoperative patients' perspectives on rating pain: A qualitative study

    NARCIS (Netherlands)

    Sigrid C.J.M. Vervoort; Albert J.M. van Wijck; Cor J. Kalkman; Prof. Dr. Marieke J. Schuurmans; Jacqueline F.M. van Dijk

    2016-01-01

    Background: In postoperative pain treatment patients are asked to rate their pain experience on a single uni-dimensional pain scale. Such pain scores are also used as indicator to assess the quality of pain treatment. However, patients may differ in how they interpret the Numeric Rating Scale (NRS)

  20. 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.

  1. 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...

  2. 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.

  3. 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.

  4. 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...

  5. The effects of treadmill type on heart rate and pain threshold velocity in individuals with lower-extremity musculoskeletal pain.

    Science.gov (United States)

    Langford, Brian J; Jones, Evan M; Cowan, James E; Hollingsworth, Danny J; Deyle, Gail D; Douglas, S Christie; Allison, Stephen C

    2003-09-01

    This study utilized a quasi-experimental design in which subjects served as their own controls. To determine whether heart rate, pain threshold velocity, and pain perception varied in patients running on a soft-belt treadmill versus a standard hard-belt treadmill. According to promotional literature, the relatively new Orbiter soft-belt tread produces a greater increase in heart rate at a given velocity as well as a higher velocity tolerance while walking or running. The manufacturer also asserts that decreased forces transmitted through the lower extremity should decrease pain levels while exercising on the soft-belt treadmill. Twenty-seven subjects walked or ran on each of 2 treadmills at incrementally increasing velocities until they experienced either the onset of pain or an increase in pain from baseline levels. Locomotion continued for 2 minutes after that, during which time heart rate and pain level on a visual analog scale (VAS) were recorded. Two univariate paired t tests and a Wilcoxon's signed rank test revealed a greater heart rate and pain threshold velocity when using the soft-belt treadmill with no statistical difference in the pain reported between the 2 treadmills. Our study revealed a 10% higher heart rate and a 14.5% higher pain threshold velocity with the soft-belt treadmill compared to a hard-belt treadmill. These differences are considered clinically meaningful.

  6. 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.

  7. 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

  8. 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.

  9. Comparison of Contraction Rates of Abdominal Muscles of Chronic Low Back Pain Patients in Different Postures

    OpenAIRE

    Cho, Sung-Hak; Kim, Kang Hoon; Baek, Il-Hun; Goo, Bong-Oh

    2013-01-01

    [Purpose] This study examined the contraction rates of abdominal muscles in relation to the posture of chronic lumbar pain patients and normal subjects. [Subjects] The subjects were 17 chronic low back pain (CLBP) patients and 17 normal people between the ages of 20 and 59. [Methods] Experimental postures included a supine position, a sitting position, and a standing position. Measurements were taken at rest and during abdominal contraction. The measurement at rest was taken during expiration...

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

    Science.gov (United States)

    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.

  11. 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.

  12. 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

  13. Rate of injury and subjective benefits of gravitational wellness weightlifting

    Directory of Open Access Journals (Sweden)

    Burke DT

    2014-09-01

    wellness gym found that by lifting large weights over short arcs 30 minutes per week, participants significantly increased their strength, reduced their musculoskeletal pain, improve their subjective well-being, and reported a low rate of injury. Keywords: gravitational wellness system, rate of injuries, weight training, descriptive study

  14. [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.

  15. 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

  16. 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.

  17. Assessment of post-laparotomy pain in laboratory mice by telemetric recording of heart rate and heart rate variability

    Directory of Open Access Journals (Sweden)

    Kasermann Hans P

    2007-08-01

    Full Text Available Abstract Background Pain of mild to moderate grade is difficult to detect in laboratory mice because mice are prey animals that attempt to elude predators or man by hiding signs of weakness, injury or pain. In this study, we investigated the use of telemetry to identify indicators of mild-to-moderate post-laparotomy pain. Results Adult mice were subjected to laparotomy, either combined with pain treatment (carprofen or flunixin, 5 mg/kg s/c bid, for 1 day or without pain relief. Controls received anesthesia and analgesics or vehicle only. Telemetrically measured locomotor activity was undisturbed in all animals, thus confirming that any pain experienced was of the intended mild level. No symptoms of pain were registered in any of the groups by scoring the animals' outer appearance or spontaneous and provoked behavior. In contrast, the group receiving no analgesic treatment after laparotomy demonstrated significant changes in telemetry electrocardiogram recordings: increased heart rate and decreased heart rate variability parameters pointed to sympathetic activation and pain lasting for 24 hours. In addition, core body temperature was elevated. Body weight and food intake were reduced for 3 and 2 days, respectively. Moreover, unstructured cage territory and destroyed nests appeared for 1–2 days in an increased number of animals in this group only. In controls these parameters were not affected. Conclusion In conclusion, real-time telemetric recordings of heart rate and heart rate variability were indicative of mild-to-moderate post-laparotomy pain and could define its duration in our mouse model. This level of pain cannot easily be detected by direct observation.

  18. Assessment of post-laparotomy pain in laboratory mice by telemetric recording of heart rate and heart rate variability

    Science.gov (United States)

    Arras, Margarete; Rettich, Andreas; Cinelli, Paolo; Kasermann, Hans P; Burki, Kurt

    2007-01-01

    Background Pain of mild to moderate grade is difficult to detect in laboratory mice because mice are prey animals that attempt to elude predators or man by hiding signs of weakness, injury or pain. In this study, we investigated the use of telemetry to identify indicators of mild-to-moderate post-laparotomy pain. Results Adult mice were subjected to laparotomy, either combined with pain treatment (carprofen or flunixin, 5 mg/kg s/c bid, for 1 day) or without pain relief. Controls received anesthesia and analgesics or vehicle only. Telemetrically measured locomotor activity was undisturbed in all animals, thus confirming that any pain experienced was of the intended mild level. No symptoms of pain were registered in any of the groups by scoring the animals' outer appearance or spontaneous and provoked behavior. In contrast, the group receiving no analgesic treatment after laparotomy demonstrated significant changes in telemetry electrocardiogram recordings: increased heart rate and decreased heart rate variability parameters pointed to sympathetic activation and pain lasting for 24 hours. In addition, core body temperature was elevated. Body weight and food intake were reduced for 3 and 2 days, respectively. Moreover, unstructured cage territory and destroyed nests appeared for 1–2 days in an increased number of animals in this group only. In controls these parameters were not affected. Conclusion In conclusion, real-time telemetric recordings of heart rate and heart rate variability were indicative of mild-to-moderate post-laparotomy pain and could define its duration in our mouse model. This level of pain cannot easily be detected by direct observation. PMID:17683523

  19. Influence of Catastrophizing and Personality Traits on Recalled Ratings of Acute Pain Experience in Healthy Young Adults.

    Science.gov (United States)

    Pallegama, Ranjith Wasantha; Ariyasinghe, Sajjiv; Perera, Eranthi Dinoka; Treede, Rolf-Detlef

    2017-01-01

    To investigate whether pain catastrophizing and personality traits bias recalled ratings of acute pain in an experimental tonic pain model. Fifty-six undergraduates (14 males) recruited from the University of Peradeniya (mean age 21.7 ± 0.8 SD years). Participants completed the Pain Catastrophizing Scale and the Eysenck Personality Questionnaire. They were subjected to two cold pressor tests (dominant and non-dominant hands) and pain threshold, maximum pain intensity, and pain tolerance were recorded. One-week later, the maximum pain intensities of both hands were recalled and percentage distortions in recalling were calculated. Based on a 180 s cutoff, two participants were considered pain-insensitive during the test and were excluded from the analysis. The maximum pain intensity was recalled with a moderate accuracy (Intraclass Correlation Coefficients = 0.68 for dominant and 0.59 for non-dominant hands). Hierarchical multiple regression analyses revealed that maximum pain intensity ( P  memory for painful events in healthy subjects was reasonably accurate over a period of 1 week. Pain catastrophizing biased pain recall, whereas among personality traits only neuroticism exhibited a weak positive association with the recalled ratings.

  20. 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.

  1. Reduced knee flexion is a possible cause of increased loading rates in individuals with patellofemoral pain.

    Science.gov (United States)

    Silva, Danilo de Oliveira; Briani, Ronaldo Valdir; Pazzinatto, Marcella Ferraz; Ferrari, Deisi; Aragão, Fernando Amâncio; Azevedo, Fábio Mícolis de

    2015-11-01

    Stair ascent is an activity that exacerbates symptoms of individuals with patellofemoral pain. The discomfort associated with this activity usually results in gait modification such as reduced knee flexion in an attempt to reduce pain. Although such compensatory strategy is a logical approach to decrease pain, it also reduces the normal active shock absorption increasing loading rates and may lead to deleterious and degenerative changes of the knee joint. Thus, the aims of this study were (i) to investigate whether there is reduced knee flexion in adults with PFP compared to healthy controls; and (ii) to analyze loading rates in these subjects, during stair climbing. Twenty-nine individuals with patellofemoral pain and twenty-five control individuals (18-30 years) participated in this study. Each subject underwent three-dimensional kinematic and kinetic analyses during stair climbing on two separate days. Between-groups analyses of variance were performed to identify differences in peak knee flexion and loading rates. Intraclass correlation coefficient was performed to verify the reliability of the variables. On both days, the patellofemoral pain group demonstrated significantly reduced peak knee flexion and increased loading rates. In addition, the two variables obtained high to very high reliability. Reduced knee flexion during stair climbing as a strategy to avoid anterior knee pain does not seem to be healthy for lower limb mechanical distributions. Repeated loading at higher loading rates may be damaging to lower limb joints. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. 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.

  3. 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.

  4. 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

  5. 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.

  6. Newborn infant pain assessment using heart rate variability analysis.

    Science.gov (United States)

    Faye, Papa M; De Jonckheere, Julien; Logier, Regis; Kuissi, Eliane; Jeanne, Mathieu; Rakza, Thameur; Storme, Laurent

    2010-01-01

    Systems controlling cardiovascular function are closely coupled with the perception of pain. Heart rate variability (HRV) is a well-established noninvasive measure of cardiac autonomic control. We hypothesized that pain may alter HRV in the newborn infant and that HRV analysis could be used as an indicator of prolonged pain in the newborn infant. To test the hypothesis, we measured the magnitude of the heart rate high-frequency variations using an innovative High Frequency Variability Index (HFVI) in newborn infants at risk of postoperative pain. We investigated newborn infants with a gestational age (GA) more than 34 weeks, and who were admitted after a major surgical procedure. Inclusions ranged from 2 to 72 hours after the surgery. The postoperative pain was scored using EDIN scale (neonatal pain and discomfort scale) at the end of the 2 hours recording period. The infants were separated in: (1) Group "Low EDIN," when EDIN=5. Predictive positive and negative values of a threshold value of HFVI in assessing pain have been studied. Twenty-eight newborn infants were enrolled in the study (mean GA=37.8+/-1.5 wk) at a median delay between the surgery and the recording of 5 hours. Mean EDIN were 2+/-1 and 7+/-2 in respectively the groups "Low EDIN" and "High EDIN." The 2 groups were similar for GA, basal heart and respiratory rates, SpO2, mean arterial blood pressure, and morphine infusion rate. HFVI was significantly lower in the group "High EDIN" than in the group "Low EDIN" (0.7+/-0.2 vs. 1.2+/-0.3, respectively; P=5, with a sensitivity of 90%, and a specificity of 75%. The results of this study indicate that postoperative pain is associated with a decreased high-frequency HRV in full-term newborn infants. Our findings suggest that HRV could be used as an indicator to assess prolonged pain in the newborn infants.

  7. The influence of negative mood on heart rate complexity measures and baroreflex sensitivity in healthy subjects.

    Science.gov (United States)

    Köbele, Ralf; Koschke, Mandy; Schulz, Steffen; Wagner, Gerd; Yeragani, Shravya; Ramachandraiah, Chaitra T; Voss, Andreas; Yeragani, Vikram K; Bär, Karl-Jürgen

    2010-01-01

    Decreased cardiac vagal function is linked with increased cardiac mortality and depression is associated with decreased heart rate variability. We have previously shown that the Mood Induction Procedure (MIP) in healthy subjects alters pain perception and thalamic activity during pain perception. To study the effect of negative emotion on heart rate variability and complexity measures as well as on baroreceptor sensitivity, as these parameters reflect cardiac autonomic function. We studied 20 healthy female controls before and after neutral MIP and 20 healthy female subjects before and after negative MIP. We investigated measures of valence of mood, heart rate variability and complexity and the baroreceptor sensitivity index. While there was a significant difference in the valence of mood between the neutral and the negative effect condition, there were no significant differences in any of the heart rate or baroreceptor sensitivity measures between the two groups. Our findings did not show any significant influence of acute negative MIP on heart rate variability and complexity measures and baroreceptor sensitivity, even though depressive disorder and stress are associated with decreased heart rate variability. These findings are discussed in the context of clinical depression and anxiety and the increased risk for cardiac mortality. In contrast to the presented results here, we have previously shown that MIP in healthy subjects alters pain perception and thalamic activity.

  8. 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.

  9. 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...

  10. 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.

  11. The Roles of Ethnicity, Sex, and Parental Pain Modeling in Rating of Experienced and Imagined Pain Events

    Science.gov (United States)

    Boissoneault, Jeff; Bunch, Jennifer R.; Robinson, Michael

    2015-01-01

    To investigate the association of ethnicity, sex, and parental pain modeling on the evaluation of experienced and imagined painful events, 173 healthy volunteers (96 women) completed the Prior Pain Experience Questionnaire, a 79-question assessment of the intensity of painful events, and a questionnaire regarding exposure to parental pain models. Consistent with existing literature, greater ratings of experienced pain were noted among Black vs. White participants. Parental pain modeling was associated with higher imagined pain ratings, but only when the parent matched the participant’s sex. This effect was greater among White and Asian participants than Black or Hispanic participants, implying ethno-cultural effects may moderate the influence of pain modeling on the evaluation of imagined pain events. The clinical implications of these findings, as well as the predictive ability of imagined pain ratings for determining future experiences of pain, should be investigated in future studies. PMID:26085306

  12. The psychometric properties of an Arabic numeric pain rating scale for measuring osteoarthritis knee pain.

    Science.gov (United States)

    Alghadir, Ahmad H; Anwer, Shahnawaz; Iqbal, Zaheen Ahmed

    2016-12-01

    The aims of this study were to translate the numeric rating scale (NRS) into Arabic and to evaluate the test-retest reliability and convergent validity of an Arabic Numeric Pain Rating Scale (ANPRS) for measuring pain in osteoarthritis (OA) of the knee. The English version of the NRS was translated into Arabic as per the translation process guidelines for patient-rated outcome scales. One hundred twenty-one consecutive patients with OA of the knee who had experienced pain for more than 6 months were asked to report their pain levels on the ANPRS, visual analogue scale (VAS), and verbal rating scale (VRS). A second assessment was performed 48 h after the first to assess test-retest reliability. The test-retest reliability was calculated using the intraclass correlation coefficient (ICC2,1). The convergent validity was assessed using Spearman rank correlation coefficient. In addition, the minimum detectable change (MDC) and standard error of measurement (SEM) were also assessed. The repeatability of ANPRS was good to excellent (ICC 0.89). The SEM and MDC were 0.71 and 1.96, respectively. Significant correlations were found with the VAS and VRS scores (p Arabic numeric pain rating scale is a valid and reliable scale for measuring pain levels in OA of the knee. Implications for Rehabilitation The Arabic Numeric Pain Rating Scale (ANPRS) is a reliable and valid instrument for measuring pain in osteoarthritis (OA) of the knee, with psychometric properties in agreement with other widely used scales. The ANPRS is well correlated with the VAS and NRS scores in patients with OA of the knee. The ANPRS appears to measure pain intensity similar to the VAS, NRS, and VRS and may provide additional advantages to Arab populations, as Arabic numbers are easily understood by this population.

  13. 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.

  14. 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.

  15. 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 ...

  16. 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.

  17. 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...

  18. 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.

  19. [Analysing heart rate variability to improve the monitoring of pain].

    Science.gov (United States)

    Butruille, Laura; De Jonckheere, Julien; Jeanne, Mathieu; Tavernier, Benoît; Logier, Régis

    2016-12-01

    An innovative technique based on the analysis of instantaneous heart rate variability helps to improve the prevention and management of pain and discomfort. Simple to implement, this non-invasive technique is based on the continuous recording of the electrocardiograph signal. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  20. 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.

  1. 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.

  2. Comparison of contraction rates of abdominal muscles of chronic low back pain patients in different postures.

    Science.gov (United States)

    Cho, Sung-Hak; Kim, Kang Hoon; Baek, Il-Hun; Goo, Bong-Oh

    2013-08-01

    [Purpose] This study examined the contraction rates of abdominal muscles in relation to the posture of chronic lumbar pain patients and normal subjects. [Subjects] The subjects were 17 chronic low back pain (CLBP) patients and 17 normal people between the ages of 20 and 59. [Methods] Experimental postures included a supine position, a sitting position, and a standing position. Measurements were taken at rest and during abdominal contraction. The measurement at rest was taken during expiration with comfortable breathing, and the measurement during contraction was taken at maximum expiration of forced expiration. Muscle contraction rates (on contraction and at relaxation) were calculated. [Results] There were significant differences between CLBP patients and normal subjects in the transversus abdominis (TrA) in the standing position. [Conclusion] Changes in contraction rates of the abdominal muscles of normal subjects and CLBP patients were examined in different postures at maximum expiration. It was found that the contraction rate of TrA in CLBP patients in a standing position, is significantly lower than that of normal subjects.

  3. 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

  4. Reliability and concurrent validity of visual analogue scale and modified verbal rating scale of pain assessment in adult patients with knee osteoathritis in Nigeria

    OpenAIRE

    M. O.B Olaogun; R. A. Adedoyin; R. O. Anifaloba

    2003-01-01

    The objective of this study was to determine the reliability and concurrent validity of two pain rating scales - Visual Analogue Scale (VAS) and Verbal Rating Scale (VRS). The verbal rating scale was modified by translating the English description of subjective pain experience into vernacular (Yoruba) equivalents and rating the knee pain when the patient was  standing with the knee  flexed . Twenty seven patients who were clinically and radiologically diagnosed with osteoarthritis (OA) and wi...

  5. 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.

  6. Neutrophil Ingestion Rate Of Nitroblue Tetrazolium In Subjects With ...

    African Journals Online (AJOL)

    Objectives: This study was designed to assess the WBC count, absolute neutrophil count, CD4 +T cell count and neutrophil ingestion rate of nitroblue tetrazolium in subjects with Malaria and HIV Co-morbidity. Method and materials: 134 participants were recruited and group as follow: Symptomatic HIV infected participants ...

  7. Prediction of subjective ratings of emotional pictures by EEG features

    Science.gov (United States)

    McFarland, Dennis J.; Parvaz, Muhammad A.; Sarnacki, William A.; Goldstein, Rita Z.; Wolpaw, Jonathan R.

    2017-02-01

    Objective. Emotion dysregulation is an important aspect of many psychiatric disorders. Brain-computer interface (BCI) technology could be a powerful new approach to facilitating therapeutic self-regulation of emotions. One possible BCI method would be to provide stimulus-specific feedback based on subject-specific electroencephalographic (EEG) responses to emotion-eliciting stimuli. Approach. To assess the feasibility of this approach, we studied the relationships between emotional valence/arousal and three EEG features: amplitude of alpha activity over frontal cortex; amplitude of theta activity over frontal midline cortex; and the late positive potential over central and posterior mid-line areas. For each feature, we evaluated its ability to predict emotional valence/arousal on both an individual and a group basis. Twenty healthy participants (9 men, 11 women; ages 22-68) rated each of 192 pictures from the IAPS collection in terms of valence and arousal twice (96 pictures on each of 4 d over 2 weeks). EEG was collected simultaneously and used to develop models based on canonical correlation to predict subject-specific single-trial ratings. Separate models were evaluated for the three EEG features: frontal alpha activity; frontal midline theta; and the late positive potential. In each case, these features were used to simultaneously predict both the normed ratings and the subject-specific ratings. Main results. Models using each of the three EEG features with data from individual subjects were generally successful at predicting subjective ratings on training data, but generalization to test data was less successful. Sparse models performed better than models without regularization. Significance. The results suggest that the frontal midline theta is a better candidate than frontal alpha activity or the late positive potential for use in a BCI-based paradigm designed to modify emotional reactions.

  8. Heart rate variability modulation after manipulation in pain-free patients vs patients in pain.

    Science.gov (United States)

    Roy, Richard A; Boucher, Jean P; Comtois, Alain S

    2009-05-01

    The purpose of this study was to examine heart rate variability (HRV) in the presence or the absence of pain in the lower back, while receiving one chiropractic treatment at L5 from either a manually assisted mechanical force (Activator) or a traditional diversified technique spinal manipulation. A total of 51 participants were randomly assigned to a control (n = 11), 2 treatment, or 2 sham groups (n = 10 per group). Participants underwent an 8-minute acclimatizing period. The HRV tachygram (RR interval) data were recorded directly into a Suunto watch (model T6; FitzWright Company Ltd, Langley, British Columbia, Canada). We analyzed the 5-minute pretreatment and posttreatment intervals. The spectral analysis of the tachygram was performed with Kubios software. All groups decreased in value except the control group that reacted in the opposite direction, when comparing the pretests and posttests for the high-frequency component. The very low frequency increased in all groups except the control group. The low frequency decreased in all groups except the sham pain-free group. The low frequency-high frequency ratio decreased in the treatment pain group by 0.46 and in the sham pain-free group by 0.26. The low frequency-high frequency ratio increase was 0.13 for the sham pain group, 0.04 for the control group, and 0.34 for the treatment pain-free group. The mean RR increased by 11.89 milliseconds in the sham pain-free group, 18.65 milliseconds in the treatment pain group, and 13.14 milliseconds in the control group. The mean RR decreased in the treatment pain-free group by 1.75 milliseconds and by 0.01 milliseconds in the sham pain group. Adjusting the lumbar vertebrae affected the lumbar parasympathetic nervous system output for this group of participants. Adaptation in the parasympathetic output, reflected by changes in high frequency, low frequency, and very low frequency, may be independent of type of adjustment. Therefore, the group differences found in the

  9. Does Ramadan fasting affect expiratory flow rates in healthy subjects?

    Science.gov (United States)

    Subhan, Mirza M F; Siddiqui, Qamar A; Khan, Mohammed N; Sabir, Salman

    2006-11-01

    To assess whether Ramadan fasting affects the expiratory flow rates in healthy subjects, and to know if these effects correlate to a change in other variables. This unmatched case-control longitudinal study includes 46 non-smoking healthy subjects who undertook lung function testing at the Aga Khan University, Pakistan. Expiratory flow rates and body mass were measured in 3 Islamic months, corresponding to November 2001 to January 2002. There was a significant reduction in body mass in Ramadan compared to pre and post Ramadan. No significant changes in expiratory flows were seen during Ramadan as compared to the pre Ramadan period. However, forced expiratory flow rates at 75% of vital capacity (FEF(75)) and between 75% and 85% of vital capacity (FEF(75-85)) showed a significant increase in the post Ramadan period compared to Ramadan. Changes in FEF(75) were negatively correlated to changes in body mass between Ramadan and post Ramadan. This study shows that Ramadan fasting will not affect expiratory flow rates in healthy subjects. Post Ramadan values did show an increase in FEF(75) and FEF(75-85), possibly due to changes in body water and fat content. The reductions in body mass were most probably due to lack of nutrition and not dehydration as the fasts were performed in winter. Collection of reference values or early phase clinical trials measuring expiratory flow rates should not be affected by Ramadan fasting.

  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. 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.

  12. 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.

  13. 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®

  14. 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.

  15. Effects of Posteroanterior Thoracic Mobilization on Heart Rate Variability and Pain in Women with Fibromyalgia

    Directory of Open Access Journals (Sweden)

    Michel Silva Reis

    2014-01-01

    Full Text Available Fibromyalgia (FM has been associated with cardiac autonomic abnormalities and pain. Heart rate variability (HRV is reduced in FM with autonomic tone dominated by sympathetic activity. The purpose of this study was to evaluate the effects of one session of a posteroanterior glide technique on both autonomic modulation and pain in woman with FM. This was a controlled trial with immediate followup; twenty premenopausal women were allocated into 2 groups: (i women diagnosed with FM (n=10 and (ii healthy women (n=10. Both groups received one session of Maitland mobilization grade III posteroanterior central pressure glide, at 2 Hz for 60 s at each vertebral segment. Autonomic modulation was assessed by HRV and pain by a numeric pain scale before and after the intervention. For HRV analyses, heart rate and RR intervals were recorded for 10 minutes. FM subjects demonstrated reduced HRV compared to controls. Although the mobilization technique did not significantly reduce pain, it was able to improve HRV quantified by an increase in rMSSD and SD1 indices, reflecting an improved autonomic profile through increased vagal activity. In conclusion, women with FM presented with impaired cardiac autonomic modulation. One session of Maitland spine mobilization was able to acutely improve HRV.

  16. 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.

  17. 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.

  18. 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.

  19. The Verbal Rating Scale Is Reliable for Assessment of Postoperative Pain in Hip Fracture Patients

    DEFF Research Database (Denmark)

    Bech, R. D.; Lauritsen, J.; Ovesen, O.

    2015-01-01

    Background. Hip fracture patients represent a challenge to pain rating due to the high prevalence of cognitive impairment. Methods. Patients prospectively rated pain on the VRS. Furthermore, patients described the changes in pain after raising their leg, with one of five descriptors. Agreement....... The VRS is reliable for assessment of pain after hip fracture. The validity of intermittent questioning about possible change in pain intensity is poor....

  20. Pain-related psychological distress, self-rated health and significance of neuropathic pain in Danish soldiers injured in Afghanistan

    DEFF Research Database (Denmark)

    Duffy, J R; Warburg, Finn; Koelle, S-F T

    2015-01-01

    BACKGROUND: Pain and mental health concerns are prevalent among veterans. While the majority of research has focused on chronic pain as an entity, there has been little work directed towards investigating the role of neuropathic pain in relation to psychological comorbidity. As such, we...... hypothesised that participants with signs of neuropathic pain would report higher levels of psychological distress and diminished self-rated health compared to those without a neuropathic component. METHODS: A retrospective review of standardised questionnaires (PainDETECT Questionnaire, Post-traumatic Stress...... Disorder Checklist-Civilian, the Hospital Anxiety and Depression Scale, and EuroQOL Visual Analogue Scale) administered to injured soldiers. The participants were classified into three groups according to the PainDETECT questionnaire: non-neuropathic pain, possible neuropathic pain and definite neuropathic...

  1. 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.

  2. 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.

  3. Incontinence rates after midurethral sling revision for vaginal exposure or pain.

    Science.gov (United States)

    Jambusaria, Lisa H; Heft, Jessica; Reynolds, W Stuart; Dmochowski, Roger; Biller, Daniel H

    2016-12-01

    Midurethral slings have become the preferred surgical treatment for stress urinary incontinence. Midline transection of midurethral sling for dysfunctional voiding is an effective treatment and also has a low rate of recurrent stress incontinence. Recurrent stress incontinence after sling revision for pain and mesh exposure has not been well defined. It is therefore difficult to counsel patients on risk of recurrent stress incontinence when sling revision is performed for pain or mesh exposure. We examined the rate of postoperative stress incontinence after midurethral sling revision for the indication of mesh exposure or pain, as well as postoperative pain and urinary urgency. This is a retrospective cohort of 245 patients undergoing a vaginal midurethral sling revision in a 10-year period for the indication of mesh exposure or pain. Preoperative indication for revision, baseline characteristics, and preoperative reports of stress incontinence, pain, and urgency were collected. The type of sling revision was then categorized into partial or complete removal. A partial removal of the sling was defined as removing only the portion of sling exposed or causing pain. A complete removal of the sling was defined as vaginal removal of sling laterally out to the pubic rami. Subjective reports of stress incontinence, pain, and urgency at short-term (16 weeks) and long-term (>16 weeks) follow-up visits were gathered. The primary outcome of the study was recurrent stress incontinence. In our cohort of 245 women who underwent midurethral sling revision, 94 patients had removal for mesh exposure (36 partial and 58 complete) and 151 had removal for pain (25 partial and 126 complete). All patients had a short-term follow-up with a mean time of 5.9 ± 2.8 weeks and 69% patients had long-term follow-up with a mean time of 29.1 ± 17.7 weeks. No differences were seen in preoperative reports of stress incontinence, urgency, or pain in either group. In the patients with revision for

  4. 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...

  5. Pre-surgical child behavior ratings and pain management after two different techniques of tonsil surgery.

    Science.gov (United States)

    Ericsson, Elisabeth; Wadsby, Marie; Hultcrantz, Elisabeth

    2006-10-01

    The purpose of this investigation was to compare child behavior before surgery with experience of pain and anxiety in relation to two techniques of tonsil surgery, to relate previous experiences of surgery/tonsillitis with anxiety and pain, and to compare the children's, parent's and nurse's rating of pain. Ninety-two children (5-15 years) with sleep-disordered breathing (SDB) and with or without recurrent tonsillitis were randomized to partial tonsil resection/tonsillotomy (TT) or full tonsillectomy (TE). Parents: Child Behavior Checklist (CBCL). Children: State-Trait-Anxiety Inventory for Children (STAIC) and seven-point Faces Pain Scale (FPS). Parents/staff: seven-point Verbal Pain Rating Scale (VPRS). Pain relievers were opoids, paracetamol and diclophenac. These children with SDB scored significantly higher on CBCL than did normative groups, but no connection was observed between CBCL rating and experience of pain. There was no relation between pre-operative anxiety and pain. The post-operative anxiety level (STAIC) correlated with pain. The TE-group scored higher on STAIC after surgery. Previous experience of surgery or tonsillitis did not influence post-operative pain. The TE-group rated higher experience of pain despite more medication. The nurses scored pain lower than the parents/children and under-medicated. SDB may influence children's behavior, but with no relation to post-operative pain. The surgical method predicts pain better than does the child's behavior rating. The nurses underestimated the pain experienced by the child.

  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. 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.

  8. 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

  9. Partners' empathy increases pain ratings: effects of perceived empathy and attachment style on pain report and display.

    Science.gov (United States)

    Hurter, Sarah; Paloyelis, Yannis; Williams, Amanda C de C; Fotopoulou, Aikaterini

    2014-09-01

    Pain can be influenced by its social context. We aimed to examine under controlled experimental conditions how empathy from a partner and personal attachment style affect pain report, tolerance, and facial expressions of pain. Fifty-four participants, divided into secure, anxious, and avoidant attachment style groups, underwent a cold pressor task with their partners present. We manipulated how much empathy the participants perceived that their partners had for them. We observed a significant main effect of perceived empathy on pain report, with greater pain reported in the high perceived empathy condition. No such effects were found for pain tolerance or facial display. We also found a significant interaction of empathy with attachment style group, with the avoidant group reporting and displaying less pain than the secure and the anxious groups in the high perceived empathy condition. No such findings were observed in the low empathy condition. These results suggest that empathy from one's partner may influence pain report beyond behavioral reactions. In addition, the amount of pain report and expression that people show in high empathy conditions depends on their attachment style. Believing that one's partner feels high empathy for one's pain may lead individuals to rate the intensity of pain as higher. Individual differences in attachment style moderate this empathy effect. Copyright © 2014 American Pain Society. Published by Elsevier Inc. All rights reserved.

  10. A comparative study of pulse rate variability and heart rate variability in healthy subjects.

    Science.gov (United States)

    Wong, Jih-Sen; Lu, Wan-An; Wu, Kung-Tai; Liu, Margaret; Chen, Gau-Yang; Kuo, Cheng-Deng

    2012-04-01

    Both heart rate variability (HRV) and pulse rate variability (PRV) are noninvasive means for the assessment of autonomic nervous control of the heart. However, it is not settled whether or not the PRV obtained from either hand can be the surrogate of HRV. The HRV measures obtained from electrocardiographic signals and the PRV measures obtained from the pulse waves recorded from the index fingers of both hands were compared in normal subjects by using linear regression analysis and Bland and Altman method. Highly significant correlations (P heart rate and ultra-low frequency power (ULFP). The PRV of either hand is close to, but not the same as the HRV in healthy subjects. The HRV, right PRV and left PRV are not surrogates of one another in normal subjects except heart rate and ULFP. Since HRV is generally accepted as the standard method for the assessment of the autonomic nervous modulation of a subject, the PRV of either hand may not be suitable for the assessment of the cardiac autonomic nervous modulation of the subject.

  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. Individual differences in the cardiovascular responses to tonic muscle pain: parallel increases or decreases in muscle sympathetic nerve activity, blood pressure and heart rate.

    Science.gov (United States)

    Fazalbhoy, Azharuddin; Birznieks, Ingvars; Macefield, Vaughan G

    2012-10-01

    We recently showed that acute muscle pain, induced by bolus intramuscular injection of hypertonic saline, causes a sustained increase in muscle sympathetic nerve activity (MSNA) and a modest increase in blood pressure and heart rate. However, it is not known whether long-lasting (tonic) pain, which more closely resembles chronic pain, causes a sustained increase in MSNA and blood pressure. We tested this hypothesis by recording MSNA in 12 healthy subjects. Tonic pain was induced for ~60 min by slow intramuscular infusion of hypertonic saline (7%) into the ipsilateral tibialis anterior muscle. Pain was sustained at a tolerable level (5/10 to 6/10 on a visual analog scale). Seven subjects showed progressive increases in mean MSNA amplitude during tonic pain, increasing to 154 ± 17% (SEM) at 45 min and remaining essentially constant for the duration of the infusion. In these subjects, blood pressure and heart rate also increased. Conversely, for the other five subjects MSNA showed a progressive decline, with a peak fall of 67 ± 11% at 40 min; blood pressure and heart rate also fell in these subjects. We conclude that tonic muscle pain has long-lasting effects on the sympathetic control of blood pressure, causing a sustained increase in some subjects yet a sustained decrease in others. This may have implications for individual differences in the cardiovascular consequences of chronic pain.

  13. The Verbal Rating Scale Is Reliable for Assessment of Postoperative Pain in Hip Fracture Patients

    DEFF Research Database (Denmark)

    Bech, R. D.; Lauritsen, J.; Ovesen, O.

    2015-01-01

    Background. Hip fracture patients represent a challenge to pain rating due to the high prevalence of cognitive impairment. Methods. Patients prospectively rated pain on the VRS. Furthermore, patients described the changes in pain after raising their leg, with one of five descriptors. Agreement be...

  14. 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...

  15. 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...

  16. Partners' Empathy Increases Pain Ratings: Effects of Perceived Empathy and Attachment Style on Pain Report and Display

    Science.gov (United States)

    Hurter, Sarah; Paloyelis, Yannis; de C. Williams, Amanda C.; Fotopoulou, Aikaterini

    2014-01-01

    Pain can be influenced by its social context. We aimed to examine under controlled experimental conditions how empathy from a partner and personal attachment style affect pain report, tolerance, and facial expressions of pain. Fifty-four participants, divided into secure, anxious, and avoidant attachment style groups, underwent a cold pressor task with their partners present. We manipulated how much empathy the participants perceived that their partners had for them. We observed a significant main effect of perceived empathy on pain report, with greater pain reported in the high perceived empathy condition. No such effects were found for pain tolerance or facial display. We also found a significant interaction of empathy with attachment style group, with the avoidant group reporting and displaying less pain than the secure and the anxious groups in the high perceived empathy condition. No such findings were observed in the low empathy condition. These results suggest that empathy from one's partner may influence pain report beyond behavioral reactions. In addition, the amount of pain report and expression that people show in high empathy conditions depends on their attachment style. Perspective Believing that one's partner feels high empathy for one's pain may lead individuals to rate the intensity of pain as higher. Individual differences in attachment style moderate this empathy effect. PMID:24953886

  17. 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.

  18. Sternal Pulse Rate Variability Compared with Heart Rate Variability on Healthy Subjects

    DEFF Research Database (Denmark)

    Chreiteh, Shadi; Belhage, Bo; Hoppe, Karsten

    2014-01-01

    The heart rate variability (HRV) is a commonly used method to quantify the sympathetic and the parasympathetic modulation of the heart rate. HRV is mainly conducted on electrocardiograms (ECG). However, the use of photoplethysmography (PPG) as a marker of the autonomic tone is emerging....... In this study we investigated the feasibility of deriving pulse rate variability (PRV) using PPG signals recorded by a reflectance PPG sensor attached to the chest bone (sternum) and comparing it to HRV. The recordings were conducted on 9 healthy subjects being in a relaxed supine position and under forced...... the parameters (r > 0:95 with p using sternal PPG can be an alternative to HRV analysis on healthy subjects at rest....

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. Sternal pulse rate variability compared with heart rate variability on healthy subjects.

    Science.gov (United States)

    Chreiteh, Shadi S; Belhage, Bo; Hoppe, Karsten; Branebjerg, Jens; Thomsen, Erik V

    2014-01-01

    The heart rate variability (HRV) is a commonly used method to quantify the sympathetic and the parasympathetic modulation of the heart rate. HRV is mainly conducted on electrocardiograms (ECG). However, the use of photo-plethysmography (PPG) as a marker of the autonomic tone is emerging. In this study we investigated the feasibility of deriving pulse rate variability (PRV) using PPG signals recorded by a reflectance PPG sensor attached to the chest bone (sternum) and comparing it to HRV. The recordings were conducted on 9 healthy subjects being in a relaxed supine position and under forced respiration, where the subjects were asked to breathe following a visual scale with a rate of 27 breaths/min. HRV parameters such as the mean intervals (meanNN), the standard deviation of intervals (SDNN), the root mean square of difference of successive intervals (RMSSD), and the proportion of intervals differing more than 50 ms (pNN50) were calculated from the R peak-to-R peak (R-R) and pulse-to-pulse (P-P) intervals. In the frequency domain the low and high frequency ratio of the power spectral density (LF/HF) was also computed. The Pearson correlation coefficient showed significant correlation for all the parameters (r > 0.95 with p healthy subjects at.

  4. 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...

  5. 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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

  8. The use of subjective rating of exertion in Ergonomics.

    Science.gov (United States)

    Capodaglio, P

    2002-01-01

    In Ergonomics, the use of psychophysical methods for subjectively evaluating work tasks and determining acceptable loads has become more common. Daily activities at the work site are studied not only with physiological methods but also with perceptual estimation and production methods. The psychophysical methods are of special interest in field studies of short-term work tasks for which valid physiological measurements are difficult to obtain. The perceived exertion, difficulty and fatigue that a person experiences in a certain work situation is an important sign of a real or objective load. Measurement of the physical load with physiological parameters is not sufficient since it does not take into consideration the particular difficulty of the performance or the capacity of the individual. It is often difficult from technical and biomechanical analyses to understand the seriousness of a difficulty that a person experiences. Physiological determinations give important information, but they may be insufficient due to the technical problems in obtaining relevant but simple measurements for short-term activities or activities involving special movement patterns. Perceptual estimations using Borg's scales give important information because the severity of a task's difficulty depends on the individual doing the work. Observation is the most simple and used means to assess job demands. Other evaluations integrating observation are the followings: indirect estimation of energy expenditure based on prediction equations or direct measurement of oxygen consumption; measurements of forces, angles and biomechanical parameters; measurements of physiological and neurophysiological parameters during tasks. It is recommended that determinations of performances of occupational activities assess rating of perceived exertion and integrate these measurements of intensity levels with those of activity's type, duration and frequency. A better estimate of the degree of physical activity

  9. 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.

  10. 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

  11. 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.

  12. The relationship between medical comorbidity and self-rated pain, mood disturbance, and function in older people with chronic pain.

    Science.gov (United States)

    Leong, Ian Y; Farrell, Michael J; Helme, Robert D; Gibson, Stephen J

    2007-05-01

    Aging is associated with greater risk for many illnesses and the prospect of multiple, concurrent disease states. Chronic pain is also very common in advanced age, and there is likely to be a relationship with comorbid burden, but few studies have examined this issue. This study tests the hypothesis that comorbid burden is associated with greater levels of self-reported pain and associated disturbance in mood and function. Psychometric and medical data were collected from 562 patients (mean age = 76.3 years) attending a geriatric pain clinic. The number of categories endorsed on the Cumulative Illness Rating Scale (CIRS) score was used to measure accumulated comorbid burden. These groups were tested for differences in the severity of self-reported pain. The predictive capacity of comorbid burden for explaining variance in mood disturbance and functional disability was assessed after controlling for any differences in age and severity of pain. Over 50% of the sample had three or more comorbid problems. Groups with greater levels of comorbidity scored higher on the Present Pain Intensity Index, the sensory and affective subscales of the McGill Pain Questionnaire. Multiple regression analysis showed that the CIRS score explained a significant proportion of the variance in scores on the Geriatric Depression Scale (4.1%), Human Activities Profile (4.8%), and the physical domain of the Sickness Impact Profile (5.9%). Greater levels of comorbidity are associated with reports of more severe pain, more depressive symptoms, reduced activity levels, and higher physical impact from pain.

  13. 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.

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

    Directory of Open Access Journals (Sweden)

    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. 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.

  16. 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.

  17. Identifying a long-term/chronic, non-cancer pain population using a one-dimensional verbal pain rating scale

    DEFF Research Database (Denmark)

    Jensen, Marianne Kjettrup; Sjøgren, Per; Ekholm, Ola

    2004-01-01

    the respondents were categorized into three groups: a high pain group (HPG) consisting of persons reporting moderate to severe pain (VRS 4-6), a low pain group (LPG) who rated their pain as very mild or mild (VRS 2-3), and a control group (CG) with no pain (VRS 1). The investigated sample comprised 3992 persons...... (HPG=563 persons, LPG=1714, and CG=1715 persons). Older age, educational level (... observed between the LPG and CG. The proportion of respondents with good perceived health was significantly lower in the HPG compared with LPG and CG. The dominant complaints in the HPG were related to the musculoskeletal system. During a 14-day period prior to the interview persons in the HPG had a mean...

  18. 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.

  19. 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.

  20. 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.

  1. Strength training improves fatigue resistance and self-rated health in workers with chronic pain

    DEFF Research Database (Denmark)

    Sundstrup, Emil; Jakobsen, Markus Due; Brandt, Mikkel

    2016-01-01

    of a randomized controlled trial investigates the effect of strength training on muscular fatigue resistance and self-rated health among workers with chronic pain. Sixty-six slaughterhouse workers with chronic upper limb pain and work disability were randomly allocated to 10 weeks of strength training or usual......-rated health and pain. Time to fatigue, muscle strength, hand/wrist pain, and self-rated health improved significantly more following strength training than usual care (all P strength training and this change was correlated to the reduction in fear avoidance...... (Spearman's rho = -0.40; P = 0.01). In conclusion, specific strength training improves muscular fatigue resistance and self-rated health and reduces pain of the hand/wrist in manual workers with chronic upper limb pain. This trial is registered with ClinicalTrials.gov NCT01671267....

  2. 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

  3. 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.

  4. [Lifting capacity with low back pain : Discrepancy between self-rated and real lifting capacity in patients with back pain and pain-free controls].

    Science.gov (United States)

    Pfingsten, M; Wendt, A; Kröner-Herwig, B; Lüder, S; Hildebrandt, J; Petzke, F

    2011-12-01

    The fear-avoidance model implies that in situations with physical demands patients with back pain will overestimate the demand and underestimate their own capacities. A total of 71 patients with back pain and 48 pain-free control subjects carried out a standardized lifting test with a preceding estimation of their lifting capacity. In both groups the self-estimation and real lifting capacity were in concordance for most group members with patients showing less disconcordance than controls. In the control group 35% of the subjects even underestimated their lifting capacity, which was the case in only 14% of the patients. Patients more frequently overestimated their capacity than pain-free controls (14% vs. 2%). Within the patients subgroups could be identified where patients in general either underestimated or overestimated their own capacity. A comparison between the groups demonstrated significant differences in pain intensity, fear avoidance beliefs and effort. As an explanation for these unexpected results it can be hypothesized that in cases of back pain, patients' attention is focused on pain-relevant issues which enables a more realistic estimation of their lifting capacity.

  5. 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

  6. 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

  7. Confidentiality and Professional Affiliation Effects on Subject Ratings of Interviewers.

    Science.gov (United States)

    Drake, David W.; And Others

    The purpose of this research was to study the effects of different statements regarding confidentiality (absolute; limited; nondirective) on subject impressions of interviewers. In addition, the professional affiliation of the interviewer was manipulated (psychologist, minister/pastoral counselor, social worker) to assess potential influence of…

  8. Long-Term Monitoring of Physical Behavior Reveals Different Cardiac Responses to Physical Activity among Subjects with and without Chronic Neck Pain

    Directory of Open Access Journals (Sweden)

    David M. Hallman

    2015-01-01

    Full Text Available Background. We determined the extent to which heart rate variability (HRV responses to daily physical activity differ between subjects with and without chronic neck pain. Method. Twenty-nine subjects (13 women with chronic neck pain and 27 age- and gender-matched healthy controls participated. Physical activity (accelerometry, HRV (heart rate monitor, and spatial location (Global Positioning System (GPS were recorded for 74 hours. GPS data were combined with a diary to identify periods of work and of leisure at home and elsewhere. Time- and frequency-domain HRV indices were calculated and stratified by period and activity type (lying/sitting, standing, or walking. ANCOVAs with multiple adjustments were used to disclose possible group differences in HRV. Results. The pain group showed a reduced HRV response to physical activity compared with controls (p=.001, according to the sympathetic-baroreceptor HRV index (LF/HF, ratio between low- and high-frequency power, even after adjustment for leisure time physical activity, work stress, sleep quality, mental health, and aerobic capacity (p=.02. The parasympathetic response to physical activity did not differ between groups. Conclusions. Relying on long-term monitoring of physical behavior and heart rate variability, we found an aberrant sympathetic-baroreceptor response to daily physical activity among subjects with chronic neck pain.

  9. 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.

  10. Comparative effects of pulsed and continuous short wave diathermy on pain and selected physiological parameters among subjects with chronic knee osteoarthritis.

    Science.gov (United States)

    Teslim, Onigbinde Ayodele; Adebowale, Adenle Charles; Ojoawo, Adesola Ojo; Sunday, Odejide Akinwole; Bosede, Arilewola

    2013-01-01

    The purposes of this study were to compare the effects of pulsed and continuous short wave diathermy on pain, range of motion, pulse rate and skin temperature in subjects with chronic knee osteoarthritis. 24 Participants with grade 111 OA of the knee were randomly selected into CSWD and PSWD groups. Pre and post treatment parameters were recorded at onset and the end of 4th week. ANO VA, independent, paired t-test and chi-square were used to analyze the data. The pain experienced by participants in the CSWD group was significantly lower than that of the PSWD groups (P effective than PSWD in alleviating pain and in increasing knee flexion range of motion among subjects with chronic knee OA. Also, a mild elevation of skin temperature was able to elicit physiological effects that could exert therapeutic effects.

  11. The functional rating index: reliability and validity of the Persian language version in patients with neck pain.

    Science.gov (United States)

    Ansari, Noureddin Nakhostin; Feise, Ronald J; Naghdi, Soofia; Mohseni, Aref; Rezazadeh, Mahdi

    2012-06-15

    Psychometric testing of the Persian Functional Rating Index (PFRI). To determine the reliability and validity of the PFRI in Persian-speaking subjects with neck pain (NP). The Functional Rating Index is a self-report questionnaire that can be used for patients with back pain or NP. The PFRI has been recently validated in patients with low back pain, whereas it is not validated in patients with NP. One hundred patients with NP, mean age of 42 years, participated in the study; 50 patients agreed to be tested on 2 occasions during a 7-day interval for the reliability phase of the study. A visual analogue scale, the Neck Disability Index, and the Neck Pain and Disability Scale were also completed to assess validity. Fifty healthy subjects completed the PFRI for discriminative validity. Floor and ceiling effects were not observed. Independent t test showed a statistically significant difference in PFRI total scores between patients and healthy subjects supporting the discriminative validity of the PFRI (P visual analogue scale demonstrated concurrent criterion validity, with Pearson correlation coefficients of 0.75 for test and 0.70 for retest. Construct validity was supported by a significant Pearson correlation between the PFRI and the Neck Disability Index (r = 0.72, P Scale (r = 0.63, P valid and reliable for use in a Persian-speaking population with NP.

  12. Facet joint pain in chronic spinal pain: an evaluation of prevalence and false-positive rate of diagnostic blocks.

    Science.gov (United States)

    Manchukonda, Rajeev; Manchikanti, Kavita N; Cash, Kimberly A; Pampati, Vidyasagar; Manchikanti, Laxmaiah

    2007-10-01

    A retrospective review. Evaluation of the prevalence of facet or zygapophysial joint pain in chronic spinal pain of cervical, thoracic, and lumbar origin by using controlled, comparative local anesthetic blocks and evaluation of false-positive rates of single blocks in the diagnosis of chronic spinal pain of facet joint origin. Facet or zygapophysial joints are clinically important sources of chronic cervical, thoracic, and lumbar spine pain. The previous studies have demonstrated the value and validity of controlled, comparative local anesthetic blocks in the diagnosis of facet joint pain, with a prevalence of 15% to 67% variable in lumbar, thoracic, and cervical regions. False-positive rates of single diagnostic blocks also varied from 17% to 63%. Five hundred consecutive patients receiving controlled, comparative local anesthetic blocks of medial branches for the diagnosis of facet or zygapophysial joint pain were included. Patients were investigated with diagnostic blocks using 0.5 mL of 1% lidocaine per nerve. Patients with lidocaine-positive results were further studied using 0.5 mL of 0.25% bupivacaine per nerve on a separate occasion. Medial branch blocks were performed with intermittent fluoroscopic visualization, at 2 levels to block a single joint. A positive response was considered as one with at least 80% pain relief from a block of at least 2 hours duration when lidocaine was used, and at least 3 hours or longer than the duration of relief with lidocaine when bupivacaine was used, and also the ability to perform prior painful movements. A total of 438 patients met inclusion criteria. The prevalence of facet joint pain was 39% in the cervical spine [95% confidence interval (CI), 32%-45%]; 34% (95% CI, 22%-47%) in the thoracic pain; and 27% (95% CI, 22%-33%) in the lumbar spine. The false-positive rate with a single block in the cervical region was 45%, in the thoracic region was 42%, and in the lumbar region 45%. This retrospective review once again

  13. Comparison between children and adolescents with and without chronic benign pain: consultation rate and pain characteristics

    NARCIS (Netherlands)

    F.C. van Eekelen; C.W. Perquin (Christel); J.A.M. Hunfeld (Joke); A.A.J.M. Hazebroek-Kampschreur (Alice); L.W.A. van Suijlekom-Smit (Lisette); B.W. Koes (Bart); J. Passchier (Jan); J.C. van der Wouden (Hans)

    2002-01-01

    textabstractThe aim of the study was to determine whether children with chronic benign pain are in contact with their general practitioner (GP) more frequently than those without chronic benign pain. A random sample of children and adolescents aged between 0 and 18 years of age was

  14. The relationship between pain catastrophizing, kinesiophobia and subjective knee function during rehabilitation following anterior cruciate ligament reconstruction and meniscectomy: A pilot study.

    Science.gov (United States)

    Tichonova, Ana; Rimdeikienė, Inesa; Petruševičienė, Daiva; Lendraitienė, Eglė

    2016-01-01

    Psychological responses to the initial injury and rehabilitation might be an important additional determinant of functional level outcomes after knee surgery. The objectives of this study were (1) to measure pain catastrophizing and kinesiophobia levels and (2) determine their association with self-reported subjective knee function during rehabilitation, following anterior cruciate ligament reconstruction (ACLR) and meniscectomy. The study involved 41 participants. The levels of catastrophizing (Pain Catastrophizing Scale [PCS]), kinesiophobia (Tampa Scale of Kinesiophobia [TSK-11]), pain (Numeric Pain Rating Scale [NRS]), and subjective knee function (the Knee Injury and Osteoarthritis Outcome Score [KOOS]) were assessed before and after completion of 14-session rehabilitation program. The mean level of catastrophizing changed from 5.8 (SD, 0.9) to 4.2 (SD, 0.5) during rehabilitation (Pkinesiophobia changed from 22.7 (SD, 0.7) to 18.4 (SD, 0.6) (Pkinesiophobia decreased during rehabilitation. A higher pain catastrophizing level correlated with a greater level of knee pain during activities, more difficulties experienced during daily activities before and after rehabilitation. A high level of kinesiophobia correlated with more difficulties experienced in daily activities and poorer knee-related quality of life before and after rehabilitation. Copyright © 2016 The Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  15. [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.

  16. 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...

  17. 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.

  18. 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.

  19. Endogenous Pain Modulation: Association with Resting Heart Rate Variability and Negative Affectivity.

    Science.gov (United States)

    Van Den Houte, Maaike; Van Oudenhove, Lukas; Bogaerts, Katleen; Van Diest, Ilse; Van den Bergh, Omer

    2017-07-21

    Several chronic pain syndromes are characterized by deficient endogenous pain modulation as well as elevated negative affectivity and reduced resting heart rate variability. In order to elucidate the relationships between these characteristics, we investigated whether negative affectivity and heart rate variability are associated with endogenous pain modulation in a healthy population. An offset analgesia paradigm with noxious thermal stimulation calibrated to the individual's pain threshold was used to measure endogenous pain modulation magnitude in 63 healthy individuals. Pain ratings during constant noxious heat stimulation to the arm (15 seconds) were compared with ratings during noxious stimulation comprising a 1 °C rise and return of temperature to the initial level (offset trials, 15 seconds). Offset analgesia was defined as the reduction in pain following the 1 °C decrease relative to pain at the same time point during continuous heat stimulation. Evidence for an offset analgesia effect could only be found when noxious stimulation intensity (and, hence, the individual's pain threshold) was intermediate (46 °C or 47 °C). Offset analgesia magnitude was also moderated by resting heart rate variability: a small but significant offset effect was found in participants with high but not low heart rate variability. Negative affectivity was not related to offset analgesia magnitude. These results indicate that resting heart rate variability (HRV) is related to endogenous pain modulation (EPM) in a healthy population. Future research should focus on clarifying the causal relationship between HRV and EPM and chronic pain by using longitudinal study designs.

  20. 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...

  1. The impact of food viscosity on eating rate, subjective appetite, glycemic response and gastric emptying rate.

    Directory of Open Access Journals (Sweden)

    Yong Zhu

    Full Text Available Understanding the impact of rheological properties of food on postprandial appetite and glycemic response helps to design novel functional products. It has been shown that solid foods have a stronger satiating effect than their liquid equivalent. However, whether a subtle change in viscosity of a semi-solid food would have a similar effect on appetite is unknown. Fifteen healthy males participated in the randomized cross-over study. Each participant consumed a 1690 kJ portion of a standard viscosity (SV and a high viscosity (HV semi-solid meal with 1000 mg acetaminophen in two separate sessions. At regular intervals during the three hours following the meal, subjective appetite ratings were measured and blood samples collected. The plasma samples were assayed for insulin, glucose-dependent insulinotropic peptide (GIP, glucose and acetaminophen. After three hours, the participants were provided with an ad libitum pasta meal. Compared with the SV meal, HV was consumed at a slower eating rate (P = 0.020, with postprandial hunger and desire to eat being lower (P = 0.019 and P<0.001 respectively while fullness was higher (P<0.001. In addition, consuming the HV resulted in lower plasma concentration of GIP (P<0.001, higher plasma concentration of glucose (P<0.001 and delayed gastric emptying as revealed by the acetaminophen absorption test (P<0.001. However, there was no effect of food viscosity on insulin or food intake at the subsequent meal. In conclusion, increasing the viscosity of a semi-solid food modulates glycemic response and suppresses postprandial satiety, although the effect may be short-lived. A slower eating rate and a delayed gastric emptying rate can partly explain for the stronger satiating properties of high viscous semi-solid foods.

  2. 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.

  3. 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.

  4. 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.

  5. Investigation of High-Sensitivity C-reactive Protein and Erythrocyte Sedimentation Rate in Low Back Pain Patients

    Science.gov (United States)

    Lee, Sang Ho

    2010-01-01

    Background Chronic low back pain can be a manifestation of lumbar degenerative disease, herniation of intervertebral discs, arthritis, or lumbar stenosis. When nerve roots are compromised, low back pain, with or without lower extremity involvement, may occur. Local inflammatory processes play an important role in patients with acute lumbosciatic pain. The purpose of this study was to assess the value of erythrocyte sedimentation rate (ESR) and high sensitivity C-reactive protein (hsCRP) measurements in patients with chronic low back pain or radiculopathy. Methods ESR and hsCRP were measured in 273 blood samples from male and female subjects with low back pain and/or radiculopathy due to herniated lumbar disc, spinal stenosis, facet syndrome, and other diseases. The hsCRP and ESR were measured prior to lumbar epidural steroid injection. Results The mean ESR was 18.8 mm/h and mean hsCRP was 1.1 mg/L. ESR had a correlation with age. Conclusions A significant systemic inflammatory reaction did not appear to arise in patients with chronic low back pain. PMID:20556218

  6. Parkinson’s disease patients’ subjective descriptions of characteristics of chronic pain, sleeping patterns and health-related quality of life

    Directory of Open Access Journals (Sweden)

    Skogar Ö

    2012-10-01

    Full Text Available Örjan Skogar,1,5 Per-Arne Fall,2 Gunnar Hallgren,3 Birgitta Bringer,2 Miriam Carlsson,1 Ulla Lennartsson,3 Håkan Sandbjörk,3 Carl-Johan Törnhage,4 Johan Lökk51Department of Geriatrics, Ryhov Hospital, Jonkoping, Sweden; 2Department of Geriatrics, University Hospital, Linkoping, Sweden; 3Department of Neurology, 4Department of Pediatrics, Skaraborg Hospital, Skövde, Sweden; 5Institution of Neurobiology, Karolinska Institutet, Stockholm, SwedenObjective: Nonmotor symptoms are common in Parkinson’s disease (PD. Health-related quality of life (HRQoL is negatively affected by different factors, of which pain and sleep disturbances are important contributors. This study was performed to evaluate and describe subjective experiences of pain, sleeping patterns, and HRQoL in a cohort of PD patients with chronic pain.Methods: A total of 45 participants with established PD for more than 2 years, and PD-related pain for the preceding three months, were recruited from three sites in Sweden. Data regarding time point for onset, duration and degree of pain parameters, body localization of pain, external influences, and treatments were obtained. HRQoL was evaluated with the Short Form-36® Health Survey, and sleeping patterns were registered with the Parkinson’s disease Sleep Scale, both completed along with a questionnaire.Results: In one-third of participants, pain preceded the PD diagnosis. Median pain score measured with a visual analog scale was 6.6 and 5.9 (for females and males, respectively the week before the study. In almost half of the participants, pain was present during all their waking hours. Significantly more females described their pain as troublesome, while more males described their pain as irritating. Feelings of numbness and creeping sensations at night were strongly associated with the maximal visual analog scale scores. Polypharmacy was common; 89% used medication for anxiety/insomnia, and 18% used antidepressants. Only one

  7. 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.

  8. Influence of preoperative pain in the success rate of indirect pulp capping: a retrospective study.

    Science.gov (United States)

    Moura-Netto, Cacio; Kerber Tedesco, Tamara; Werner, Simone; Volpi Mello-Moura, Anna C; Prócida Raggio, Daniela

    2017-04-01

    The association of preoperative pain and indirect pulp treatment in permanent teeth is still unknown. This study aimed to evaluate the influence of preoperative pain in the success rate of indirect pulp capping. The sample of this retrospective study was constituted for 133 teeth treated in a Private clinic in Joinvile, Brazil, by one experienced dentist between 2007 and 2012. Data related to clinical and demographic variables that could influence in the success rate of indirect pulp capping were also collected, such patient age and sex, type of teeth and arch. Chi‑square test was used to evaluate the association between preoperative pain with postoperative one and success of the treatment. Logistic regression was performed to identify significant clinical and demographical factors associated with the success of the indirect pulp capping. The overall success rate was 100% in the absence of preoperative pain. However, when the preoperative pain was present, the failure rate was 18.3%. Statistical analysis showed significant association between preoperative pain and postoperative one and failure rate of the indirect pulp capping. The other independent variables were not associated with the success rate of the treatment. The presence of preoperative pain is associated with the decrease of the success rate of indirect pulp capping.

  9. 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

  10. Pain during photodynamic therapy is associated with protoporphyrin IX fluorescence and fluence rate

    DEFF Research Database (Denmark)

    Wiegell, S.R.; Skiveren, J.; Philipsen, P.A.

    2008-01-01

    Background Pain during photodynamic therapy (PDT) is a considerable problem that needs to be studied to improve this otherwise attractive treatment of skin diseases. Objectives To compare pain during PDT using two different fluence rates, and also to evaluate the association between pain...... and protoporphyrin IX (PpIX) fluorescence, lesion type, lesion preparation and lesion localization. Methods Twenty-six patients with actinic keratoses (AKs) in different localizations and 34 patients with facial acne vulgaris were treated with methyl aminolaevulinate-PDT. Patients with acne were illuminated using...... two different fluence rates. Pain score during PDT and PpIX fluorescence prior to illumination were measured. Results The study showed that pain during illumination was associated with the PpIX fluorescence in the treatment area (P = 0.0003, R-2 = 0.31). When using a fluence rate of 34 mW cm(-2...

  11. 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.

  12. Objective and subjective memory ratings in cannabis-dependent adolescents.

    Science.gov (United States)

    McClure, Erin A; Lydiard, Jessica B; Goddard, Scott D; Gray, Kevin M

    2015-01-01

    Cannabis is the most widely used illicit substance worldwide, with an estimated 160 million users. Among adolescents, rates of cannabis use are increasing, while the perception of detrimental effects of cannabis use is declining. Difficulty with memory is one of the most frequently noted cognitive deficits associated with cannabis use, but little data exist exploring how well users can identify their own memory deficits, if present. The current secondary analysis sought to characterize objective verbal and visual memory performance via a neurocognitive battery in cannabis-dependent adolescents enrolled in a pharmacotherapeutic cannabis cessation clinical trial (N = 112) and compare this to a single self-reported item assessing difficulties with memory loss. Exploratory analyses also assessed dose-dependent effects of cannabis on memory performance. A small portion of the study sample (10%) endorsed a "serious problem" with memory loss. Those participants reporting "no problem" or "serious problem" scored similarly on visual and verbal memory tasks on the neurocognitive battery. Exploratory analyses suggested a potential relationship between days of cannabis use, amount of cannabis used, and gender with memory performance. This preliminary and exploratory analysis suggests that a sub-set of cannabis users may not accurately perceive difficulties with memory. Further work should test this hypothesis with the use of a control group, comprehensive self-reports of memory problems, and adult populations that may have more years of cannabis use and more severe cognitive deficits. © American Academy of Addiction Psychiatry.

  13. A multidisciplinary rehabilitation programme improves disability, kinesiophobia and walking ability in subjects with chronic low back pain: results of a randomised controlled pilot study.

    Science.gov (United States)

    Monticone, Marco; Ambrosini, Emilia; Rocca, Barbara; Magni, Silvia; Brivio, Flavia; Ferrante, Simona

    2014-10-01

    To evaluate the effect of a multidisciplinary rehabilitation programme on disability, kinesiophobia, catastrophizing, pain, quality of life and gait disturbances in patients with chronic low back pain (CLBP). This was a parallel-group, randomised, superiority-controlled pilot study in which 20 patients were randomly assigned to a programme consisting of motor training (spinal stabilising exercises plus usual-care) and cognitive-behavioural therapy (experimental group, 10 subjects) or usual-care alone (control group, 10 subjects). Before treatment, 8 weeks later (post-treatment), and 3 months after the end of treatment, the Oswestry Disability Index, the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, a pain numerical rating scale, and the Short-Form Health Survey were assessed. Spatio-temporal gait parameters were also measured by means of an electronic walking mat. A linear mixed model for repeated measures was used for each outcome measure. The programme had significant group (p = 0.027), time (p kinesiophobia, catastrophizing, and the quality of life also revealed significant time, group, and time-by-group interaction effects in favour of the experimental group, and there was a significant effect of time on pain. Both groups showed a general improvement in gait parameters, with the experimental group increasing cadence significantly more. The multidisciplinary rehabilitation programme including cognitive-behavioural therapy was superior to the exercise programme in reducing disability, kinesiophobia, catastrophizing, and enhancing the quality of life and gait cadence of patients with CLBP.

  14. 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.

  15. 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

  16. 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.

  17. Suffering Makes You Egoist: Acute Pain Increases Acceptance Rates and Reduces Fairness during a Bilateral Ultimatum Game

    Science.gov (United States)

    Mancini, Alessandra; Betti, Viviana; Panasiti, Maria Serena; Pavone, Enea Francesco; Aglioti, Salvatore Maria

    2011-01-01

    Social preferences like interpersonal altruism, fairness, reciprocity and inequity aversion are inherently linked to departures from pure self-interest. During economic interactions, for example, defectors may be punished even if this implies a cost for the punishers. This violation of canonical assumptions in economics indicates that socially oriented decisions may predominate over self-centred stances. Here we explore whether the personal experience of pain changes the balance between self-gain and socially based choices. We used laser stimulation to induce pain or a warm sensation in subjects playing a modified version of the Ultimatum Game (UG) both in the role of responder and proposer. After each shot, responders evaluated the fairness of the offer. Moreover, responders and proposers rated the intensity and unpleasantness of the sensation evoked by the laser stimulation. Results show that suffering proposers decrease fair offers and suffering responders increase their acceptance rate irrespective of economic offer. Crucially, the intensity of painful stimulation has a predictive role on Moderately Unfair offers' acceptance rates. Thus the personal experience of pain may favour the emergence of a self-centered perspective aimed at maximizing self-gain. The results suggest that bodily states play a fundamental role in higher-order interpersonal negotiations and interactions. PMID:22022492

  18. 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.

  19. Strength Training Improves Fatigue Resistance and Self-Rated Health in Workers with Chronic Pain

    DEFF Research Database (Denmark)

    Sundstrup, Emil; Jakobsen, Markus Due; Brandt, Mikkel

    2016-01-01

    of a randomized controlled trial investigates the effect of strength training on muscular fatigue resistance and self-rated health among workers with chronic pain. Sixty-six slaughterhouse workers with chronic upper limb pain and work disability were randomly allocated to 10 weeks of strength training or usual......Chronic musculoskeletal pain is widespread in the working population and leads to muscular fatigue, reduced work capacity, and fear of movement. While ergonomic intervention is the traditional approach to the problem, physical exercise may be an alternative strategy. This secondary analysis...... (Spearman's rho = -0.40; P = 0.01). In conclusion, specific strength training improves muscular fatigue resistance and self-rated health and reduces pain of the hand/wrist in manual workers with chronic upper limb pain. This trial is registered with ClinicalTrials.gov NCT01671267....

  20. 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...

  1. 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

  2. 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.

  3. Cut-Off Points for Mild, Moderate, and Severe Pain on the Numeric Rating Scale for Pain in Patients with Chronic Musculoskeletal Pain: Variability and Influence of Sex and Catastrophizing

    NARCIS (Netherlands)

    Boonstra, A.M.; Stewart, R.; Koke, A.J.A.; Oosterwijk, R.F.A.; Swaan, J.L.; Schreurs, Karlein Maria Gertrudis; Schiphorst Preuper, H.R.

    2016-01-01

    Objectives: The 0–10 Numeric Rating Scale (NRS) is often used in pain management. The aims of our study were to determine the cut-off points for mild, moderate, and severe pain in terms of pain-related interference with functioning in patients with chronic musculoskeletal pain, to measure the

  4. Cut-Off Points for Mild, Moderate, and Severe Pain on the Numeric Rating Scale for Pain in Patients with Chronic Musculoskeletal Pain : Variability and Influence of Sex and Catastrophizing

    NARCIS (Netherlands)

    Boonstra, Anne M; Stewart, Roy E; Köke, Albère J A; Oosterwijk, René F A; Swaan, Jeannette L; Schreurs, Karlein M G; Schiphorst Preuper, Henrica R

    2016-01-01

    Objectives: The 0-10 Numeric Rating Scale (NRS) is often used in pain management. The aims of our study were to determine the cut-off points for mild, moderate, and severe pain in terms of pain-related interference with functioning in patients with chronic musculoskeletal pain, to measure the

  5. 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.

  6. Changes in shoulder pain and disability after thrust manipulation in subjects presenting with second and third rib syndrome.

    Science.gov (United States)

    Dunning, James; Mourad, Firas; Giovannico, Giuseppe; Maselli, Filippo; Perreault, Thomas; Fernández-de-Las-Peñas, César

    2015-01-01

    The purpose of this preliminary study was to investigate changes in shoulder pain, disability, and perceived level of recovery after 2 sessions of upper thoracic and upper rib high-velocity low-amplitude (HVLA) thrust manipulation in patients with shoulder pain secondary to second and third rib syndrome. This exploratory study evaluated 10 consecutive individuals with shoulder pain, with or without brachial pain, and a negative Neer impingement test, who completed the Shoulder Pain and Disability Index (SPADI), the numeric pain rating scale (NPRS), and the global rating of change. Patients received 2 sessions of HVLA thrust manipulation targeting the upper thoracic spine bilaterally and the second and third ribs on the symptomatic side. Outcome measures were completed after the first treatment session, at 48 hours, 1 month, and 3 months. Patients showed a significant decrease in SPADI (F = 59.997; P = .001) and significant decrease in resting shoulder NPRS (F = 63.439; P = .001). For both NPRS and SPADI, there were significant differences between the pretreatment scores and each of the postintervention scores through 3-month follow-up (P shoulder pain secondary to second and third rib syndrome who received upper thoracic and upper rib HVLA thrust manipulations showed significant reductions in pain and disability and improvement in perceived level of recovery. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  7. 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.

  8. 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

  9. The Relationship between Rate of Algometer Application and Pain Pressure Threshold in the Assessment of Myofascial Trigger Point Sensitivity.

    Science.gov (United States)

    Linde, Lukas D; Kumbhare, Dinesh A; Joshi, Maneil; Srbely, John Z

    2017-04-25

    Pressure algometry is a commonly employed technique in the assessment of both regional and widespread musculoskeletal pain. Despite its acceptance amongst clinicians and scientists, the relationship between rate of pressure application (RoA) and pain pressure threshold (PPT) remains poorly understood. We set out to test the hypothesis that a strong, positive, linear relationship exists between the RoA and the PPT within the infraspinatus of young healthy subjects. Thirty-three participants were randomly recruited from the local university community. PPT measures were recorded from a clinically identified myofascial trigger point within the right infraspinatus muscle during pressure algometry. A total of 2 PPT measures were recorded using each of 3 different RoAs, including low (15 N/s), medium (35 N/s), and high (55 N/s). Three baseline trials were also conducted at 30 N/s. The Pearson's correlation coefficient between RoA and PPT was calculated for each subject and averaged across participants. The mean(SD) correlation between subjects was 0.77 (0.19), and the mean (SD) slope of the linear regression was 0.13 (0.09). Our results demonstrate that there is a strong, linear relationship between the RoA and PPT when using the pressure algometry technique. The low slope between RoA and PPT suggests clinicians can rely on PPT assessments despite small RoA fluctuations. Future research should explore this relationship further in a clinical population and in other muscles affected by chronic myofascial pain. Advancing cost-effective, reliable, and clinically feasible tools such as algometry is important to enhancing the diagnosis and management of chronic myofascial pain. © 2017 World Institute of Pain.

  10. 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...

  11. 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...

  12. 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.

  13. 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.

  14. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short‐Form McGill Pain Questionnaire (SF‐MPQ), Chronic Pain Grade Scale (CPGS), Short Form‐36 Bodily Pain Scale (SF‐36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP)

    National Research Council Canada - National Science Library

    Hawker, Gillian A; Mian, Samra; Kendzerska, Tetyana; French, Melissa

    2011-01-01

    ..., Chronic Pain Grade Scale, and Short Form‐36 Bodily Pain Scale), and finally an arthritis‐specific pain questionnaire (Measure of Intermittent and Constant Osteoarthritis Pain). Composite measures of arthritis symptoms, including pain and associated disability, specifically the Western Ontario and McMaster Universities Osteoarthritis Index and the Arthritis...

  15. Group-based multimodal exercises integrated with cognitive-behavioural therapy improve disability, pain and quality of life of subjects with chronic neck pain: a randomized controlled trial with one-year follow-up.

    Science.gov (United States)

    Monticone, Marco; Ambrosini, Emilia; Rocca, Barbara; Cazzaniga, Daniele; Liquori, Valentina; Pedrocchi, Alessandra; Vernon, Howard

    2017-06-01

    To evaluate the effect of a group-based multidisciplinary rehabilitation programme on disability, pain and quality of life in subjects with chronic neck pain. Randomized controlled trial. Specialized rehabilitation centre. A total of 170 patients (mean age of 53 years (13); 121 females). The multidisciplinary group underwent a multidisciplinary rehabilitation programme combining multimodal exercises with psychologist-lead cognitive-behavioural therapy sessions. The general exercise group underwent general physiotherapy. Both groups followed group-based programmes once a week for ten weeks. Additionally, the multidisciplinary group met with the psychologist once a week for a 60-minute session. The Neck Disability Index (primary outcome), the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, a pain numerical rating scale and the Short-Form Health Survey. The participants were evaluated before, after training and after 12 months. A linear mixed model for repeated measures was used for each outcome measure. Significant effects ( p-value <0.001) were found over time and between groups for all outcome measures. After training, significant improvements were found for both groups for all outcome measures except kinesiophobia and catastrophizing, which did not change in the control group; however, the improvements were significantly greater for the multidisciplinary group. At 12-month follow-up a clinically meaningful between-group difference of 12.4 Neck Disability Index points was found for disability. A group-based multidisciplinary rehabilitation programme including cognitive-behavioural therapy was superior to group-based general physiotherapy in improving disability, pain and quality of life of subjects with chronic neck pain. The effects lasted for at least one year.

  16. Predicting SF-6D utility scores from the Neck Disability Index and Numeric Rating Scales for Neck and Arm Pain

    Science.gov (United States)

    Carreon, Leah Y.; Anderson, Paul A.; McDonough, Christine M.; Djurasovic, Mladen; Glassman, Steven D.

    2010-01-01

    Study Design Cross-sectional cohort Objective This study aims to provide an algorithm estimate SF-6D utilities using data from the NDI, neck pain and arm pain scores. Summary of Background Data Although cost-utility analysis is increasingly used to provide information about the relative value of alternative interventions, health state values or utilities are rarely available from clinical trial data. The Neck Disability Index (NDI) and numeric rating scales for neck and arm pain, are widely used disease-specific measures of symptoms, function and disability in patients with cervical degenerative disorders. The purpose of this study is to provide an algorithm to allow estimation of SF-6D utilities using data from the NDI, and numeric rating scales for neck and arm pain. Methods SF-36, NDI, neck and arm pain rating scale scores were prospectively collected pre-operatively, at 12 and 24 months post-operatively in 2080 patients undergoing cervical fusion for degenerative disorders. SF-6D utilities were computed and Spearman correlation coefficients were calculated for paired observations from multiple time points between NDI, neck and arm pain scores and SF-6D utility scores. SF-6D scores were estimated from the NDI, neck and arm pain scores using a linear regression model. Using a separate, independent dataset of 396 patients in which and NDI scores were available SF-6D was estimated for each subject and compared to their actual SF-6D. Results The mean age for those in the development sample, was 50.4 ± 11.0 years and 33% were male. In the validation sample the mean age was 53.1 ± 9.9 years and 35% were male. Correlations between the SF-6D and the NDI, neck and arm pain scores were statistically significant (p<0.0001) with correlation coefficients of 0.82, 0.62, and 0.50 respectively. The regression equation using NDI alone to predict SF-6D had an R2 of 0.66 and a root mean square error (RMSE) of 0.056. In the validation analysis, there was no statistically

  17. 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

  18. 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

  19. 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.

  20. 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...

  1. Recurrence rate and subjective symptoms after standardized (Hamburg protocol) phototherapeutic keratectomy on recurrent corneal erosions.

    Science.gov (United States)

    Mehlan, J; Steinberg, J; Traber, L; Katz, T; Linke, S J

    2016-10-01

    To evaluate the objective and subjective outcome after phototherapeutic keratectomy (PTK) on recurrent corneal erosions (Hamburg protocol). For the standardized PTK according to Hamburg protocol a manual abrasio corneae performed with 20 % alcohol is followed by an excimer ablation depth of ≥15 μm (group1 15 μm; group 2 > 15 μm ablation depth) and 7 mm optical zone. All patients (N = 48) were invited for follow-up examinations and the evaluation of changes concerning subjective symptoms. A significantly reduced subjective impairment of night vision, significantly less pain and less foreign body sensations (for all p Hamburg Schema) is a safe and effective procedure to reduce subjective symptoms and improve discomfort in recurrent corneal erosion.

  2. 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.

  3. 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...

  4. 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

  5. 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.

  6. 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. 

  7. 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....

  8. 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.

  9. 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 ...

  10. The pain-induced decrease in low-threshold motor unit discharge rate is not associated with the amount of increase in spike-triggered average torque.

    Science.gov (United States)

    Farina, Dario; Arendt-Nielsen, Lars; Roatta, Silvestro; Graven-Nielsen, Thomas

    2008-01-01

    Activation of nociceptive afferents decreases motor unit discharge rates in static contractions. There is also evidence that during experimental muscle pain the motor unit twitch force increases, which has been hypothesized to compensate for the decrease in discharge rate to maintain constant force. This study examined whether there is an association between the magnitude of change in motor unit discharge rate and the amount of increase in the spike-triggered average torque during experimental muscle pain. Sixteen subjects performed three constant-torque isometric ankle dorsi-flexions at 10% of the maximal force (MVC) alternated with two contractions at constant discharge rate of a target motor unit, before and following injection of 0.5 ml of hypertonic (painful) or isotonic (control) saline into the tibialis anterior muscle. The discharge rate of the target unit at 10% MVC decreased following injection of hypertonic saline (P<0.05; mean+/-SD, before: 9.9+/-1.3 pulses per second, pps; after injection: 8.9+/-1.0 pps). The peak of the spike-triggered average torque increased with pain (P<0.05; before: 0.56+/-0.55 mNm; during pain: 0.95+/-1.02 mNm) but the increase was not correlated with the decrease in discharge rate (R=0.08). Propagation velocity and action potential peak-to-peak amplitude did not change with pain. The pain-induced modifications in the estimated motor unit twitch torque (1) were not caused by changes in muscle fiber action potential, and (2) were not associated with the decrease in discharge rate. Maintenance of constant force during static painful contractions is not explained by a matching between changes in contractile and control motor unit properties.

  11. Influence of deep breathing exercise on spontaneous respiratory rate and heart rate variability: a randomised controlled trial in healthy subjects.

    Science.gov (United States)

    Tharion, Elizabeth; Samuel, Prasanna; Rajalakshmi, R; Gnanasenthil, G; Subramanian, Rajam Krishna

    2012-01-01

    Studies show that yogic type of breathing exercises reduces the spontaneous respiratory rate. However, there are no conclusive studies on the effects of breathing exercise on heart rate variability. We investigated the effects of non-yogic breathing exercise on respiratory rate and heart rate variability. Healthy subjects (21-33 years, both genders) were randomized into the intervention group (n=18), which performed daily deep breathing exercise at 6 breaths/min (0.1 Hz) for one month, and a control group (n=18) which did not perform any breathing exercise. Baseline respiratory rate and short-term heart rate variability indices were assessed in both groups. Reassessment was done after one month and the change in the parameters from baseline was computed for each group. Comparison of the absolute changes [median (inter-quartile ranges)] of the parameters between the intervention and control group showed a significant difference in the spontaneous respiratory rate [intervention group -2.50 (-4.00, -1.00), control group 0.00 (-1.00, 1.00), cycles/min, Prate and cardiac autonomic modulation of the intervention group were significant, when compared to the changes in the control group. Thus practice of deep slow breathing exercise improves heart rate variability in healthy subjects, without altering their cardiac autonomic balance. These findings have implications in the use of deep breathing exercises to improve cardiac autonomic control in subjects known to have reduced heart rate variability.

  12. Measuring IBS patient reported outcomes with an abdominal pain numeric rating scale: results from the proof cohort

    Science.gov (United States)

    SPIEGEL, B.; BOLUS, R.; HARRIS, L. A.; LUCAK, S.; NALIBOFF, B.; ESRAILIAN, E.; CHEY, W. D.; LEMBO, A.; KARSAN, H.; TILLISCH, K.; TALLEY, J.; MAYER, E.; CHANG, L.

    2009-01-01

    Background Controversy exists about how to effectively measure patient reported outcomes in IBS clinical trials. Pain numeric rating scales (NRS) are widely used in the non-IBS pain literature. The FDA has proposed using the NRS in IBS. Aim To test the psychometrics of an abdominal pain NRS in IBS. Methods We analyzed data from a longitudinal cohort of Rome III IBS subjects. At entry, subjects completed a 10-point NRS, bowel symptoms, IBS severity measurements (IBSSS, FBDSI), health related quality of life indices (IBS-QOL, EQ5D), and the worker productivity activity index (WPAI). We repeated assessments at 3 months along with a response scale to calculate the minimal clinically important difference (MCID). Results There were 277 subjects (82% women; age=42±15) at baseline and 90 at 3 months. The NRS correlated cross-sectionally with IBSSS (r=0.60; p<0.0011), FBDSI (r=0.49; p<0.0001), IBS-QOL (r=0.43; p<0.0001), EQ5D (r=0.48; p<0.0001), presenteeism (r=0.39; p<0.0001), absenteeism (r=0.17; p=0.04), and distension (r=0.46; p<0.0001), but not stool frequency or form. The MCID was 2.2 points, correlating with a 29.5% reduction over time. Conclusions An abdominal pain NRS exhibits excellent validity and can be readily interpreted with an MCID in patients with IBS. These data support the use of the NRS in IBS clinical trials. PMID:19751360

  13. Autonomic components of Complex Regional Pain Syndrome (CRPS) are favourably affected by Electrical Twitch-Obtaining Intramuscular Stimulation (ETOIMS): effects on blood pressure and heart rate.

    Science.gov (United States)

    Chu, Jennifer; Bruyninckx, Frans; Neuhauser, Duncan V

    2017-07-01

    Favourable pain relief results on evoking autonomous twitches at myofascial trigger points with Electrical Twitch Obtaining Intramuscular Stimulation (ETOIMS). To document autonomic nervous system (ANS) dysfunction in Complex Regional Pain Syndrome (CRPS) from blood pressure (BP) and pulse/heart rate changes with ETOIMS. A patient with persistent pain regularly received serial ETOIMS sessions of 60, 90, 120 or ≥150 min over 24 months. Outcome measures include BP: systolic, diastolic, pulse pressure and pulse/heart rate, pre-session/immediate-post-session summed differences (SDPPP index), and pain reduction. His results were compared with that of two other patients and one normal control. Each individual represented the following maximal elicitable twitch forces (TWF) graded 1-5: maximum TWF2: control subject; maximum TWF3: CRPS patient with suspected ANS dysfunction; and maximum TWF4 and TWF5: two patients with respective slow-fatigue and fast-fatigue twitches who during ETOIMS had autonomous twitching at local and remote myotomes simultaneously from denervation supersensitivity. ETOIMS results between TWFs were compared using one-way analysis of variance test. The patients showed immediate significant pain reduction, BP and pulse/heart rate changes/reduction(s) except for diastolic BP in the TWF5 patient. TWF2 control subject had diastolic BP reduction with ETOIMS but not with rest. Linear regression showed TWF grade to be the most significant variable in pain reduction, more so than the number of treatments, session duration and treatment interval. TWF grade was the most important variable in significantly reducing outcome measures, especially pulse/heart rate. Unlike others, the TWF3 patient had distinctive reductions in SDPPP index. Measuring BP and pulse/heart rate is clinically practical for alerting ANS dysfunction maintained CRPS. SDPPP index (≥26) and pulse/heart rate (≥8) reductions with almost every ETOIMS treatment, plus inability to evoke

  14. 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.

  15. Acoustic noise in functional magnetic resonance imaging reduces pain unpleasantness ratings.

    Science.gov (United States)

    Boyle, Y; Bentley, D E; Watson, A; Jones, A K P

    2006-07-01

    Functional magnetic resonance imaging (fMRI) is increasingly used in cognitive studies. Unfortunately, the scanner produces acoustic noise during the image acquisition process. Interference from acoustic noise is known to affect auditory, visual and motor processing, raising the possibility that acoustic interference may also modulate processing of other sensory modalities such as pain. With the increasing use of fMRI in the investigation of the mechanisms of pain perception, particularly in relation to attention, this issue has become highly relevant. Pain is a complex experience, composed of sensory-discriminative, affective-motivational and cognitive-evaluative components. The aim of this experiment was to assess the effect of MRI scanner noise, compared to white noise, on the affective (unpleasantness) and the sensory-discriminative (localisation) components of pain. Painful radiant heat from a CO(2) laser was delivered to the skin of the right forearm in 24 healthy volunteers. The volunteers attended to either pain location or pain unpleasantness during three conditions: i) no noise, ii) exposure to MRI scanner noise (85 dB) or iii) exposure to white noise (85 dB). Both MRI scanner noise and white noise significantly reduced unpleasantness ratings (from 5.1 +/- 1.6 in the control condition to 4.7 +/- 1.5 (P = 0.002) and 4.6 +/- 1.6 (P white noise respectively), whereas the ability to localise pain was not significantly affected (from 85.4 +/- 9.2% correct in the control condition to 83.1 +/- 10.3% (P = 0.06) and 83.9 +/- 9.5% (P = 0.27) with MRI scanner and white noise respectively). This phenomenon should be taken into account in the design of fMRI studies into human pain perception.

  16. 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

  17. 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...

  18. Reliability and concurrent validity of visual analogue scale and modified verbal rating scale of pain assessment in adult patients with knee osteoathritis in Nigeria

    Directory of Open Access Journals (Sweden)

    M. O.B Olaogun

    2003-02-01

    Full Text Available The objective of this study was to determine the reliability and concurrent validity of two pain rating scales - Visual Analogue Scale (VAS and Verbal Rating Scale (VRS. The verbal rating scale was modified by translating the English description of subjective pain experience into vernacular (Yoruba equivalents and rating the knee pain when the patient was  standing with the knee  flexed . Twenty seven patients who were clinically and radiologically diagnosed with osteoarthritis (OA and with knee pain were purposively selected for the study. Two testers (physiotherapists independently rated the pain experienced by patients, when bearing full weight while standing on the affected leg with slight knee flexion, over a period of several days. For each patient pain was rated with the VAS and the modified VRS (MVRS. There were significant correlations between VAS and MVRS by the same tester (tester 1 and tester2 (r=0.92, p<0.01; r = 0.89,            p<0.01respectively, and between VAS and MVRS between tester 1 and tester 2 (r=0.91,p<0.01. There were no significant differences between VAS for tester 1 and VAS for tester 2, and between MVRS for tester 1and MVRS for tester 2 (p> 0.01.  According to this study, the two pain rating scales for knee OA are reliable. Our use of VAS and MVRS togetherwith the procedure involving the flexed knee posture is, therefore, recommended for wider clinical trials.

  19. Back pain in the working population: Prevalence rates in Dutch trades and professions

    NARCIS (Netherlands)

    Hildebrandt, V.H.

    1995-01-01

    An analysis of three health surveys in the Dutch working population is described, aimed at the identification of Dutch trades and professions with relative high and low prevalence rates of back pain. The sample was representative of the working population in the Netherlands and consisted of 5840 men

  20. Reduced nicotine content cigarette advertising: How false beliefs and subjective ratings affect smoking behavior.

    Science.gov (United States)

    Mercincavage, Melissa; Saddleson, Megan L; Gup, Emily; Halstead, Angela; Mays, Darren; Strasser, Andrew A

    2017-04-01

    Tobacco advertising can create false beliefs about health harms that are reinforced by product design features. Reduced nicotine content (RNC) cigarettes may reduce harm, but research has not addressed advertising influences. This study examined RNC cigarette advertising effects on false harm beliefs, and how these beliefs - along with initial subjective ratings of RNC cigarettes - affect subsequent smoking behaviors. We further explored whether subjective ratings moderate associations between false beliefs and behavior. Seventy-seven daily, non-treatment-seeking smokers (66.2% male) participated in the first 15days of a randomized, controlled, open-label RNC cigarette trial. Participants viewed an RNC cigarette advertisement at baseline before completing a 5-day period of preferred brand cigarette use, followed by a 10-day period of RNC cigarette use (0.6mg nicotine yield). Participants provided pre- and post-advertisement beliefs, and subjective ratings and smoking behaviors for cigarettes smoked during laboratory visits. Viewing the advertisement increased beliefs that RNC cigarettes contain less nicotine and are healthier than regular cigarettes (p'sbelief that they are less likely to cause cancer (p=0.046). Neither false beliefs nor subjective ratings directly affected smoking behaviors. Significant interactions of strength and taste ratings with beliefs (p'sbeliefs were associated with greater RNC cigarette consumption. Smokers may misconstrue RNC cigarettes as less harmful than regular cigarettes. These beliefs, in conjunction with favorable subjective ratings, may increase product use. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. 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...

  2. 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.

  3. Comparison of the subjective sense of high or low metabolism and objectively measured resting metabolic rate.

    Science.gov (United States)

    Wallhuss, Andreas; Isik, Markus; Nystrom, Fredrik H

    2010-09-01

    To measure caloric intake, physical activity level and resting metabolic rate in participants having the subjective opinion of either having a high or low metabolic rate. Recruitment by local advertising of healthy subjects feeling that they have high or low metabolism, i.e. either a tendency to easily stay lean ('high') or to very easily gain weight ('low') also when taking food intake in comparison with physical activity into account. Walking distance was estimated by pedometry, assessment of caloric intake was determined by food registration. Measurement of resting metabolic rate was performed in the fasting state. We recruited 44 participants with a sense of 'high' metabolism and 12 subjects in the contrasting group. Subjects with 'high' metabolism were leaner ('high': 20.4 +/- 2.1 kg/m(2), 'low': 27.8 +/- 7.5 kg/m(2), p difference in the measured resting metabolic rate between the two groups ('high': 7230 +/- 1233 kJ/24 h, 'low': 7430 +/- 1422 kJ/24 h, p = 0.6), nor was there any difference in physical activity measured by pedometry. Resting metabolic rate was negatively correlated with age and positively correlated with BMI in multivariate analyses of the total cohort. The sense of having a low or high metabolic rate is not related to actual resting metabolic rate.

  4. Heart rate variability during treatment of breakthrough pain in patients with advanced cancer: a pilot study

    Directory of Open Access Journals (Sweden)

    Masel EK

    2016-12-01

    Full Text Available Eva Katharina Masel, Patrick Huber, Tobias Engler, Herbert Hans WatzkeClinical Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria Background: Decisions on the intensity of analgesic therapy and judgments regarding its efficacy are difficult at the end of life, when many patients are not fully conscious and pain is a very common symptom. In healthy individuals and in postoperative settings, nociception and subsequent pain relief have been shown to induce changes in the autonomic nervous system (ANS, which can be detected by measuring heart rate variability (HRV. Objectives: The changes in the ANS were studied by measuring HRV during opioid therapy for cancer breakthrough pain (CBTP in palliative-care patients with cancer and compared these changes with patient-reported pain levels on a numeric rating scale (NRS. Patients and methods: The study included ten patients with advanced cancer and baseline opioid therapy. In each patient, a 24-hour peak-to-peak HRV measurement with a sampling rate of 4,000 Hz was performed. High frequency (HF, low frequency (LF, total power, pNN50 (indicating parasympathetic activity, and log LF/HF were obtained in two intervals prior to therapy and in four intervals thereafter. Intensity of CBTP was recorded using a patient-reported NRS prior to therapy and 30 minutes afterward. Results: CBTP occurred in seven patients (three males and four females; mean age: 62 ± 5.2 years and was treated with opioids. A highly significant positive correlation was found between opioid-induced reduction in patient-reported pain intensity based on NRS and changes in log LF/HF (r > 0.700; p < 0.05. Log LF/HF decreased in patients who had a reduction in pain of >2 points on the NRS but remained unchanged in the other patients. Conclusion: Our data suggest that log LF/HF may be a useful surrogate marker for alleviation of CBTP in patients with advanced cancer and might

  5. 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

  6. 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.

  7. 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.

  8. 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.

  9. 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

  10. 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

  11. Responsiveness of the activities of daily living scale of the knee outcome survey and numeric pain rating scale in patients with patellofemoral pain.

    Science.gov (United States)

    Piva, Sara R; Gil, Alexandra B; Moore, Charity G; Fitzgerald, G Kelley

    2009-02-01

    To assess internal and external responsiveness of the Activity of Daily Living Scale of the Knee Outcome Survey and Numeric Pain Rating Scale on patients with patellofemoral pain. One group pre-post design. A total of 60 individuals with patellofemoral pain (33 women; mean age 29.9 (standard deviation 9.6) years). The Activity of Daily Living Scale and the Numeric Pain Rating Scale were assessed before and after 8 weeks of physical therapy program. Patients completed a global rating of change scale at the end of therapy. The standardized effect size, Guyatt responsiveness index, and the minimum clinical important difference were calculated. Standardized effect size of the Activity of Daily Living Scale was 0.63, Guyatt responsiveness index was 1.4, area under the curve was 0.83 (95% confidence interval: 0.72, 0.94), and the minimum clinical important difference corresponded to an increase of 7.1 percentile points. Standardized effect size of the Numeric Pain Rating Scale was 0.72, Guyatt responsiveness index was 2.2, area under the curve was 0.80 (95% confidence interval: 0.70, 0.92), and the minimum clinical important difference corresponded to a decrease of 1.16 points. Information from this study may be helpful to therapists when evaluating the effectiveness of rehabilitation intervention on physical function and pain, and to power future clinical trials on patients with patellofemoral pain.

  12. 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.

  13. Correlation between the pain numeric rating scale and the 12-item WHO Disability Assessment Schedule 2.0 in patients with musculoskeletal pain.

    Science.gov (United States)

    Saltychev, Mikhail; Bärlund, Esa; Laimi, Katri

    2017-10-18

    The aim of this study was to assess the correlation between pain severity measured on a numeric rating scale and restrictions of functioning measured with the WHO Disability Assessment Schedule (WHODAS 2.0). This was a cross-sectional study of 1207 patients with musculoskeletal pain conditions. Correlation was assessed using Spearman's and Pearson tests. Although all the Spearman's rank correlations between WHODAS 2.0 items and pain severity were statistically significant, they were mostly weak, with only a few moderate associations for 'S2 household responsibilities', 'S8 washing', 'S9 dressing', and 'S12 day-to-day work'. The correlation between the WHODAS 2.0 total score and pain severity was also moderate: 0.41 [95% confidence interval (CI): 0.36-0.45] for average pain and 0.42 (95% CI: 0.37-0.46) for worst pain. The correlation between the WHODAS 2.0 total score and pain level was also assessed using Pearson's product-moment correlation, yielding figures that were similar to Spearman's correlation: 0.42 (Pcorrelation between pain severity measured by numeric rating scale and functioning level measured by WHODAS 2.0 was weak to moderate, with slightly stronger associations in physical domains of functioning.

  14. 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®.

  15. Greater rates of cartilage loss in painful knees than in pain-free knees after adjustment for radiographic disease stage: data from the osteoarthritis initiative.

    Science.gov (United States)

    Eckstein, Felix; Cotofana, Sebastian; Wirth, Wolfgang; Nevitt, Michael; John, Markus R; Dreher, Donatus; Frobell, Richard

    2011-08-01

    To investigate whether rates of cartilage loss differ in knees with frequent baseline pain versus those without pain, after adjustment for radiographic osteoarthritis (OA) stage. One knee in each of 718 Osteoarthritis Initiative participants was examined: 310 with calculated Kellgren/Lawrence (K/L) grade 2, 299 with calculated K/L grade 3, and 109 with calculated K/L grade 4. Twelve-month change in (subregional) cartilage thickness was assessed by magnetic resonance imaging. Change in cartilage thickness in the central subregion of the weight-bearing medial femoral condyle and ordered value 1 (OV1) were selected as primary end points. Frequent knee symptoms were defined as pain, aching, or stiffness on most days of at least 1 month during the previous year. The mean 12-month rate of change in cartilage thickness in the central subregion of the medial femoral condyle was -12 μm (standardized response mean [SRM] -0.15) in knees without pain (n = 146), -27 μm (SRM -0.25) in those with infrequent pain (n = 255), and -54 μm (SRM -0.32) in those with frequent pain (n = 317). Rates differed significantly between frequently painful knees and pain-free knees after adjustment for age, sex, body mass index, and calculated K/L grade (P = 0.011, R(2) = 2.6%, partial R(2) for frequent pain = 1.4%). Similar results were found in stratified samples of calculated K/L grade 2/calculated K/L grade 3 knees, and in analyses restricted to knees with consistent pain frequency between baseline and followup. OV1 results showed similar trends but were not significant. Knees with frequent pain display greater rates of medial cartilage loss longitudinally than knees without pain, with or without adjustment or stratification for radiographic disease stage. Enrollment of participants with frequent knee pain in clinical trials can increase the observed rate of structural progression (i.e., cartilage loss) and sensitivity to change. Copyright © 2011 by the American College of Rheumatology.

  16. Personality in Free-Ranging Hanuman Langur (Semnopithecus entellus) Males: Subjective Ratings and Recorded Behavior

    Czech Academy of Sciences Publication Activity Database

    Konečná, M.; Lhota, S.; Weiss, A.; Urbánek, Tomáš; Adamová, T.; Pluháček, J.

    2008-01-01

    Roč. 122, č. 4 (2008), s. 379-389 ISSN 0735-7036 Institutional research plan: CEZ:AV0Z70250504 Keywords : trait rating * questionnaires * behavior al indices Subject RIV: AN - Psychology Impact factor: 2.081, year: 2008

  17. Nocturnal variations in subcutaneous blood flow rate in lower leg of normal human subjects

    DEFF Research Database (Denmark)

    Sindrup, J H; Kastrup, J; Jørgensen, B

    1991-01-01

    Subcutaneous adipose tissue blood flow rate was measured in the lower leg of 22 normal human subjects over 12- to 20-h ambulatory conditions. The 133Xe washout technique, portable CdTe(Cl) detectors, and a portable data storage unit were used. The tracer depot was applied on the medial aspect...

  18. A Framework for Control System Design Subject to Average Data-Rate Constraints

    DEFF Research Database (Denmark)

    Silva, Eduardo; Derpich, Milan; Østergaard, Jan

    2011-01-01

    This paper studies discrete-time control systems subject to average data-rate limits. We focus on a situation where a noisy linear system has been designed assuming transparent feedback and, due to implementation constraints, a source-coding scheme (with unity signal transfer function) has to be ...

  19. 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.

  20. Seasonal differences in melatonin concentrations and heart rates during sleep in obese subjects in Japan

    Science.gov (United States)

    Sato, Maki; Kanikowska, Dominika; Iwase, Satoshi; Shimizu, Yuuki; Nishimura, Naoki; Inukai, Yoko; Sato, Motohiko; Sugenoya, Junichi

    2013-09-01

    During the past several decades, obesity has been increasing globally. In Japan, obesity is defined by a BMI of 25 kg/m2 or over; 28.6 % of men and 20.6 % of women are obese. Obese people have an increased incidence of developing cardiovascular, renal, and hormonal diseases and sleep disorders. Obese people also have shortened sleep durations. We investigated seasonal differences in melatonin concentrations, heart rates, and heart rate variability during sleep in obese subjects in Japan. Five obese (BMI, 32.0 ± 4.9 kg/m2) and five non-obese (BMI, 23.2 ± 2.9 kg/m2) men participated in this study in the summer and winter. Electrocardiograms were measured continuously overnight in a climatic chamber at 26 °C with a relative humidity of 50 %. Saliva samples for melatonin were collected at 2300 hours, 0200 hours, and 0600 hours. We found that melatonin concentrations during sleep in obese subjects were significantly lower than those in non-obese subjects in the winter. Heart rate during sleep in winter was significantly higher than that in summer in both obese and non-obese subjects. Heart rate variability was not significantly different in the summer and winter in both obese and non-obese subjects. Our results show that decreased nocturnal melatonin concentrations during winter in obese men may be related to higher heart rates, and this may suggest that obese men are at an increased risk of a cardiovascular incident during sleep, especially in the winter.

  1. Subjective thermal sensation and human body exergy consumption rate: analysis and correlation

    DEFF Research Database (Denmark)

    Simone, Angela; Dovjak, M.; Kolarik, Jakub

    2011-01-01

    , it is reasonable to consider both the exergy flows in building and those within the human body. There is a need to verify the human-body exergy model with the Thermal-Sensation (TS) response of subjects exposed to different combinations of indoor climate parameters (temperature, humidity, etc.). First results...... available on the relation between human-body exergy consumption rates and subjectively assessed thermal sensation showed that the minimum human body exergy consumption rate is associated with thermal sensation votes close to thermal neutrality, tending to slightly cool side of thermal sensation. By applying...... the exergy concept to the built indoor environment, additional results are going to be explored. By using the data available so far of operative temperature (to), the human body exergy consumption rates increase as to increases above 24°C or decreases below 22°C at relative humidity (RH) lower than 50...

  2. Rates of opioid misuse, abuse, and addiction in chronic pain: a systematic review and data synthesis.

    Science.gov (United States)

    Vowles, Kevin E; McEntee, Mindy L; Julnes, Peter Siyahhan; Frohe, Tessa; Ney, John P; van der Goes, David N

    2015-04-01

    Opioid use in chronic pain treatment is complex, as patients may derive both benefit and harm. Identification of individuals currently using opioids in a problematic way is important given the substantial recent increases in prescription rates and consequent increases in morbidity and mortality. The present review provides updated and expanded information regarding rates of problematic opioid use in chronic pain. Because previous reviews have indicated substantial variability in this literature, several steps were taken to enhance precision and utility. First, problematic use was coded using explicitly defined terms, referring to different patterns of use (ie, misuse, abuse, and addiction). Second, average prevalence rates were calculated and weighted by sample size and study quality. Third, the influence of differences in study methodology was examined. In total, data from 38 studies were included. Rates of problematic use were quite broad, ranging from Abuse was reported in only a single study. Only 1 difference emerged when study methods were examined, where rates of addiction were lower in studies that identified prevalence assessment as a primary, rather than secondary, objective. Although significant variability remains in this literature, this review provides guidance regarding possible average rates of opioid misuse and addiction and also highlights areas in need of further clarification.

  3. 49 CFR Appendix B to Part 541 - Light Duty Truck Lines With Theft Rates Below the 1990/91 Median Theft Rate, Subject to the...

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 6 2010-10-01 2010-10-01 false Light Duty Truck Lines With Theft Rates Below the 1990/91 Median Theft Rate, Subject to the Requirements of This Standard B Appendix B to Part 541... Appendix B to Part 541—Light Duty Truck Lines With Theft Rates Below the 1990/91 Median Theft Rate, Subject...

  4. Relationship between heart rate variability and endothelial function in healthy subjects.

    Science.gov (United States)

    Pinter, Alexandra; Horvath, Tamas; Sarkozi, Adrienn; Kollai, Mark

    2012-08-16

    In various diseased states reduced cardiac vagal activity is accompanied by impaired endothelial function. Evidence from animal studies indicates interaction between the two systems, but such data from human studies is limited. The aim of this study was to test the hypothesis that cardiac vagal activity and endothelial function are related in healthy individuals. 46 young males were studied. From 10 minute long ECG recordings mean RR-interval and time and frequency domain vagal heart rate variability indices (RMSSD; pNN50 and HF, respectively) were determined. Heart rate variability indices were used to define cardiac vagal activity. Endothelial function was assessed by measuring brachial artery flow mediated dilation. Hyperemic, diastolic shear rate was used to normalize flow mediated dilation. All three vagal heart rate variability indices correlated significantly and positively with flow mediated dilation across subjects, with r values within the range of 0.43-0.52, pheart rate variability indices remained significantly associated with normalized flow mediated dilation. RR-interval was related to most heart rate variability indices, but was not related to flow mediated dilation. Our data demonstrate that vagal heart rate variability indices are related to flow mediated dilation across healthy male subjects. The results cannot serve as evidence of a causal relationship, but are of interest and render for further investigation into underlying mechanisms. Copyright © 2012 Elsevier B.V. All rights reserved.

  5. 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.

  6. Merging physical parameters and laboratory subjective ratings for the soundscape assessment of urban squares.

    Science.gov (United States)

    Brambilla, Giovanni; Maffei, Luigi; Di Gabriele, Maria; Gallo, Veronica

    2013-07-01

    An experimental study was carried out in 20 squares in the center of Rome, covering a wide range of different uses, sonic environments, geometry, and architectural styles. Soundwalks along the perimeter of each square were performed during daylight and weekdays taking binaural and video recordings, as well as spot measurements of illuminance. The cluster analysis performed on the physical parameters, not only acoustic, provided two clusters that are in satisfactory agreement with the "a priori" classification. Applying the principal component analysis (PCA) to five physical parameters, two main components were obtained which might be associated to two environmental features, namely, "chaotic/calm" and "open/enclosed." On the basis of these two features, six squares were selected for the laboratory audio-video tests where 32 subjects took part filling in a questionnaire. The PCA performed on the subjective ratings on the sonic environment showed two main components which might be associated to two emotional meanings, namely, "calmness" and "vibrancy." The linear regression modeling between five objective parameters and the mean value of subjective ratings on chaotic/calm and enclosed/open attributes showed a good correlation. Notwithstanding these interesting results being limited to the specific data set, it is worth pointing out that the complexity of the soundscape quality assessment can be more comprehensively examined merging the field measurements of physical parameters with the subjective ratings provided by field and/or laboratory tests.

  7. 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.

  8. Modeling the time--varying subjective quality of HTTP video streams with rate adaptations.

    Science.gov (United States)

    Chen, Chao; Choi, Lark Kwon; de Veciana, Gustavo; Caramanis, Constantine; Heath, Robert W; Bovik, Alan C

    2014-05-01

    Newly developed hypertext transfer protocol (HTTP)-based video streaming technologies enable flexible rate-adaptation under varying channel conditions. Accurately predicting the users' quality of experience (QoE) for rate-adaptive HTTP video streams is thus critical to achieve efficiency. An important aspect of understanding and modeling QoE is predicting the up-to-the-moment subjective quality of a video as it is played, which is difficult due to hysteresis effects and nonlinearities in human behavioral responses. This paper presents a Hammerstein-Wiener model for predicting the time-varying subjective quality (TVSQ) of rate-adaptive videos. To collect data for model parameterization and validation, a database of longer duration videos with time-varying distortions was built and the TVSQs of the videos were measured in a large-scale subjective study. The proposed method is able to reliably predict the TVSQ of rate adaptive videos. Since the Hammerstein-Wiener model has a very simple structure, the proposed method is suitable for online TVSQ prediction in HTTP-based streaming.

  9. Psilocybin links binocular rivalry switch rate to attention and subjective arousal levels in humans.

    Science.gov (United States)

    Carter, Olivia L; Hasler, Felix; Pettigrew, John D; Wallis, Guy M; Liu, Guang B; Vollenweider, Franz X

    2007-12-01

    Binocular rivalry occurs when different images are simultaneously presented to each eye. During continual viewing of this stimulus, the observer will experience repeated switches between visual awareness of the two images. Previous studies have suggested that a slow rate of perceptual switching may be associated with clinical and drug-induced psychosis. The objective of the study was to explore the proposed relationship between binocular rivalry switch rate and subjective changes in psychological state associated with 5-HT2A receptor activation. This study used psilocybin, the hallucinogen found naturally in Psilocybe mushrooms that had previously been found to induce psychosis-like symptoms via the 5-HT2A receptor. The effects of psilocybin (215 microg/kg) were considered alone and after pretreatment with the selective 5-HT2A antagonist ketanserin (50 mg) in ten healthy human subjects. Psilocybin significantly reduced the rate of binocular rivalry switching and increased the proportion of transitional/mixed percept experience. Pretreatment with ketanserin blocked the majority of psilocybin's "positive" psychosis-like hallucinogenic symptoms. However, ketanserin had no influence on either the psilocybin-induced slowing of binocular rivalry or the drug's "negative-type symptoms" associated with reduced arousal and vigilance. Together, these findings link changes in binocular rivalry switching rate to subjective levels of arousal and attention. In addition, it suggests that psilocybin's effect on binocular rivalry is unlikely to be mediated by the 5-HT2A receptor.

  10. 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

  11. 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.

  12. 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.

  13. 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.

  14. Caffeine Enhances Heart Rate Variability in Middle-Aged Healthy, But Not Heart Failure Subjects.

    Science.gov (United States)

    Notarius, Catherine F; Floras, John S

    2012-06-01

    In chronic heart failure (CHF) due to left ventricular dysfunction, diminished heart rate variability (HRV) is an independent predictor of poor prognosis. Caffeine has been shown to increase HRV in young healthy subjects. Such an increase may be of potential benefit to patients with CHF. We hypothesized that intravenous infusion of caffeine would increase HRV in CHF, and in age-matched healthy control subjects. On two separate days, 11 patients (1F) with CHF (age=51.3±4.6 years; left ventricular ejection fraction=18.6±2.7%; mean±standard error) and 10 healthy control subjects (age=48.0±4.0) according to a double-blind randomization design, received either saline or caffeine (4 mg/kg) infusion. We assessed HRV over 7 minutes of supine rest (fast Fourier Transform analysis) to determine total spectral power as well as its high-frequency (HF) (0.15-0.50 Hz) and low-frequency (LF) (0.05-0.15 Hz) components, and recorded muscle sympathetic nerve activity (MSNA) directly from the peroneal nerve (microneurography). In healthy control subjects, compared with saline, caffeine reduced both heart rate and sympathetic nerve traffic (p≤0.003) and increased the ratio of HF/total power (p≤0.05). Baseline LF power and the ratio LF/HF were significantly lower in CHF compared with controls (p=0.02), but caffeine had no effect on any element of HRV. Caffeine increases cardiac vagal heart rate modulation and reduces MSNA in middle-aged healthy subjects, but not in those with CHF.

  15. A relation between calculated human body exergy consumption rate and subjectively assessed thermal sensation

    DEFF Research Database (Denmark)

    Simone, Angela; Kolarik, Jakub; Iwamatsu, Toshiya

    2011-01-01

    occupants, it is reasonable to consider both the exergy flows in building and those within the human body. Until now, no data have been available on the relation between human-body exergy consumption rates and subjectively assessed thermal sensation. The objective of the present work was to relate thermal...... sensation data, from earlier thermal comfort studies, to calculated human-body exergy consumption rates. The results show that the minimum human body exergy consumption rate is associated with thermal sensation votes close to thermal neutrality, tending to the slightly cool side of thermal sensation....... Generally, the relationship between air temperature and the exergy consumption rate, as a first approximation, shows an increasing trend. Taking account of both convective and radiative heat exchange between the human body and the surrounding environment by using the calculated operative temperature, exergy...

  16. Disentangling preference ratings of concert hall acoustics using subjective sensory profiles.

    Science.gov (United States)

    Lokki, Tapio; Pätynen, Jukka; Kuusinen, Antti; Tervo, Sakari

    2012-11-01

    Subjective evaluation of acoustics was studied by recording nine concert halls with a simulated symphony orchestra on a seat 12 m from the orchestra. The recorded music was spatially reproduced for subjective listening tests and individual vocabulary profiling. In addition, the preferences of the assessors and objective parameters were gathered. The results show that concert halls were discriminated using perceptual characteristics, such as Envelopment/Loudness, Reverberance, Bassiness, Proximity, Definition, and Clarity. With these perceptual dimensions the preference ratings can be explained. Seventeen assessors were divided into two groups based on their preferences. The first group preferred concert halls with relatively intimate sound, in which it is quite easy to hear individual instruments and melody lines. In contrast, the second group preferred a louder and more reverberant sound with good envelopment and strong bass. Even though all halls were recorded exactly at the same distance, the preference is best explained with subjective Proximity and with Bassiness, Envelopment, and Loudness to some extent. Neither the preferences nor the subjective ratings could be fully explained by objective parameters (ISO3382-1:2009), although some correlations were found.

  17. Classification of heart rate signals of healthy and pathological subjects using threshold based symbolic entropy.

    Science.gov (United States)

    Aziz, Wajid; Rafique, M; Ahmad, I; Arif, M; Habib, Nazneen; Nadeem, M S A

    2014-09-01

    The dynamical fluctuations of biological signals provide a unique window to construe the underlying mechanism of the biological systems in health and disease. Recent research evidences suggest that a wide class of diseases appear to degrade the biological complexity and adaptive capacity of the system. Heart rate signals are one of the most important biological signals that have widely been investigated during the last two and half decades. Recent studies suggested that heart rate signals fluctuate in a complex manner. Various entropy based complexity analysis measures have been developed for quantifying the valuable information that may be helpful for clinical monitoring and for early intervention. This study is focused on determining HRV dynamics to distinguish healthy subjects from patients with certain cardiac problems using symbolic time series analysis technique. For that purpose, we have employed recently developed threshold based symbolic entropy to cardiac inter-beat interval time series of healthy, congestive heart failure and atrial fibrillation subjects. Normalized Corrected Shannon Entropy (NCSE) was used to quantify the dynamics of heart rate signals by continuously varying threshold values. A rule based classifier was implemented for classification of different groups by selecting threshold values for the optimal separation. The findings indicated that there is reduction in the complexity of pathological subjects as compared to healthy ones at wide range of threshold values. The results also demonstrated that complexity decreased with disease severity.

  18. 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

  19. 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.

  20. Association of patient-rated severity with other outcomes in patients with painful diabetic peripheral neuropathy

    Directory of Open Access Journals (Sweden)

    Taylor-Stokes G

    2011-12-01

    Full Text Available Gavin Taylor-Stokes1, James Pike1, Alesia Sadosky2, Arthi Chandran2, Thomas Toelle31Adelphi Real World, Adelphi Mill, Bollington, Macclesfield, Cheshire, UK; 2Pfizer Inc, New York, NY, USA; 3Department of Neurology, Technische Universität München, Munich, GermanyObjective: To evaluate the association of patient-reported severity of painful diabetic peripheral neuropathy (pDPN with other outcomes in a European population of patients using the Adelphi Disease Specific Programme for pDPN (DSP III, 2008.Methods: The severity of patients' pDPN (mild, moderate, or severe was rated independently by both patients and physicians. Relationships were evaluated between patient-reported pDPN severity and other patient-reported outcomes including pain, sleep, function, and work productivity. Physicians rated the severity of patients’ pDPN (1 = mild, 2 = moderate, 3 = severe and sleep interference.Results: Patient-reported data were available from 634 individuals (56.2% male, mean age 63 years from France, Germany, Italy, and the UK, of whom only 22.2% reported that they were currently employed. pDPN severity was rated as mild, moderate, and severe by 22.2%, 60.9%, and 16.9% of the patients, respectively. There was a significant association between patient-rated and physician-rated pDPN severity (P < 0.0001, although there were discrepancies in agreement (kappa = 0.37, 95% confidence interval [CI] 0.31, 0.43; weighted kappa = 0.43, 95% CI 0.37, 0.48 among physician and patient ratings in a substantial proportion of patients across severity categories. Higher pDPN severity was associated with greater interference of daily function including sleep (P < 0.0001 for all pairwise comparisons. Among employed patients, percent of pDPN-related impairment while at work (presenteeism and overall work impairment increased with greater pDPN severity, resulting in indirect costs that increased significantly with pDPN severity; $8266, $15,449, and $24,300 for mild

  1. The Mayo Clinic quadratic equation improves the prediction of glomerular filtration rate in diabetic subjects.

    Science.gov (United States)

    Rigalleau, Vincent; Lasseur, Catherine; Raffaitin, Christelle; Perlemoine, Caroline; Barthe, Nicole; Chauveau, Philippe; Combe, Christian; Gin, Henri

    2007-03-01

    Although recommended, both the Cockcroft and Gault formula (CG) and the modification of diet in renal disease (MDRD) equation are not ideally predictive of glomerular filtration rate (GFR) in diabetic subjects; we tested whether the new Mayo Clinic Quadratic (MCQ) equation performed better. In 200 diabetic subjects with a wide range of renal function, GFR was measured by 51Cr-EDTA clearance, and compared with the results of the three predictive equations by regression analysis and Bland and Altman procedures. The correlations with body mass index, age and albumin excretion rates were tested. The precisions (absolute difference as percentage), diagnostic accuracies [receiver operating characteristic (ROC) curves for the diagnosis of moderate and severe chronic kidney disease (CKD)], and the results of stratification according to the KDOQ classification were compared. The CG and MCQ overestimated mean GFR, whereas the MDRD underestimated it. Correlation coefficients and areas under the ROC curves were better for the MDRD and the MCQ as compared with the CG, which was biased by body weight (+30% overestimation in obese diabetic subjects). The absolute differences with true GFR were slightly lower for the MDRD than the MCQ, and both better than the CG. Both the MDRD and MCQ correctly stratified 65% of the subjects (CG: 55%, P<0.05). In contrast with the MDRD, the MCQ did not underestimate normal GFR, and its performance for stratification was uniformly good over a wide GFR range. In diabetic subjects, the MCQ has a similar diagnostic performance to the MDRD, but it does not underestimate normal GFR, which is an important advantage.

  2. Responsiveness of the Tampa Scale of Kinesiophobia in Italian subjects with chronic low back pain undergoing motor and cognitive rehabilitation.

    Science.gov (United States)

    Monticone, Marco; Ambrosini, Emilia; Rocca, Barbara; Foti, Calogero; Ferrante, Simona

    2016-09-01

    The Tampa Scale of Kinesiophobia (TSK) is a commonly used measure for the assessment of kinesiophobia related to spinal diseases. The Italian version showed satisfactory psychometric properties, but its responsiveness has not yet been evaluated. This observational study is aimed at evaluating the responsiveness and minimal important changes (MICs) for the TSK in subjects with chronic low back pain. At the beginning and end of an 8-week multidisciplinary rehabilitation programme, 205 patients completed the TSK. After the programme, patients also completed the global perceived effect (GPE) scale, which was divided to produce a dichotomous outcome. Responsiveness was calculated by distribution [effect size (ES); standardised response mean (SRM)] and anchor-based methods [receiver-operating characteristics (ROC) curves; correlations between change scores of the TSK and GPE]. ROC curves were also used to compute the best cut-off levels between subjects with a "good" or "poor" outcome (MICs). The ES and the SRM were 1.49 and 1.36, respectively. The ROC analyses revealed a MIC value (AUC; sensitivity; specificity) of 5.5 (0.996; 95; 97). To avoid any dependence on the baseline scores, the MIC value [area under the curve (AUC); sensitivity; and specificity] was computed also based on the percentage of change from the baseline and a value of 18 % (0.998; 97; 98 %) was obtained. The correlation between change scores of the TSK and GPE was high (0.871). The TSK was sensitive in detecting clinical changes in subjects with chronic low back pain. We recommend taking the MICs provided into account when assessing patients' improvement or planning studies in this clinical context.

  3. Outcomes are not different for patient-matched vs. non-matched treatment in subjects with chronic, recurrent low back pain: a randomized clinical trial

    Science.gov (United States)

    Henry, Sharon M.; Van Dillen, Linda; Ouellette-Morton, Rebecca H.; Hitt, Juvena R.; Lomond, Karen V.; DeSarno, Michael J.; Bunn, Janice Y.

    2014-01-01

    Background Classification schemas for low back pain (LBP), such as the Treatment Based Classification and the Movement System Impairment schemas, use common clinical features to subgroup patients with LBP and are purported to improve treatment outcomes. Purpose To assess if providing matched treatments based on patient specific clinical features led to superior treatment outcomes compared to an unmatched treatment for subjects with chronic, recurrent LBP. Study Design A randomized controlled trial. Patient Sample Subjects (n=124) with LBP (≥ 12 months) with or without recurrences underwent a standardized clinical exam to group them into one of 2 strata: (1) ineligible or (2) eligible for stabilization exercises based on the Treatment Based Classification schema. Subjects underwent additional clinical tests to assign them to one of the 5 possible Movement System Impairment categories. Outcome Measures Questionnaires were collected electronically at: Week 0, prior to treatment; Week 7 (following the 6 weekly, one hour treatment sessions); and 12 months. Using the Oswestry Disability Index (0-100) and the Numeric Pain Rating Scale (0-10), the primary analysis was performed using the intention-to-treat principle. Secondary outcomes included fear-avoidance beliefs as well as psychosocial, work related and general health status. Methods After subjects were categorized based on their particular clinical features using both the Treatment Based Classification and Movement System Impairment schemas, they were randomized into one of two treatments using a 3:1 ratio for matched or unmatched treatments. The treatments were (1) trunk stabilization exercise, or (2) Movement System Impairment-directed exercises. The study was funded by National Institutes of Health (NCMRR/R01HD040909; $1,485,000). There are no study specific conflicts of interest to report. Results Of the patients allocated to treatment for this study, 76 received a matched treatment and 25 received an unmatched

  4. Monitoring heart rate variability to assess experimentally induced pain using the analgesia nociception index: A randomised volunteer study.

    Science.gov (United States)

    Jess, Gunnar; Pogatzki-Zahn, Esther M; Zahn, Peter K; Meyer-Frießem, Christine H

    2016-02-01

    Pain assessment using a numerical rating scale (NRS) is considered good clinical practice, but objective assessment in noncommunicating patients is still a challenge. A potential solution is to monitor changes in heart rate variability transformed into the analgesia nociception index (ANI), that offers a noninvasive means of pain quantification. The aim was to measure magnitudes, descending slopes and time courses of ANI following expected and unexpected painful, nonpainful and sham experimental stimuli and compare these with pain intensity as assessed by NRS in conscious human volunteers. We expected a negative correlation between ANI and NRS after painful stimuli. Randomised stimuli and placebo-controlled, single-blinded study. Experimental pain simulation laboratory, Bochum, Germany. Twenty healthy male students, (mean ± standard deviation; 24.2 ± 1.9 years) recruited via local advertising, were consecutively included. ANI values were continuously recorded. After resting, four stimuli were applied in a random order on the right forearm (unexpected and expected electrical pain, expected nonpainful and sham stimuli). Blinded volunteers were asked to rate all four stimuli on NRS. ANI means (0-100), amplitudes, maxima, minima and slopes with NRS pain intensity scores (0-10). Resting alert volunteers showed ANI values of 82.05 ± 10.71. ANI decreased after a random stimulus (maximal decrease of 25.0 ± 7.3%), but different kinds of stimuli evoked similar results. NRS scores (median; interquartiles) were significantly (P = 0.008) higher after expected (5.25; 3.5-6.75) compared with unexpected (4.50; 3.0-5.0) pain stimuli. No correlation was found between ANI and NRS. ANI did not allow a differentiation of painful, nonpainful or sham stimuli in alert volunteers. Therefore, ANI does not exclusively detect nociception, but may be modified by stress and emotion. Thus, we conclude that ANI is not a specific, robust measure for assessment of pain

  5. Prognostic value of ambulatory heart rate revisited in 6928 subjects from 6 populations

    DEFF Research Database (Denmark)

    Hansen, Tine Willum; Thijs, Lutgarde; Staessen, Jan A.

    2008-01-01

    The evidence relating mortality and morbidity to heart rate remains inconsistent. We performed 24-hour ambulatory blood pressure monitoring in 6928 subjects (not on beta-blockers; mean age: 56.2 years; 46.5% women) enrolled in prospective population studies in Denmark, Belgium, Japan, Sweden......, Uruguay, and China. We computed standardized hazard ratios for heart rate, while stratifying for cohort, and adjusting for blood pressure and other cardiovascular risk factors. Over 9.6 years (median), 850, 325, and 493 deaths accrued for total, cardiovascular, and noncardiovascular mortality......, respectively. The incidence of fatal combined with nonfatal end points was 805, 363, 439, and 324 for cardiovascular, stroke, cardiac, and coronary events, respectively. Twenty-four-hour heart rate predicted total (hazard ratio: 1.15) and noncardiovascular (hazard ratio: 1.18) mortality but not cardiovascular...

  6. The Prognostic Value of Ambulatory Heart Rate Revisited in 6928 Subjects from 6 Populations

    DEFF Research Database (Denmark)

    Hansen, Tine Willum; Thijs, Lutgarde; Staessen, Jan A.

    2008-01-01

    The evidence relating mortality and morbidity to heart rate remains inconsistent. We performed 24-hour ambulatory blood pressure monitoring in 6928 subjects (not on β-blockers; mean age: 56.2 years; 46.5% women) enrolled in prospective population studies in Denmark, Belgium, Japan, Sweden, Uruguay......, and China. We computed standardized hazard ratios for heart rate, while stratifying for cohort, and adjusting for blood pressure and other cardiovascular risk factors. Over 9.6 years (median), 850, 325, and 493 deaths accrued for total, cardiovascular, and noncardiovascular mortality, respectively....... The incidence of fatal combined with nonfatal end points was 805, 363, 439, and 324 for cardiovascular, stroke, cardiac, and coronary events, respectively. Twenty-four-hour heart rate predicted total (hazard ratio: 1.15) and noncardiovascular (hazard ratio: 1.18) mortality but not cardiovascular mortality...

  7. A Computational Framework to Optimize Subject-Specific Hemodialysis Blood Flow Rate to Prevent Intimal Hyperplasia

    Science.gov (United States)

    Mahmoudzadeh, Javid; Wlodarczyk, Marta; Cassel, Kevin

    2017-11-01

    Development of excessive intimal hyperplasia (IH) in the cephalic vein of renal failure patients who receive chronic hemodialysis treatment results in vascular access failure and multiple treatment complications. Specifically, cephalic arch stenosis (CAS) is known to exacerbate hypertensive blood pressure, thrombosis, and subsequent cardiovascular incidents that would necessitate costly interventional procedures with low success rates. It has been hypothesized that excessive blood flow rate post access maturation which strongly violates the venous homeostasis is the main hemodynamic factor that orchestrates the onset and development of CAS. In this article, a computational framework based on a strong coupling of computational fluid dynamics (CFD) and shape optimization is proposed that aims to identify the effective blood flow rate on a patient-specific basis that avoids the onset of CAS while providing the adequate blood flow rate required to facilitate hemodialysis. This effective flow rate can be achieved through implementation of Miller's surgical banding method after the maturation of the arteriovenous fistula and is rooted in the relaxation of wall stresses back to a homeostatic target value. The results are indicative that this optimized hemodialysis blood flow rate is, in fact, a subject-specific value that can be assessed post vascular access maturation and prior to the initiation of chronic hemodialysis treatment as a mitigative action against CAS-related access failure. This computational technology can be employed for individualized dialysis treatment.

  8. Moving in an environment of induced sensorimotor incongruence does not influence pain sensitivity in healthy volunteers: a randomised within-subject experiment.

    Directory of Open Access Journals (Sweden)

    Benedict Martin Wand

    Full Text Available OBJECTIVES: It has been proposed that in the same way that conflict between vestibular and visual inputs leads to motion sickness, conflict between motor commands and sensory information associated with these commands may contribute to some chronic pain states. Attempts to test this hypothesis by artificially inducing a state of sensorimotor incongruence and assessing self-reported pain have yielded equivocal results. To help clarify the effect sensorimotor incongruence has on pain we investigated the effect of moving in an environment of induced incongruence on pressure pain thresholds (PPT and the pain experienced immediately on completion of PPT testing. METHODS: Thirty-five healthy subjects performed synchronous and asynchronous upper-limb movements with and without mirror visual feedback in random order. We measured PPT over the elbow and the pain evoked by testing. Generalised linear mixed-models were performed for each outcome. Condition (four levels and baseline values for each outcome were within-subject factors. RESULTS: There was no effect of condition on PPT (p = 0.887 or pressure-evoked pain (p = 0.771. A sensitivity analysis using only the first PPT measure after each condition confirmed the result (p = 0.867. DISCUSSION: Inducing a state of movement related sensorimotor incongruence in the upper-limb of healthy volunteers does not influence PPT, nor the pain evoked by testing. We found no evidence that sensorimotor incongruence upregulates the nociceptive system in healthy volunteers.

  9. [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.

  10. Subjective Ratings of Beauty and Aesthetics: Correlations With Statistical Image Properties in Western Oil Paintings

    Science.gov (United States)

    Lehmann, Thomas; Redies, Christoph

    2017-01-01

    For centuries, oil paintings have been a major segment of the visual arts. The JenAesthetics data set consists of a large number of high-quality images of oil paintings of Western provenance from different art periods. With this database, we studied the relationship between objective image measures and subjective evaluations of the images, especially evaluations on aesthetics (defined as artistic value) and beauty (defined as individual liking). The objective measures represented low-level statistical image properties that have been associated with aesthetic value in previous research. Subjective rating scores on aesthetics and beauty correlated not only with each other but also with different combinations of the objective measures. Furthermore, we found that paintings from different art periods vary with regard to the objective measures, that is, they exhibit specific patterns of statistical image properties. In addition, clusters of participants preferred different combinations of these properties. In conclusion, the results of the present study provide evidence that statistical image properties vary between art periods and subject matters and, in addition, they correlate with the subjective evaluation of paintings by the participants. PMID:28694958

  11. Trunk and pelvic coordination at various walking speeds during an anterior load carriage task in subjects with and without chronic low back pain

    OpenAIRE

    Kim, Tackhoon; Chai, Eunsu

    2015-01-01

    [Purpose] This study compared the coordination patterns of the trunk and pelvis in the transverse plane between healthy subjects and patients with chronic low back pain during an anterior load carriage task at various walking speeds. [Subjects] Ten healthy subjects and 10 patients with chronic low back pain performed an anterior carriage task with a load of 10% body weight at walking speeds of 3.5, 4.5, or 5.5?km/h. [Methods] The trunk and pelvic kinematics were measured by using a motion ana...

  12. Eccentric training for shoulder abductors improves pain, function and isokinetic performance in subjects with shoulder impingement syndrome: a case series.

    Science.gov (United States)

    Camargo, Paula R; Avila, Mariana A; Alburquerque-Sendín, Francisco; Asso, Naoe A; Hashimoto, Larissa H; Salvini, Tania F

    2012-01-01

    Conservative treatments have been proposed for people with shoulder impingement syndrome (SIS), such as strengthening of the rotator cuff and scapular muscles and stretching of the soft tissues of the shoulder. However, there is a lack of studies analyzing the effectiveness of eccentric training in the treatment of SIS. To evaluate the effects of eccentric training for shoulder abductors on pain, function, and isokinetic performance during concentric and eccentric abduction of the shoulder in subjects with SIS. Twenty subjects (7 females, 34.2 SD 10.2 years, 1.7 SD 0.1 m, 78.0 SD 16.3 kg) with unilateral SIS completed the study protocol. Bilateral isokinetic eccentric training at 60º/s for shoulder abductors was performed for six consecutive weeks, twice a week, on alternate days. For each training day, three sets of 10 repetitions were performed with a 3-minute rest period between the sets for each side. The range of motion trained was 60° (ranging from 80° to 20°). The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was used to evaluate functional status and symptoms of the upper limbs. Peak torque, total work and acceleration time were measured during concentric and eccentric abduction of the arm at 60º/s and 180º/s using an isokinetic dynamometer. DASH scores, peak torque, total work and acceleration time improved (pshoulder abductors improves physical function of the upper limbs in subjects with SIS.

  13. Delayed onset of electromyographic activity of vastus medialis obliquus relative to vastus lateralis in subjects with patellofemoral pain syndrome.

    Science.gov (United States)

    Cowan, S M; Bennell, K L; Hodges, P W; Crossley, K M; McConnell, J

    2001-02-01

    To determine whether electromyographic (EMG) onsets of vastus medialis obliquus (VMO) and vastus lateralis (VL) are altered in the presence of patellofemoral pain syndrome (PFPS) during the functional task of stair stepping. Cross-sectional. University laboratory. Thirty-three subjects with PFPS and 33 asymptomatic controls. Subjects ascended and descended a set of stairs-2 steps, each 20-cm high-at usual stair-stepping pace. EMG readings of VMO and VL taken on middle stair during step up (concentric contraction) and step down (eccentric contraction). Relative difference in onset of surface EMG activity of VMO compared with VL during a stair-stepping task. EMG onsets were determined by using a computer algorithm and were verified visually. In the PFPS population, the EMG onset of VL occurred before that of VMO in both the step up and step down phases of the stair-stepping task (p EMG activity of VMO and VL in either phase of the task for the control subjects. This finding supports the hypothesized relationship between changes in the timing of activity of the vastimuscles and PFPS. This finding provides theoretical rationale to support physiotherapy treatment commonly used in the management of PFPS.

  14. Subjects for achievement of blast furnace operation with low reducing agent rate

    Energy Technology Data Exchange (ETDEWEB)

    Ujisawa, Y.; Nakano, K.; Matsukura, Y.; Sunahara, K.; Komatsu, S.; Yamamoto, T. [Sumitomo Metal Industry Ltd., Kashima (Japan). Corp R& amp; D Labs.

    2006-12-15

    The technology which reduces the reducing agent rate by the improvement in the reaction efficiency of blast furnace leads to reduction of hot metal manufacturing cost, but also solution of recent CO{sub 2} emission reduction. The subjects for achievement of the blast furnace operation with low reducing agent rate were described on reduction measures of the carbon consumption and problem of the measures referring to the example of reducing agent rate of the present state blast furnace concerning blast operation and reactive improvement. And, carried out concrete measures were introduced in order to aim at the low reducing agent rate operation. The following results were obtained. 1) Since it has reached the already high reaction efficiency in present state blast furnace, it is not easy to attempt further reduction of the reducing agent rate. 2) The blast furnace use of high reactivity coke or reduced iron is equal level or over it in comparison with the reduction effect by the assumed blast operation in this paper. 3) The promotion of coke reaction load with the gasification is worried, when it aims at the low reducing agent rate operation by the high reactivity coke use. 4) It is estimated that the threshold also exists for the reducibility of competing ore, when it aims at the low reducing agent rate operation using the high reactivity coke. 5) The use of the low SiO{sub 2} sinter is effective for the improvement on the permeability in the blast furnace, when it aims at the low fuel rate operation. However, the new technology of the permeability improvement is desired, since there is a limit for low SiO{sub 2} of the sintered ore, when future raw material supply and demand is considered.

  15. Bony deviations revealed by cone beam computed tomography of the temporomandibular joint in subjects without ongoing pain.

    Science.gov (United States)

    Bakke, Merete; Petersson, Arne; Wiesel, Mie; Svanholt, Palle; Sonnesen, Liselotte

    2014-01-01

    To assess the prevalence of temporomandibular joint (TMJ) bony changes in cone beam computed tomography (CBCT) images of adult subjects without ongoing orofacial pain or complaints from the TMJ. The study included 84 TMJs from 28 men and 14 women (mean age [± SD]: 51 ± 11 years) without orofacial pain or TMJ complaints who were participants in a study of patients with obstructive sleep apnea. They were examined before any treatment with the Research Diagnostic Criteria for Temporomandibular Disorders and with CBCT (NewTom VGi; 15 × 15 cm, exposure time 18 seconds, axial thickness 0.3 mm). Osseous TMJ deviations were assessed blindly and classified. Degenerative changes were noted in the CBCT images of 33 (39.3%) of the TMJs, of which 21 were classified as osteoarthritic alterations and 12 as indeterminate changes of osteoarthritis. Two TMJs were clinically classified as osteoarthrosis and 6 as disc displacement with reduction. The CBCT images of the 2 TMJs with a clinical diagnosis of osteoarthrosis showed also bony changes, but the CBCT images also revealed osteoarthritic bony changes in the 18 TMJs without any clinical diagnosis. CBCT images of asymptomatic adult TMJs commonly show degenerative bony alterations. Accordingly, such radiographic findings should be used with care and only as a supplement to clinical assessment.

  16. Electromyographic activity of the shoulder muscles during rehabilitation exercises in subjects with and without subacromial pain syndrome: a systematic review.

    Science.gov (United States)

    Kinsella, Rita; Pizzari, Tania

    2017-04-01

    Subacromial pain syndrome (SPS) is a common cause of shoulder pain and muscle activity deficits are postulated to contribute to the development and progression of the disorder. The purpose of this systematic review was to definitively determine whether evidence exists of differences in electromyography (EMG) characteristics between subjects with and without SPS. Six key databases were searched: MEDLINE, EMBASE, CINAHL, SPORTdiscus, PEDro and The Cochrane Library (inception to May 2016). The search yielded 1414 records using terms relating to shoulder impingement, EMG, scapular and rotator cuff muscles. Twenty-two papers remained once duplicates were removed and selection criteria applied. Data extraction, quality assessment and data synthesis were performed. Effect sizes and 95% confidence intervals were calculated. There was limited evidence that serratus anterior has lower amplitude, delayed activation and earlier termination in SPS participants. For the majority of muscles, regardless of task, load or arm position, significant differences were not demonstrated or results were contradictory. The understanding of SPS is changing and EMG appears unable to capture the complexities associated with this condition. Addressing aberrant movement patterns and facilitating balanced activation of all shoulder muscles may be a more appropriate treatment direction for the future.

  17. Substances used and prevalence rates of pharmacological cognitive enhancement among healthy subjects.

    Science.gov (United States)

    Franke, Andreas G; Bagusat, Christiana; Rust, Sebastian; Engel, Alice; Lieb, Klaus

    2014-11-01

    Pharmacological "cognitive enhancement" (CE) is defined as the use of any psychoactive drug with the purpose of enhancing cognition, e.g. regarding attention, concentration or memory by healthy subjects. Substances commonly used as CE drugs can be categorized into three groups of drugs: (1) over-the-counter (OTC) drugs such as coffee, caffeinated drinks/energy drinks, caffeine tablets or Ginkgo biloba; (2) drugs being approved for the treatment of certain disorders and being misused for CE: drugs to treat attention-deficit/hyperactivity disorder (ADHD) such as the stimulants methylphenidate (MPH, e.g. Ritalin(®)) or amphetamines (AMPH, e.g. Attentin(®) or Adderall(®)), to treat sleep disorders such as modafinil or to treat Alzheimer's disease such as acetylcholinesterase inhibitors; (3) illicit drugs such as illicit AMPH, e.g. "speed", ecstasy, methamphetamine (crystal meth) or others. Evidence from randomized placebo-controlled trials shows that the abovementioned substances have limited pro-cognitive effects as demonstrated, e.g. regarding increased attention, increased cognitive speed or shortening of reaction times, but on the same time poses considerable safety risks on the consumers. Prevalence rates for the use of CE drugs among healthy subjects show a broad range from less than 1 % up to more than 20 %. The range in prevalence rates estimates results from several factors which are chosen differently in the available survey studies: type of subjects (students, pupils, special professions, etc.), degree of anonymity in the survey (online, face-to-face, etc.), definition of CE and substances used/misused for CE, which are assessed (OTC drugs, prescription, illicit drugs) as well as time periods of use (e.g. ever, during the past year/month/week, etc.). A clear and comprehensive picture of the drugs used for CE by healthy subjects and their adverse events and safety risks as well as comprehensive and comparable international data on the prevalence rates of

  18. Effects of caffeine on alcohol reinforcement: beverage choice, self-administration, and subjective ratings.

    Science.gov (United States)

    Sweeney, Mary M; Meredith, Steven E; Evatt, Daniel P; Griffiths, Roland R

    2017-03-01

    Combining alcohol and caffeine is associated with increased alcohol consumption, but no prospective experimental studies have examined whether added caffeine increases alcohol consumption. This study examined how caffeine alters alcohol self-administration and subjective reinforcing effects in healthy adults. Thirty-one participants completed six double-blind alcohol self-administration sessions: three sessions with alcohol only (e.g., beverage A) and three sessions with alcohol and caffeine (e.g., beverage B). Participants chose which beverage to consume on a subsequent session (e.g., beverage A or B). The effects of caffeine on overall beverage choice, number of self-administered drinks, subjective ratings (e.g., Biphasic Alcohol Effects Scale), and psychomotor performance were examined. A majority of participants (65%) chose to drink the alcohol beverage containing caffeine on their final self-administration session. Caffeine did not increase the number of self-administered drinks. Caffeine significantly increased stimulant effects, decreased sedative effects, and attenuated decreases in psychomotor performance attributable to alcohol. Relative to nonchoosers, caffeine choosers reported overall lower stimulant ratings and reported greater drinking behavior prior to the study. Although caffeine did not increase the number of self-administered drinks, most participants chose the alcohol beverage containing caffeine. Given the differences in subjective ratings and pre-existing differences in self-reported alcohol consumption for caffeine choosers and nonchoosers, these data suggest that decreased stimulant effects of alcohol and heavier self-reported drinking may predict subsequent choice of combined caffeine and alcohol beverages. These predictors may identify individuals who would benefit from efforts to reduce risk behaviors associated with combining alcohol and caffeine.

  19. Suboccipital decompression enhances heart rate variability indices of cardiac control in healthy subjects.

    Science.gov (United States)

    Giles, Paul D; Hensel, Kendi L; Pacchia, Christina F; Smith, Michael L

    2013-02-01

    Osteopathic manipulative treatment (OMT) focused on the upper cervical spine is theorized to affect the function of the vagus nerve and thereby influence the parasympathetic branch of the autonomic nervous system. This study was designed to determine the acute effect of upper cervical spine manipulation on cardiac autonomic control as measured by heart rate variability. Nineteen healthy, young adult subjects underwent three different experimental interventions administered in random order: cervical OMT, sham manipulation, and time control. Six minutes of electrocardiographic data were collected before and after each intervention, and heart rate variability was assessed by both time-domain and frequency-domain measures. No differences in resting heart rate or any measure of heart rate variability were observed between the baseline periods prior to each intervention. The OMT protocol resulted in an increase in the standard deviation of the normal-to-normal intervals (0.12±0.082 seconds, p0.11 for all variables). These data support the hypothesis that upper cervical spine manipulation can acutely affect measures of heart rate variability in healthy individuals.

  20. Suboccipital Decompression Enhances Heart Rate Variability Indices of Cardiac Control in Healthy Subjects

    Science.gov (United States)

    Giles, Paul D.; Hensel, Kendi L.; Pacchia, Christina F.

    2013-01-01

    Abstract Objectives Osteopathic manipulative treatment (OMT) focused on the upper cervical spine is theorized to affect the function of the vagus nerve and thereby influence the parasympathetic branch of the autonomic nervous system. This study was designed to determine the acute effect of upper cervical spine manipulation on cardiac autonomic control as measured by heart rate variability. Design Nineteen healthy, young adult subjects underwent three different experimental interventions administered in random order: cervical OMT, sham manipulation, and time control. Six minutes of electrocardiographic data were collected before and after each intervention, and heart rate variability was assessed by both time-domain and frequency-domain measures. Results No differences in resting heart rate or any measure of heart rate variability were observed between the baseline periods prior to each intervention. The OMT protocol resulted in an increase in the standard deviation of the normal-to-normal intervals (0.12±0.082 seconds, p0.11 for all variables). Conclusions These data support the hypothesis that upper cervical spine manipulation can acutely affect measures of heart rate variability in healthy individuals. PMID:22994907

  1. Lumbar spine stability for subjects with and without low back pain during one-leg standing test.

    Science.gov (United States)

    Sung, Paul S; Yoon, BumChul; Lee, Dongchul C

    2010-07-15

    An experimental design comparing kinematic changes in the lumbar spine axis in subjects with and without low back pain (LBP) while standing on one leg with and without visual feedback. The purpose of this study was to evaluate the lumbar stability index, which includes relative holding time (RHT) and relative standstill time (RST), in subjects with and without LBP. Even though a number of studies have evaluated postural adjustments based on kinematic changes in subjects with LBP, lumbar spine stability has not been examined for abnormal postural responses with visual feedback. All participants were asked to maintain the stork test position (standing on one leg with the contra lateral hip flexed 90 degrees) for 25 seconds. The outcome measures included RHT and RST for the axes of the core spine and lumbar spine. Independent t tests were used to compare the differences between groups. Two-way repeated measure analysis of variance was used to compare the differences for both axes. The age variable was used as a covariate to control confounding effects for the data analyses. The RHT was longer for the lumbar spine axis in subjects without LBP than those with LBP, especially without visual feedback. There was also significant interaction in RST between subjects with and without LBP (F = 7.18, P = 0.01). For the core axis of the trunk, significant differences existed based on the main effect of side (F = 9.07, P = 0.004), trunk rotation (F = 24.30, P = 0.001), and both of these interactions (F = 8.93, P = 0.004). However, there was a lack of significant interaction with age for the lumbar and core spine axes (F = 0.06, P = 0.81). Although the control group included slightly younger volunteers compared with the LBP group, the stability index of the core spine significantly decreased in RHT and RST, especially when visual feedback was blocked for subjects with LBP. The interaction between visual feedback and trunk rotation indicated that core spine stability is critical in

  2. A kinematic and kinetic analysis of spinal region in subjects with and without recurrent low back pain during one leg standing.

    Science.gov (United States)

    Sung, Paul S; Leininger, Peter M

    2015-08-01

    The purpose of this study was to evaluate the relationship between normalized kinematic and kinetic stability indices for spinal regions with eyes-open and eyes-closed conditions during non-dominant leg standing between subjects with recurrent low back pain and control subjects. The kinematic stability index for the spinal regions (core spine model, lumbar spine, lower and upper thorax) and the kinetic stability index from force plate were measured. All participants were asked to maintain non-dominant leg standing with the dominant hip and knee flexed approximately 90 degrees for 25 seconds. Forty-two participants enrolled in the study, including 22 subjects with low back pain (12 male, 10 female) and 20 control subjects (12 male, 8 female). For the kinematic index for stability, the visual condition (F=30.06, p=0.0001) and spinal region (F=10.82, p=0.002) were statistically significant. The post hoc test results indicated a significant difference in the lumbar spine compared with the upper and lower thorax and the core spine model. The kinetic stability (average [standard deviation]) during the eyes-closed condition significantly decreased in the low back pain group (t=-3.24, p=0.002). The subjects with recurrent low back pain demonstrated higher lumbar spine stability in eyes-open condition. This higher stability of the lumbar spine might be due to a possible pain avoiding strategy from the standing limb. The low back pain group also significantly decreased kinetic stability during the eyes-closed condition. Clinicians need to consider both kinetic and kinematic indices while considering visual condition for lumbar spine stability in subjects with recurrent low back pain. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. The validity of self-rating depression scales in patients with chronic widespread pain

    DEFF Research Database (Denmark)

    Amris, K; Omerovic, E; Danneskiold-Samsøe, B

    2016-01-01

    and further aspects of validity, including fit of individual scale items to a unidimensional model indicating assessment of a single construct (depression), as a prerequisite for measurement. RESULTS: The Rasch analysis revealed substantial problems with the rating scale properties of the MDI and lack......BACKGROUND: Assessment of depression in chronic pain patients by self-rating questionnaires developed and validated for use in normal and/or psychiatric populations is common. The aim of this study was to evaluate the psychometric properties of the Major Depression Inventory (MDI) in a sample...... of unidimensionality. In contrast to somatic items, MDI items related to depressed mood and negative view of oneself were distributed at the higher end of the item difficulty measurement scale, indicating low endorsement of these items. DISCUSSION: From the perspective of the Rasch measurement model, the MDI...

  4. Sequential and base rate analysis of emotional validation and invalidation in chronic pain couples: patient gender matters.

    Science.gov (United States)

    Leong, Laura E M; Cano, Annmarie; Johansen, Ayna B

    2011-11-01

    The purpose of this study was to examine the extent to which communication patterns that foster or hinder intimacy and emotion regulation in couples were related to pain, marital satisfaction, and depression in 78 chronic pain couples attempting to problem-solve an area of disagreement in their marriage. Sequences and base rates of validation and invalidation communication patterns were almost uniformly unrelated to adjustment variables unless patient gender was taken into account. Male patient couples' reciprocal invalidation was related to worse pain, but this was not found in female patient couples. In addition, spouses' validation was related to poorer patient pain and marital satisfaction, but only in couples with a male patient. It was not only the presence or absence of invalidation and validation that mattered (base rates), but the context and timing of these events (sequences) that affected patients' adjustment. This research demonstrates that sequences of interaction behaviors that foster and hinder emotion regulation should be attended to when assessing and treating pain patients and their spouses. This article presents analyses of both sequences and base rates of chronic pain couples' communication patterns, focusing on validation and invalidation. These results may potentially improve psychosocial treatments for these couples, by addressing sequential interactions of intimacy and empathy. Copyright © 2011 American Pain Society. Published by Elsevier Inc. All rights reserved.

  5. Convection and evaporation rate of planar liquid films subjected to impulsive superheating

    Science.gov (United States)

    Kimball, J. T.; Hermanson, J. C.; Allen, J. S.

    2010-11-01

    The interfacial stability, convective structure, and evaporation rate of upward-facing, thin liquid films were studied experimentally. Four different working fluids were used. Films initially 5 mm to 100 μm thick were subjected to impulsive superheating. The films resided on a temperature controlled, gold-plated copper surface in a closed, initially degassed test chamber. Superheating was achieved by suddenly dropping the pressure of the saturated pure vapor in the test chamber. The dynamic film thickness was measured at multiple points using ultrasound, and instability wavelength and convective structure information was obtained by schlieren imaging. Considering previous quasi-steady results, the observed convection patterns in many cases suggest an initial, limited penetration of the convection structures into the film. The initial convection patterns and measured evaporation rate in these films are independent of the thermal boundary condition of the substrate. After a sufficiently long time, the convection pattern changes and approaches the previously observed quasi-steady condition.

  6. Biotic patterns of heart rate variation in depressed and psychotic subjects.

    Science.gov (United States)

    Sabelli, H; Messer, J; Kovacevic, L; Walthall, K

    2011-01-01

    This article presents novel quantitative methods to study R to R interval (RRI) series that identify their characteristic pattern of organization, Bios, and their variation in psychiatric illness. In this study twenty-four hour series of RRI were extracted from Holter recordings of healthy subjects (N = 74) and small groups of patients with affective depression or psychosis. These data were analyzed with recurrence and statistical methods. In all subjects, RRI series showed complexes (clusters of recurrences), such as those observed with mathematically-generated biotic series but not in chaotic or random series. RRI series from healthy persons showed diversification (increase in variance with the duration of the series analyzed), novelty (less recurrence isometry than copies randomized by shuffling), causal order (more consecutive isometry than shuffled copies), and asymmetric statistical distribution. These imprints of creative processes are characteristic of mathematical Bios, and are absent in chaos. Bios can be distinguished from random walk series by the nonrandom pattern of the series of differences between heartbeats, as well as by measures of consecutive isometry and of partial autocorrelation. These defining characteristics of Bios are significant signs of health. In comparison with healthy controls, psychiatric patient groups showed more isometry and more consecutive isometry than healthy subjects. Psychiatric patients also showed no diversification. This study highlights the process that produces heart rate variation as being non-stationary and creative (bios, not equilibrium or chaos) and causal (not stochastically generated by the coexistence of multiple factors). These results thus are significant regarding psychiatric health.

  7. A new rate-dependent unidirectional composite model - Application to panels subjected to underwater blast

    Science.gov (United States)

    Wei, Xiaoding; de Vaucorbeil, Alban; Tran, Phuong; Espinosa, Horacio D.

    2013-06-01

    In this study, we developed a finite element fluid-structure interaction model to understand the deformation and failure mechanisms of both monolithic and sandwich composite panels. A new failure criterion that includes strain-rate effects was formulated and implemented to simulate different damage modes in unidirectional glass fiber/matrix composites. The laminate model uses Hashin's fiber failure criterion and a modified Tsai-Wu matrix failure criterion. The composite moduli are degraded using five damage variables, which are updated in the post-failure regime by means of a linear softening law governed by an energy release criterion. A key feature in the formulation is the distinction between fiber rupture and pull-out by introducing a modified fracture toughness, which varies from a fiber tensile toughness to a matrix tensile toughness as a function of the ratio of longitudinal normal stress to effective shear stress. The delamination between laminas is modeled by a strain-rate sensitive cohesive law. In the case of sandwich panels, core compaction is modeled by a crushable foam plasticity model with volumetric hardening and strain-rate sensitivity. These constitutive descriptions were used to predict deformation histories, fiber/matrix damage patterns, and inter-lamina delamination, for both monolithic and sandwich composite panels subjected to underwater blast. The numerical predictions were compared with experimental observations. We demonstrate that the new rate dependent composite damage model captures the spatial distribution and magnitude of damage significantly more accurately than previously developed models.

  8. Estimation of Circadian Body Temperature Rhythm Based on Heart Rate in Healthy, Ambulatory Subjects.

    Science.gov (United States)

    Sim, Soo Young; Joo, Kwang Min; Kim, Han Byul; Jang, Seungjin; Kim, Beomoh; Hong, Seungbum; Kim, Sungwan; Park, Kwang Suk

    2017-03-01

    Core body temperature is a reliable marker for circadian rhythm. As characteristics of the circadian body temperature rhythm change during diverse health problems, such as sleep disorder and depression, body temperature monitoring is often used in clinical diagnosis and treatment. However, the use of current thermometers in circadian rhythm monitoring is impractical in daily life. As heart rate is a physiological signal relevant to thermoregulation, we investigated the feasibility of heart rate monitoring in estimating circadian body temperature rhythm. Various heart rate parameters and core body temperature were simultaneously acquired in 21 healthy, ambulatory subjects during their routine life. The performance of regression analysis and the extended Kalman filter on daily body temperature and circadian indicator (mesor, amplitude, and acrophase) estimation were evaluated. For daily body temperature estimation, mean R-R interval (RRI), mean heart rate (MHR), or normalized MHR provided a mean root mean square error of approximately 0.40 °C in both techniques. The mesor estimation regression analysis showed better performance than the extended Kalman filter. However, the extended Kalman filter, combined with RRI or MHR, provided better accuracy in terms of amplitude and acrophase estimation. We suggest that this noninvasive and convenient method for estimating the circadian body temperature rhythm could reduce discomfort during body temperature monitoring in daily life. This, in turn, could facilitate more clinical studies based on circadian body temperature rhythm.

  9. Managed care and patient ratings of the quality of specialty care among patients with pain or depressive symptoms

    Directory of Open Access Journals (Sweden)

    Diehr Paula

    2007-02-01

    Full Text Available Abstract Background Managed care efforts to regulate access to specialists and reduce costs may lower quality of care. Few studies have examined whether managed care is associated with patient perceptions of the quality of care provided by physician and non-physician specialists. Aim is to determine whether associations exist between managed care controls and patient ratings of the quality of specialty care among primary care patients with pain and depressive symptoms who received specialty care for those conditions. Methods A prospective cohort study design was conducted in the offices of 261 primary physicians in private practice in Seattle in 1997. Patients (N = 17,187 were screened in waiting rooms, yielding a sample of 1,514 patients with pain only, 575 patients with depressive symptoms only, and 761 patients with pain and depressive symptoms. Patients (n = 1,995 completed a 6-month follow-up survey. Of these, 691 patients received specialty care for pain, and 356 patients saw mental health specialists. For each patient, managed care was measured by the intensity of managed care controls in the patient's health plan and primary care office. Quality of specialty care at follow-up was measured by patient rating of care provided by the specialists. Outcomes were pain interference and bothersomeness, Symptom Checklist for Depression, and restricted activity days. Results The intensity of managed care controls in health plans and primary care offices was generally not associated with patient ratings of the quality of specialty care. However, pain patients in more-managed primary care offices had lower ratings of the quality of specialty care from physician specialists and ancillary providers. Conclusion For primary care patients with pain or depressive symptoms and who see specialists, managed care controls may influence ratings of specialty care for patients with pain but not patients with depressive symptoms.

  10. Metabolic clearance rate and blood production rate of testosterone and dihydrotestosterone in normal subjects, during pregnancy, and in hyperthyroidism

    Science.gov (United States)

    Saez, J. M.; Forest, M. G.; Morera, A. M.; Bertrand, J.

    1972-01-01

    The metabolic clearance rate (MCR) and blood production rate (BP) of testosterone (T) and dihydrotestosterone (DHT), the conversion of plasma testosterone to plasma dihydrotestosterone, and the renal clearance of androstenedione, testosterone, and dihydrotestosterone have been studied in man. In eight normal men, the MCRT (516±108 [SD] liters/m2/day) was significantly greater than the MCRDHT (391±71 [SD] liters/m2/day). In seven females, the MCRT (304±53 [SD] liters/m2/day) was also greater than the MCRDHT (209±45 [SD] liters/m2/day) and both values were less than their respective values in men (P hyperthyroidism, the MCR for testosterone and dihydrotestosterone were similar to those observed in pregnant females, but the conversion of testosterone into dihydrotestosterone (2.78±1.7%) (SD) was greater, and similar to that found in men. In men the production of dihydrotestosterone was 0.39±0.1 (SD) mg/day, 50% being derived from the transformation of plasma testosterone. In women the production of DHT was 0.05±0.028 (SD) mg/day, only 10% coming from testosterone. During pregnancy, the production of testosterone and dihydrotestosterone are similar to that in normal women. In three patients with testicular feminization syndrome (an adult with hyperthyroidism and two children) these two MCRs were greatly reduced compared to the normal females, but the conversion of testosterone into dihydrotestosterone was in the limits of normal male range In the normal subjects the renal clearance of androstenedione was greater than that of testosterone and dihydrotestosterone. Less than 20% of the dihydrotestosterone and less than 10% of the androstenedione in the urine is derived from the plasma dihydrotestosterone and androstenedione. PMID:5020435

  11. Vitamin B12 supplementation improves heart rate variability in healthy elderly Indian subjects.

    Science.gov (United States)

    Sucharita, S; Thomas, T; Antony, B; Vaz, M

    2012-05-21

    While vitamin B(12) deficiency is global, data in elderly Indians are lacking. The problem in India is likely to be higher because of vegetarianism and malabsorption related to gastro-intestinal parasites. Autonomic dysfunction is known to occur much earlier in pernicious anemia. However, what is not known is whether these changes are reflected in healthy elderly individuals. This study assessed cardiac sympathetic and parasympathetic activity using heart rate variability (HRV) in healthy elderly individuals of low and high vitamin B(12) status and evaluated the effect of vitamin B(12) supplementation in those with low vitamin B(12) status. 140 elderly subjects aged ≥60 years were screened; 47 healthy subjects were assessed. They underwent blood sampling, anthropometry, HRV and nerve conduction assessment. Subjects were classified based on vitamin B(12) level (148 pmol/L) into deplete vitamin B(12) and replete vitamin B(12) groups. Elderly subjects with low vitamin B(12) status underwent cyanocobalamin supplementation (100 μg) for 3 months. Low frequency (LF) HRV in absolute units was significantly lower in the low vitamin B(12) group. Following supplementation, LF HRV in absolute units and total power rose significantly as compared to pre-supplementation values for the entire supplemented group. In conclusion, elderly with lower vitamin B(12) status have reduced low frequency HRV suggestive of sympathetic involvement. Supplementation with vitamin B(12) for 3 months results in a significant increase in low frequency HRV to values comparable with unsupplemented, but vitamin B(12) replete elderly. Copyright © 2012 Elsevier B.V. All rights reserved.

  12. EFFECTS OF KINESIOTAPING ALONG WITH QUADRICEPS STRENGTHENING EXERCISES ON PAIN, JOINT RANGE OF MOTION AND FUNCTIONAL ACTIVITIES OF KNEE IN SUBJECTS WITH PATELLOFEMORAL OSTEOARTHRITIS

    Directory of Open Access Journals (Sweden)

    M. Harshitha

    2014-08-01

    Full Text Available Background: Patello femoral Osteoarthritis is the most common degenerative disease in older age group, causing pain, physical disability, and decreased quality of life.As many treatment options available, kinesiotaping is an efficacious treatment for management of pain & disability in patellofemoral joint osteoarthritis. Previous studies have shown that kinesiotaping as well as quadriceps strengthening significantly yields functional benefits. But there is lack of evidence revealing combined effectiveness & effects of kinesiotaping along with quadriceps strengthening in subjects with patellofemoral joint osteoarthritis. Methods: 30 subjects with symptoms of patellofemoral osteoarthritis fulfilled the inclusion criteria were randomly assigned into 2 groups of 15 in each group. Taping along with quadriceps strengthening program is compared to the quadriceps strengthening program alone. Pain were measured by Visual Analogue Scale (VAS, knee ROM were measured by Goniometer, Functional status were measured by Western Ontario McMaster Universities index (WOMAC, score. Measurements were taken pre & post intervention. Results: The results indicated that kinesiotaping along with quadriceps strengthening exercises showed there was statistically significant improvement in pain (<0.05, knee ROM (<0.05 and functional activities (<0.05 after 6 weeks compared to quadriceps strengthening alone. Conclusion: Subjects with kinesiotaping along with quadriceps strengthening showed significant improvement in reducing pain, in improving ROM & functional activities at the end of 6th week treatment when compared to subjects with patellofemoral osteoarthritis underwent quadriceps strengthening exercises alone.

  13. Masticatory and cervical muscle tenderness and pain sensitivity in a remote area in subjects with a temporomandibular disorder and neck disability.

    Science.gov (United States)

    Silveira, Anelise; Armijo-Olivo, Susan; Gadotti, Inae C; Magee, David

    2014-01-01

    To compare the masticatory and cervical muscle tenderness and pain sensitivity in the hand (remote region) between patients with temporomandibular disorders (TMD) and healthy controls. Twenty female subjects were diagnosed with chronic TMD, and 20 were considered healthy. Subjects completed the Neck Disability Index and Limitations of Daily Functions in a TMD questionnaire. Tenderness of the masticatory and cervical muscles and pain sensitivity in the hand were measured using an algometer. Three-way mixed analysis of variance (ANOVA) evaluated differences in muscle tenderness between groups. One-way ANOVA compared pain sensitivity in the hand between groups. Effect sizes were assessed using Cohen guidelines. Significantly increased masticatory and cervical muscle tenderness and pain sensitivity in the hand were found in subjects with TMD when compared with healthy subjects. Moderate to high effect sizes showed the clinical relevance of the findings. The results of this study have highlighted the importance of assessing TMD patients not only in the craniofacial region but also in the neck and other parts of the body. Future studies should focus on testing the effectiveness of treatments addressing the neck and the pain sensitivity in the hand in patients with TMD.

  14. Discrepancy between self- and proxy-rated pain in Alzheimer's disease: results from the danish Alzheimer intervention study

    DEFF Research Database (Denmark)

    Jensen-Dahm, C.; Vogel, A.; Waldorff, F.B.

    2012-01-01

    OBJECTIVES: To investigate the prevalence of self- and proxy-reported pain in a cohort with Alzheimer's disease (AD) and to identify characteristics of individuals with AD reporting pain. DESIGN: Data were collected at the baseline visit of the Danish Alzheimer Intervention Study. SETTING......: Community. PARTICIPANTS: Three hundred twenty-one community-living individuals with AD (MMSE >/= 20) and their primary caregivers. MEASUREMENTS: Pain was assessed as part of the EuroQol EQ-5D (caregiver- and self-rated). The Cornell Scale for Depression in Dementia, Quality of Life in Alzheimer's Disease...

  15. 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.

  16. Phenomenological features of dreams: Results from dream log studies using the Subjective Experiences Rating Scale (SERS).

    Science.gov (United States)

    Kahan, Tracey L; Claudatos, Stephanie

    2016-04-01

    Self-ratings of dream experiences were obtained from 144 college women for 788 dreams, using the Subjective Experiences Rating Scale (SERS). Consistent with past studies, dreams were characterized by a greater prevalence of vision, audition, and movement than smell, touch, or taste, by both positive and negative emotion, and by a range of cognitive processes. A Principal Components Analysis of SERS ratings revealed ten subscales: four sensory, three affective, one cognitive, and two structural (events/actions, locations). Correlations (Pearson r) among subscale means showed a stronger relationship among the process-oriented features (sensory, cognitive, affective) than between the process-oriented and content-centered (structural) features--a pattern predicted from past research (e.g., Bulkeley & Kahan, 2008). Notably, cognition and positive emotion were associated with a greater number of other phenomenal features than was negative emotion; these findings are consistent with studies of the qualitative features of waking autobiographical memory (e.g., Fredrickson, 2001). Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Assertive Communication in Condom Negotiation: Insights From Late Adolescent Couples' Subjective Ratings of Self and Partner.

    Science.gov (United States)

    Schmid, Amy; Leonard, Noelle R; Ritchie, Amanda S; Gwadz, Marya V

    2015-07-01

    Assertive communication has been associated with higher levels of condom use among youth using self-report survey methodology. The purpose of this study was to examine the subjective ratings of assertiveness among young, romantically involved couples in the context of a condom negotiation task. Using an innovative video-recall procedure, 32 couples (64 youth) engaged in a videotaped condom negotiation task and then rated self and partners' level of assertiveness. Both individual ratings of assertiveness and couple-level assertiveness were assessed using dyadic hierarchical linear modeling. Individuals' assertiveness was positively associated with condom use. Unexpectedly, the overall level of assertiveness in couples showed a curvilinear association with condom use. Very high and very low assertiveness was associated with lower condom use, whereas moderate levels of assertiveness were associated with higher condom use. Moderate levels of assertiveness during condom negotiation may facilitate condom use in young couples. Increasing condom use among romantic partners may require developing interventions that strengthen youths' ability to engage in assertive communication strategies that balance emotional intimacy with self-advocacy. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  18. 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

  19. Disturbed body perception, reduced sleep, and kinesiophobia in subjects with pregnancy-related persistent lumbopelvic pain and moderate levels of disability: An exploratory study.

    Science.gov (United States)

    Beales, Darren; Lutz, Alison; Thompson, Judith; Wand, Benedict Martin; O'Sullivan, Peter

    2016-02-01

    For a small but significant group, pregnancy-related lumbopelvic pain may become persistent. While multiple factors may contribute to disability in this group, previous studies have not investigated sleep impairments, body perception or mindfulness as potential factors associated with disability post-partum. To compare women experiencing no pain post-pregnancy with those experiencing pregnancy-related persistent lumbopelvic pain (either low- or high-level disability) across multiple biopsychosocial domains. Cross-sectional. Participants completed questionnaires for thorough profiling of factors thought to be important in pregnancy-related lumbopelvic pain. Specific measures were the Urinary Distress Inventory, Medical Outcomes Study Sleep Scale, Back Beliefs Questionnaire, Tampa Scale for Kinesiophobia, Depression Anxiety Stress Scale, Coping Strategies Questionnaire, Pain Catastrophising Scale, The Fremantle Back Awareness Questionnaire and the Mindful Attention Awareness Scale. Women where categorised into three groups; pain free (n = 26), mild disability (n = 12) and moderate disability (n = 12) (based on Oswestry Disability Index scores). Non-parametric group comparisons were used to compare groups across the profiling variables. Differences were identified for kinesiophobia (p = 0.03), body perception (p = 0.02), sleep quantity (p sleep adequacy (p = 0.02). Generally subjects in the moderate disability group had more negative findings for these variables. Disturbances in body-perception, sleep and elevated kinesiophobia were found in pregnancy-related lumbopelvic pain subjects with moderate disability, factors previously linked to persistent low back pain. The cross-sectional nature of this study does not allow for identification of directional pathways between factors. The results support the consideration of these factors in the assessment and management of pregnancy-related lumbopelvic pain. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Interrater and intrarater reliability of transverse abdominal and lumbar multifidus muscle thickness in subjects with and without low back pain.

    Science.gov (United States)

    Djordjevic, Olivera; Djordjevic, Aleksandar; Konstantinovic, Ljubica

    2014-12-01

    Two-group, repeated-measures reliability study. To determine interrater and intrarater reliability of ultrasound measurements of transverse abdominal (TrA) and lumbar multifidus (LM) muscle thickness, during rest and contraction, in subjects with low back pain (LBP) and healthy subjects over 3 consecutive days, performed by an experienced and a novice rater. Previous reliability studies of TrA or LM thickness did not simultaneously account for muscle state, rater experience, and multiday assessment in large subject samples. The 2 raters measured TrA and LM thickness on 3 consecutive days in 42 healthy subjects and 56 subjects with LBP, during rest and contraction, and calculated the percent thickness change from rest to contraction. Intraclass correlation coefficients (ICC(2,k)) and 95% minimal detectable change in thickness were derived for a single measure (day 1) and an average measure (days 1-3). The interrater ICC(2,1) values for single-measure thickness (LBP group, 0.71-0.87; healthy group, 0.94-1.00) were similar to those for average-measure thickness (LBP group, 0.73-0.84; healthy group, 0.93-1.00). Both interrater ICC(2,1) and ICC(2,3) were lower for the relative thickness change (0.61-0.96). Intrarater ICC(2,1) values across 3 consecutive days were high for both raters across the 2 groups (LBP group, 0.95-1.00; healthy group, 0.93-1.00), albeit lower for the relative thickness change (0.79-0.99). The 95% minimal detectable changes were < 0.3 mm for the TrA and < 2 mm for the LM (but, in most cases, less than 10% of average thickness). Both experienced and trained novice raters provided reliable measurements of TrA and LM thickness in participants with LBP and healthy participants, during rest and contraction. One-time measurements were similar to averaged measurements. Small absolute errors were observed. Public trial registry: Australian New Zealand Clinical Trials Registry ACTRN12613001077752.

  1. Analysis of relative kinematic index with normalized standing time between subjects with and without recurrent low back pain.

    Science.gov (United States)

    Sung, Paul S; Danial, Pamela

    2017-02-01

    Although subjects with recurrent low back pain (LBP) demonstrate altered postural control, their postural steadiness during one leg standing is unknown. The purpose of this study was to investigate postural steadiness based on relative kinematic index of the lower limbs and trunk with normalized standing time in subjects with recurrent LBP during dominant and non-dominant leg standing. Sixty individuals participated in the study, including 29 subjects in the control group (18 male, 11 female) and 31 subjects with recurrent LBP (21 male, 10 female). The outcome measures included relative kinematic index of the body regions and normalized standing time during the one leg standing test. The relative kinematic index was the ratio between standstill time and successful standing time. The normalized standing time was defined as a ratio between the successful standing time and the requested standing time. The control group demonstrated significantly longer normalized standing time on the dominant (t = -2.57, p = 0.013) and non-dominant (t = -2.78, p = 0.007) legs than the LBP group. The relative kinematic index of the core spine model significantly decreased for the dominant (t = -3.01, p = 0.004) and non-dominant (t = -3.06, p = 0.003) legs in the LBP group. In addition, the kinematic index indicated pelvis and non-dominant shank during dominant leg standing (R 2 = 0.97) in the LBP group. In the control group, the pelvis was significantly correlated with the core spine model during standing on the dominant (R 2 = 0.95) and non-dominant (R 2 = 0.97) legs. The relative kinematic index of the pelvis was found to be most significant for longer standing durations in both groups. In the LBP group, the shank and foot were significantly higher in addition to the pelvis due to possible compensatory motion. The control group took advantage of pelvic control with the core spine to minimize lower limb movements. Clinicians need to consider the core spine for

  2. Subjective sleep quality in relation to inhibition and heart rate variability in patients with panic disorder.

    Science.gov (United States)

    Hovland, Anders; Pallesen, Ståle; Hammar, Asa; Hansen, Anita Lill; Thayer, Julian F; Sivertsen, Børge; Tarvainen, Mika P; Nordhus, Inger Hilde

    2013-08-15

    Patients with panic disorder (PD) are known to report impaired sleep quality and symptoms of insomnia. PD is an anxiety disorder characterised by deficient physiological regulation as measured by heart rate variability (HRV), and reduced HRV, PD and insomnia have all been related to impaired inhibitory ability. The present study aimed to investigate the interrelationships between subjectively reported sleep impairment, cognitive inhibition and vagally mediated HRV in a sample characterised by variability on measures of all these constructs. Thirty-six patients with PD with or without agoraphobia were included. Cognitive inhibition was assessed with the Color-Word Interference Test from the Delis-Kaplan Executive Function System (D-KEFS), HRV was measured using high frequency (HF) power (ms(2)), and subjectively reported sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). Cognitive inhibition was related to both Sleep latency and Sleep disturbances, whereas HRV was only related to Sleep disturbances. These relationships were significant also after controlling for depression. Correlational design. Cognitive inhibition is related to key insomnia symptoms: sleep initiation and sleep maintenance. The data supports the psychobiological inhibition model of insomnia, and extends previous findings. Possible clinical implications of these findings are discussed. Copyright © 2013 Elsevier B.V. All rights reserved.

  3. 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.

  4. Comparative Study Between the Effect of Myofascial Release Using M2T Blade and Kinesiotape on Recreational Badminton Shoulder Pain Subjects: A Randomised Clinical Trial

    Directory of Open Access Journals (Sweden)

    Varun Naik

    2017-05-01

    Full Text Available Background: Shoulder pain is one of the most common conditions seen in recreational badminton players. It is caused due to repeated movements at the shoulder joint which further limits the range of motion and hence hampers the activities of daily living. M2T helps to release the myofascial tightness which causes the pain. Kinesiotape also helps in increasing the range of motion. Patients and Methods: Thirty recreational shoulder pain subjects were assessed and treated between the age group of 18-30 years at the KLE University’s Indoor Stadium, Jawaharlal Nehru Medical College, Belagavi, Karnataka, India. Methods: The recreational shoulder pain subjects were divided into Group “A” and Group “B” by Randomized clinical trial. Outcome measures used were the visual analogue scale (VAS for pain and the Disability of Arm, Hand, and Shoulder (DASH. VAS and DASH were assessed pre-treatment and post-treatment. Results: Inter-group comparison for both the groups had differences but showed no statistical significance. Hence based on results it can be concluded that both the treatment techniques are effective in reducing pain and increasing ability at the shoulder joint.

  5. Evaluation of Internal Echogenic Pattern of Masseter in Subjects with Myofascial Pain/ Myositis, Oral Submucous Fibrosis, Chewers, Bruxers and Healthy Individuals- A Preliminary Ultrasonographic Study.

    Science.gov (United States)

    Raghunandan Iyengar, Asha; Patil, Seema; Guddannanavar Karibasappa, Ganga; Beloor Vasudev, Subash; Kumar Joshi, Revan

    2016-12-01

    The masseter is generally involved in myofascial pain, myositis, oral submucous fibrosis (OSMF), bruxism, and in subjects with habitual tobacco/arecanut chewing. In all the above conditions, changes in the internal echogenic pattern on ultrasonography of the muscle may be observed. The present study aimed at evaluating the internal echogenic pattern of masseter by ultrasonography in subjects with various conditions affecting masster muscle. The study subjects were categorized into 5 groups consisting of 20 subjects each with the following conditions; Group 1: myofascial pain or myositis, Group 2: oral submucous fibrosis (OSMF), Group 3: habitual chewing of tobacco/arecanut without OSMF, Group 4: bruxism. Group 5 consisted of 20 healthy subjects. An ultrasonographic examination of masseter was performed in all subjects and the echogenic pattern was classified into Types I, II and III. The images were examined by two observers and inter-observer variability was assessed. Differences in internal echogenic pattern between study groups and control group was evaluated using Chi- square test. A good inter observer agreement was noted (k value= 0.8). An equal distribution of Types II and III echogenic pattern was noted in myofascial pain/myositis group. Type II was predominant in subjects with OSMF, habitual tobacco/arecanut chewing and bruxism. Type I was predominant in controls. The echogenic pattern differed significantly from controls in subjects with myofascial pain/myositis and OSMF (p=0.00001*, 0.0237* respectively), whereas in subjects with habitual tobacco/ arecanut chewing and bruxism, it did not differ significantly from controls (p=0.2482, 0.1223 respectively). Ultrasonographic examination of the echogenic pattern may help in understanding the nature of the disease process affecting the masseter muscle in various conditions.

  6. Heart Rate Variability Biofeedback Stress Relief Program for Depression*. A Replicated Single-Subject Design.

    Science.gov (United States)

    Hartogs, Bregje M A; Bartels-Velthuis, Agna A; Van der Ploeg, Karen; Bos, Elske H

    2017-07-19

    Depressive disorders often have a chronic course and the efficacy of evidence-based treatments may be overestimated. To examine the effectiveness of the Heart Rate Variability Stress Reduction Program (SRP) as a supplement to standard treatment in patients with depressive disorders. The SRP was individually administered in eight weekly sessions. Seven participants completed the full protocol and were enrolled in a single-subject ABA multiple baseline experimental design. To perform interrupted time-series analyses, daily measures were completed in a diary (depression, resilience, happiness, heart coherence and a personalized outcome measure). Five out of seven patients improved in depressed mood and/or a personalized outcome measure. The effect of treatment was reversed in four patients during the withdrawal phase. One patient reliably improved on depression, whereas two patients recovered on autonomy and one on social optimism. No consistent relationship was found between the heart rate variability-related level of coherence and self-reported mood levels. The SRP is beneficial in some domains and for some patients. A prolonged treatment or continued home practice may be required for enduring effects. The intervention had more clinical impact on resilience-related outcome measures than on symptoms. The small sample size does not permit generalization of the results. We recommend future investigation of the underlying mechanisms of the SRP.

  7. Heart rate variability in normotensive subjects with family history of hypertension.

    Science.gov (United States)

    Muralikrishnan, Krishnan; Balasubramanian, Kabali; Rao, Badanidiyur Viswanatha

    2011-01-01

    Hypertension (HT) is a major silent disease affecting young people because of their hereditary and modern lifestyles. Target organ damages occur before overt hypertension is diagnosed. Many offspring of HT parents show early changes in their cardiovascular autonomic functions. Heart rate variability (HRV) provides a window to understand the cardiac autonomic balance. This study was designed to quantify and to compare the HRV among the normotensive young male offspring without history of parenteral hypertension & diabetic (control group, n = 25, age 20.8 +/- 2.4, BMI 24.4 +/- 3.1) with parenteral history of hypertension & non diabetic (study group n = 25, age 19.7 +/- 1.9, 24.05 +/- 3.5). Blood pressure, heart rate (HR), indices of short term HRV during supine rest and quiet standing, HR variation during timed controlled deep breathing was compared between the two groups. There were significant difference in low frequency (LF) power, HF power, total power. LF and HF expressed also in normalized units at rest and standing. In time domain standard deviation of normal to normal RR interval (SDNN) at supine rest and standing were significant. Respiratory sinus arrthymia (RSA), HF in normalized units, deep breathing difference (BDD) and the ratio of maximum RR to minimum RR were also significant in the control group than study group. In the present study there was an increased sympathetic and decreased parasympathetic activity in the study group. These findings are an early marker of cardiovascular autonomic impairment in subjects with parenteral history of hypertension.

  8. Nitric oxide and regulation of heart rate in patients with postural tachycardia syndrome and healthy subjects.

    Science.gov (United States)

    Gamboa, Alfredo; Okamoto, Luis E; Raj, Satish R; Diedrich, André; Shibao, Cyndya A; Robertson, David; Biaggioni, Italo

    2013-02-01

    The objective is to study the role of nitric oxide (NO) on cardiovascular regulation in healthy subjects and postural tachycardia syndrome (POTS) patients. Reduced neuronal NO function, which could contribute to a hyperadrenergic state, and increased NO-induced vasodilation, which could contribute to orthostatic intolerance, have been reported in POTS. In protocol 1, 13 healthy volunteers (33 ± 3 years) underwent autonomic blockade with trimethaphan and were administered equipressor doses of Nω-monomethyl-L-arginine (L-NMMA, a NO synthase inhibitor) and phenylephrine to determine the direct chronotropic effects of NO (independent of baroreflex modulation). In protocol 2, we compared the effects of L-NMMA in 9 POTS patients (31 ± 3 years) and 14 healthy (32 ± 2 years) volunteers, during autonomic blockade. During autonomic blockade, L-NMMA and phenylephrine produced similar increases in systolic blood pressure (27 ± 2 versus 27 ± 3 mm Hg). Phenylephrine produced only minimal heart rate changes, whereas L-NMMA produced a modest, but significant, bradycardia (-0.8 ± 0.4 versus -4.8 ± 1.2 bpm; P=0.011). There were no differences between POTS and healthy volunteers in the systolic blood pressure increase (22 ± 2 and 28 ± 5 mm Hg) or heart rate decrease (-6 ± 2 and -4 ± 1 bpm for POTS and controls, respectively) produced by L-NMMA. In the absence of baroreflex buffering, inhibition of endogenous NO synthesis results in a significant bradycardia, reflecting direct tonic modulation of heart rate by NO in healthy individuals. We found no evidence of a primary alteration in NO function in POTS. If NO dysfunction plays a role in POTS, it is through its interaction with the autonomic nervous system.

  9. Pain tolerance and pain perception in adolescents born extremely preterm.

    Science.gov (United States)

    Vederhus, Bente Johanne; Eide, Geir Egil; Natvig, Gerd Karin; Markestad, Trond; Graue, Marit; Halvorsen, Thomas

    2012-10-01

    Neonatal pain experiences have been associated with altered processing and perception of pain in later life, but findings tend to vary among studies. We have compared experimental pain tolerance and subjective health complaints in a population-based cohort of adolescents born extremely preterm to that of matched term controls. Subjects performed a standardized cold pressor task (hand in ice water) and completed validated questionnaires regarding current subjective health complaints, including pain issues. Thirty-one (89%) of 35 eligible preterm subjects (mean gestational age 26.8 weeks) and 28 (80%) term controls participated in this follow-up study at mean age 17.8 years. Ten (32%) subjects born preterm versus 17 (61%) born at term reached the ceiling time of 180 seconds immersion time in the ice water, a hazard ratio for early withdrawal of 2.05 (95% confidence interval, 1.72 to 2.44), with males explaining most of the difference. For subjects born preterm, the risk of early withdrawal decreased significantly with more days of mechanical ventilation, more pain events, and more doses of morphine during the newborn period. Subjective pain ratings during the cold pressor task as well as health-related complaints and pain issues reported in the questionnaires were similar in the preterm and term groups. Despite reduced tolerance to experimental pain, subjects born preterm scored their pain experiences similarly to those of term controls. Surprisingly, preterm subjects exposed to most painful and invasive neonatal experiences and also to most doses of morphine had a pain response at follow-up most closely resembling that of the control group. Copyright © 2012 American Pain Society. Published by Elsevier Inc. All rights reserved.

  10. fMRI of pain studies using laser-induced heat on skin with and without the loved one near the subject - a pilot study on 'love hurts'

    Science.gov (United States)

    Sofina, T.; Kamil, W. A.; Ahmad, A. H.

    2014-11-01

    The aims of this study are to image and investigate the areas of brain response to laser-induced heat pain, to analyse for any difference in the brain response when a subject is alone and when her loved one is present next to the MRI gantry. Pain stimuli was delivered using Th-YAG laser to four female subjects. Blood-Oxygenation-Level-Dependent (BOLD) fMRI experiment was performed using blocked design paradigm with five blocks of painful (P) stimuli and five blocks of non-painful (NP) stimuli arranged in pseudorandom order with an 18 seconds rest (R) between each stimulation phase. Brain images were obtained from 3T Philips Achieva MRI scanner using 32-channel SENSE head coil. A T1-weighted image (TR/TE/slice/FOV = 9ms/4ms/4mm slices/240×240mm) was obtained for verification of brain anatomical structures. An echo-planar-imaging sequence were used for the functional scans (TR/TE/slice/flip/FOV=2000ms/35ms/4mm slices/90°/220×220mm). fMRI data sets were analysed using SPM 8.0 involving preprocessing steps followed by t-contrast analysis for individuals and FFX analysis. In both with and without-loved-one conditions, neuronal responses were seen in the somatosensory gyrus, supramarginal gyrus, thalamus and insula regions, consistent with pain-related areas. FFX analysis showed that the presence of loved one produced more activation in the frontal and supramarginal gyrus during painful and non-painful stimulations compared to absence of a loved one. Brain response to pain is modulated by the presence of a loved one, causing more activation in the cognitive/emotional area i.e. 'love hurts'.

  11. Sex differences in subjective and objective measures of pain, functional impairment, and health-related quality of life in patients with lumbar degenerative disc disease.

    Science.gov (United States)

    Gautschi, Oliver P; Corniola, Marco V; Smoll, Nicolas R; Joswig, Holger; Schaller, Karl; Hildebrandt, Gerhard; Stienen, Martin N

    2016-05-01

    Sex differences in pain perception are known to exist; however, the exact pathomechanism remains unclear. This work aims to elucidate sex differences in subjective and objective measures of pain, functional impairment, and health-related quality of life (HRQoL) in patients with lumbar degenerative disc disease. In a prospective 2-center study, back and leg pain (visual analogue scale [VAS]), functional disability (Oswestry Disability Index and Roland-Morris Disability Index), and HRQoL (EuroQol-5D and Short Form [SF12]) were collected for consecutive patients undergoing lumbar spine surgery. Objective functional impairment (OFI) was estimated using age-adjusted and sex-adjusted cutoff values for the timed-up-and-go (TUG) test. A healthy cohort of n = 110 subjects served as the control group. Univariate and multivariate analyses were performed to test the association between sex and pain, subjective and OFIs, and HRQoL. The study comprised n = 305 patients (41.6% females). Female patients had more VAS back pain (P = 0.002) and leg pain (P = 0.014). They were more likely to report higher functional impairment in terms of Oswestry Disability Index (P = 0.005). Similarly, HRQoL measured with the EuroQol-5D index (P = 0.012) and SF12 physical composite score (P = 0.005) was lower in female patients. Female patients reported higher VAS back and leg pain, functional impairment, and reduced HRQoL than male patients. However, there were no sex differences with respect to the presence and degree of OFI measured by the TUG test using age-adjusted and sex-adjusted cutoff values. As such, the TUG may be a good test to overcome sex bias for the clinical assessment of patients with degenerative disc disease.

  12. NEUROMUSCULAR FATIGUE DURING A MODIFIED BIERING-SØRENSEN TEST IN SUBJECTS WITH AND WITHOUT LOW BACK PAIN

    Directory of Open Access Journals (Sweden)

    Mark J. Pitcher

    2007-12-01

    Full Text Available Studies employing modified Biering-Sørenson tests have reported that low back endurance is related to the potential for developing low back pain. Understanding the manner in which spinal musculature fatigues in people with and without LBP is necessary to gain insight into the sensitivity of the modified Biering-Sørenson test to differentiate back health. Twenty male volunteers were divided into a LBP group of subjects with current subacute or a history of LBP that limited their activity (n = 10 and a control group (n = 10. The median frequency of the fast Fourier transform was calculated from bilateral surface electromyography (EMG of the upper lumbar erector spinae (ULES, lower lumbar erector spinae (LLES and biceps femoris while maintaining a prescribed modified Biering-Sørensen test position and exerting isometric forces equivalent to 100, 120, 140 and 160% of the estimated mass of the head-arms-trunk (HAT segment. Time to failure was also investigated across the percentages of HAT. Fatigue time decreased with increasing load and differences between groups increased as load increased, however these differences were not significant. Significant differences in the EMG median frequency between groups occurred in the right biceps femoris (p < 0.05 with significant pairwise differences occurring at 140% for the left biceps femoris and at 160% for the right biceps femoris. There were significant pairwise differences at 120% for average EMG of the right biceps femoris and at 140% for the right ULES, and right and left biceps femoris (p < 0.05. The modified Biering-Sørensen test as usually performed at 100% HAT is not sufficient to demonstrate significant differences between controls and subjects with varying degrees of mild back disability based on the Oswestry classification

  13. Reliability of the Kinematic Steadiness Index during one-leg standing in subjects with recurrent low back pain.

    Science.gov (United States)

    Sung, Paul S; Danial, Pamela; Lee, Dongchul C

    2017-10-04

    To assess the reliability of standing time and the Kinematic Steadiness Index (KSI) in one-leg standing compared with the Timed Up and Go (TUG) test while considering anthropometric factors in subjects with recurrent low back pain (LBP). Sixty-six individuals participated in the study. The data were collected on two different days, 1 week apart. The KSI of the core spine, using video motion-capture techniques, was based on the relative standing time and relative standstill time. The intraclass correlation coefficient (ICC2,1) was compared for the reliability between measures. The covariates, such as age, Body Mass Index, and the Oswestry Disability Index (ODI), were analyzed for any interactions based on these measures. The standing time (t = - 1.01, p = 0.32) and the KSI (t = - 1.70, p = 0.09) were not significantly different between measures. The TUG results were not different between measures (t = 1.01, p = 0.32). The Cronbach's alpha for the standing time was 0.84, for KSI was 0.89, and for TUG was 0.76. The standing time and KSI demonstrated an interaction with age, while the TUG demonstrated an interaction with the ODI score. The KSI during one-leg standing could help to develop a practical tool to justify quantity and quality of balance outcome measures, which identify balance deficits and core spine rehabilitation strategies in subjects with recurrent LBP.

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

    OpenAIRE

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

    2014-01-01

    Background 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. Me...

  15. The effect of lifting and lowering an external load on repositioning error of trunk flexion-extension in subjects with and without low back pain.

    Science.gov (United States)

    Lin, Yang Hua; Sun, Ming Hui

    2006-07-01

    To determine whether the repositioning error of trunk flexion-extension in individuals with low back pain is different from that in those not experiencing low back pain when lifting and lowering external loads. A case-control study. Physical therapy department of a medical centre. Twenty subjects with subacute low back pain and 20 control subjects without low back pain. Tasks with and without lifting and lowering an external load. The trunk repositioning errors were measured with Measurand Shape Tape. In subjects with low back pain, trunk repositioning errors were significantly reduced when lifting and lowering an external load in the direction of flexion (3.77 +/- 1.26 degrees in a loaded condition versus 4.82 +/- 2.97 degrees in an unloaded condition; P loaded condition versus 5.03 +/- 3.74 degrees in an unloaded condition; P external load in the direction of flexion (2.80 +/- 1.39 degrees in a loaded condition versus 2.63 +/- 1.24 degrees in an unloaded condition; P > 0.05) and extension (2.87 +/- 11.40 degrees in a loaded condition versus 3.15 +/- 11.50 degrees in an unloaded condition; P > 0.05). The direction of motion (trunk flexion or extension) was not shown to be significant in this study. Performing the task whilst lifting or lowering a submaximal load showed a reduced trunk repositioning error in subjects with subacute low back pain. Lifting and lowering a submaximal load might be considered as one of the rehabilitative strategies to hasten a return to work.

  16. Characteristics of heart rate variability in alcohol-dependent subjects and nondependent chronic alcohol users.

    Science.gov (United States)

    Karpyak, Victor M; Romanowicz, Magdalena; Schmidt, John E; Lewis, Kriste A; Bostwick, John M

    2014-01-01

    Heart rate variability (HRV) is an objective and sensitive measure of integrated physiological functioning reflective of heart rhythm responsivity to internal and external demands. Reduced HRV is associated with vulnerability to stress and deterioration of medical and/or psychiatric conditions, while increased HRV is associated with a favorable treatment response and recovery from various medical and/or psychiatric conditions. Our previous review found that acute alcohol consumption caused decreased parasympathetic and increased sympathetic HRV effects in both nonalcoholic and chronic alcohol users. This review investigates the effects of chronic alcohol consumption on HRV in alcohol-dependent subjects and nondependent users. MEDLINE, Scopus, and PubMed were searched for human experimental and clinical trials that measured the effects of chronic alcohol use on HRV. Only publications that included a description of their study designs and clearly stated methodologies for data collections, and outcome measures were reviewed. We have reviewed a total of 24 articles. In nondependent users, low dose (approximating the recommended daily amount of 1 standard drink in women and 2 in men) use is associated with increased HRV parameters compared to those who drink less frequently or abstain altogether. A further increase in consumption is associated with decreased HRV compared to both abstainers and more moderate drinkers. HRV changes during withdrawal generally follow the same negative direction but are more complex and less understood. In dependent subjects, an improvement in HRV was seen following abstinence but remained reduced compared to nonalcoholic controls. This review demonstrates that HRV changes associated with chronic use follow a J-shaped curve. It supports recommendations that limit daily alcohol intake to no more than 2 drinks for men and 1 drink for women. Future studies should investigate HRV as a biomarker of alcoholism development and treatment response as

  17. Influence of arotinolol hydrochloride on heart rate spectrum in hypertensive subjects.

    Science.gov (United States)

    Harasawa, Y; Imaizumi, T; Ando, S; Masaki, H; Harada, S; Momohara, M; Takeshita, A

    1994-05-01

    Influence of arotinolol hydrochloride and atenolol on the balance between the sympathetic and parasympathetic nervous systems was evaluated in 8 hypertensive subjects by spectral analysis of heart rate (HR) and systemic blood pressure (BP). Before and after administration of either arotinolol (n = 7) or atenolol (n = 7) for 2 weeks, BP was continuously and non-invasively monitored by a finger-cuff manometry (Finapres). A time series of instantaneous HR was constructed from the BP signal. A time series of mean BP was also constructed. Spectral analysis was performed by the use of an autoregressive algorithm on these time series (approximately 180 sec). Each spectrum was subdivided into low-(0.05-0.15 Hz, LF) and high-frequency (0.15-0.4 Hz, HF) components, and each component was divided by the sum of the two for normalization. As a measure of the balance between the sympathetic and parasympathetic nervous systems, the ratio of LF to HF (LF/HF) was evaluated. Arotinolol increased fractional HF in the HR spectrum from 0.45 +/- 0.12 to 0.73 +/- 0.08 (p < 0.01) and decreased fractional LF from 0.55 +/- 0.12 to 0.27 +/- 0.08 (p < 0.01); consequently, it decreased LF/HF from 1.4 +/- 0.5 to 0.4 +/- 0.2 (p < 0.01). Atenolol had similar effects on these parameters. Neither of these beta-adrenergic blockades produced a discernible decrease in LF/HF in the BP spectrum. In conclusion, these beta-adrenergic blockades decreased LF/HF in the HR spectrum in hypertensive subjects, which suggests that they improved the balance between the sympathetic and parasympathetic nervous systems.

  18. Dose titration of BAF312 attenuates the initial heart rate reducing effect in healthy subjects.

    Science.gov (United States)

    Legangneux, Eric; Gardin, Anne; Johns, Donald

    2013-03-01

    Previous studies have shown transient decreases in heart rate (HR) following administration of sphingosine 1-phosphate (S1P) receptor modulators including BAF312. This study was conducted to determine whether dose titration of BAF312 reduces or eliminates these effects. Fifty-six healthy subjects were randomized 1:1:1:1 to receive BAF312 in one of two dose titration (DT) regimens (DT1 and DT2: 0.25-10 mg over 9-10 days), no titration (10 mg starting dose) or placebo. Pharmacodynamic and pharmacokinetic parameters were assessed. Neither DT1 nor DT2 resulted in clinically significant bradycardia or atrioventricular conduction effects. Both titration regimens showed a favourable difference on each of days 1-12 vs. the non-titration regimen on day 1 for HR effects (P titration was 1.18 (95% confidence interval [CI] 1.13, 1.23) and 1.14 (95% CI 1.09, 1.18) for DT2 (both P titration HRs showed considerable separation from placebo throughout the study. There was no statistically significant reduction in HR vs. placebo on day 1 in either titration regimen. On days 3-7 subjects in DT1 and DT2 experienced minor reductions in HR vs. placebo (approximately 5 beats min⁻¹; P ≤ 0.0001). From days 9-12, HRs in both titration regimens were comparable with placebo. Both titration regimens effectively attenuated the initial bradyarrhythmia observed on day 1 of treatment with BAF312 10 mg. © 2012 Novartis Institutes for BioMedical Research (NIBIR). British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society.

  19. Active therapy for chronic low back pain: part 3. Factors influencing self-rated disability and its change following therapy.

    Science.gov (United States)

    Mannion, A F; Junge, A; Taimela, S; Müntener, M; Lorenzo, K; Dvorak, J

    2001-04-15

    Cross-sectional analysis of the factors influencing self-rated disability associated with chronic low back pain and prospective study of the relationship between changes in each of these factors and in disability following active therapy. To examine the relative influences of pain, psychological factors, and physiological factors on self-rated disability. In chronic LBP, the interrelationship between physical impairment, pain, and disability is particularly complicated, due to the influence of various psychological factors and the lack of unequivocal methods for assessing impairment. Investigations using new "belief" questionnaires and "sophisticated" performance tests, which have shown promise as discriminating measures of impairment, may assist in clarifying the situation. Previous studies have rarely investigated all these factors simultaneously. One hundred forty-eight patients with cLBP completed questionnaires and underwent tests of mobility, strength, muscle activation, and fatigability, and (in a subgroup) erector spinae size and fiber size/type distribution. All measures were repeated after 3 months active therapy. Relationships between each factor and self-rated disability (Roland and Morris questionnaire) at baseline, and between the changes in each factor and changes in disability following therapy, were examined. Stepwise linear regression showed that the most significant predictors of disability at baseline were, in decreasing order of importance: pain; psychological distress; fear-avoidance beliefs; muscle activation levels; lumbar range of motion; gender. Only changes in pain, psychological distress, and fear-avoidance beliefs significantly accounted for the changes in disability following therapy. A combination of pain, psychological and physiological factors was best able to predict baseline disability, although its decrease following therapy was determined only by reductions in pain and psychological variables. The active therapy program

  20. A Phase II, Randomized, Double-Blind, Placebo Controlled, Dose-Response Trial of the Melatonin Effect on the Pain Threshold of Healthy Subjects.

    Directory of Open Access Journals (Sweden)

    Luciana Cadore Stefani

    Full Text Available Previous studies have suggested that melatonin may produce antinociception through peripheral and central mechanisms. Based on the preliminary encouraging results of studies of the effects of melatonin on pain modulation, the important question has been raised of whether there is a dose relationship in humans of melatonin on pain modulation.The objective was to evaluate the analgesic dose response of the effects of melatonin on pressure and heat pain threshold and tolerance and the sedative effects.Sixty-one healthy subjects aged 19 to 47 y were randomized into one of four groups: placebo, 0.05 mg/kg sublingual melatonin, 0.15 mg/kg sublingual melatonin or 0.25 mg/kg sublingual melatonin. We determine the pressure pain threshold (PPT and the pressure pain tolerance (PPTo. Quantitative sensory testing (QST was used to measure the heat pain threshold (HPT and the heat pain tolerance (HPTo. Sedation was assessed with a visual analogue scale and bispectral analysis.Serum plasma melatonin levels were directly proportional to the melatonin doses given to each subject. We observed a significant effect associated with dose group. Post hoc analysis indicated significant differences between the placebo vs. the intermediate (0.15 mg/kg and the highest (0.25 mg/kg melatonin doses for all pain threshold and sedation level tests. A linear regression model indicated a significant association between the serum melatonin concentrations and changes in pain threshold and pain tolerance (R(2  = 0.492 for HPT, R(2  = 0.538 for PPT, R(2  = 0.558 for HPTo and R(2  = 0.584 for PPTo.The present data indicate that sublingual melatonin exerts well-defined dose-dependent antinociceptive activity. There is a correlation between the plasma melatonin drug concentration and acute changes in the pain threshold. These results provide additional support for the investigation of melatonin as an analgesic agent. Brazilian Clinical Trials Registry (ReBec: (U1111

  1. Differences in subjective and objective respiratory parameters in patients with chronic obstructive pulmonary disease with and without pain.

    Science.gov (United States)

    Bentsen, Signe Berit; Rustøen, Tone; Miaskowski, Christine

    2012-01-01

    Few studies have evaluated the associations between respiratory parameters and pain in chronic obstructive pulmonary disease (COPD). The purpose of this study is to evaluate the differences in respiratory parameters between COPD patients who did and did not have pain. In this cross-sectional study respiratory parameters were measured by spirometry and the St Georges Respiratory Questionnaire. Patients responded to a single question that asked if they were generally bothered by pain. Of the 100 patients, 45% reported that they were generally bothered by pain. Patients who had pain reported a higher number of comorbidities (P pain (P ≤ 0.03). The results of logistic regression analysis determined that a higher number of comorbidities (OR = 0.28; P = 0.026) and higher breathlessness scores (OR = 1.03; P = 0.003) made significant unique contributions to the prediction of pain group membership. Comorbidity and breathlessness were risk factors for pain and the physical dimensions of breathlessness were associated with pain.

  2. 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.

  3. Effects of cervical mobilization and exercise on pain, movement and function in subjects with temporomandibular disorders: a single group pre-post test

    Directory of Open Access Journals (Sweden)

    Letícia Bojikian CALIXTRE

    Full Text Available ABSTRACT Objective To investigate the effect of a rehabilitation program based on cervical mobilization and exercise on clinical signs and mandibular function in subjects with temporomandibular disorder (TMD. Material and Methods: Single-group pre-post test, with baseline comparison. Subjects Twelve women (22.08±2.23 years with myofascial pain and mixed TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders. Outcome measures Subjects were evaluated three times: twice before (baseline phase and once after intervention. Self-reported pain, jaw function [according to the Mandibular Functional Impairment Questionnaire (MFIQ], pain-free maximum mouth opening (MMO, and pressure pain thresholds (PPTs of both masseter and temporalis muscles were obtained. Baseline and post-intervention differences were investigated, and effect size was estimated through Cohen’s d coefficient. Results Jaw function improved 7 points on the scale after the intervention (P=0.019, and self-reported pain was significantly reduced (P=0.009. Pain-free MMO varied from 32.3±8.8 mm to 38±8.8 mm and showed significant improvement (P=0.017 with moderate effect size when compared to the baseline phase. PPT also increased with moderate effect size, and subjects had the baseline values changed from 1.23±0.2 kg/cm2 to 1.4±0.2 kg/cm2 in the left masseter (P=0.03, from 1.31±0.28 kg/cm2 to 1.51±0.2 kg/cm2 in the right masseter (P>0.05, from 1.32±0.2 kg/cm2 to 1.46±0.2 kg/cm2 in the left temporalis (P=0.047, and from 1.4±0.2 kg/cm2 to 1.67±0.3 kg/cm2 in the right temporalis (P=0.06. Conclusions The protocol caused significant changes in pain-free MMO, self-reported pain, and functionality of the stomatognathic system in subjects with myofascial TMD, regardless of joint involvement. Even though these differences are statistically significant, their clinical relevance is still questionable.

  4. Comparison of postural control between healthy subjects and individuals with nonspecific low back pain during exposure to visual stimulus.

    Science.gov (United States)

    Li, Rui; Wang, Ninghua; Yan, Xiang; Wei, Kunlin

    2014-01-01

    Low back pain (LBP) is a common clinical problem. Many researchers have demonstrated that LBP disorders have difference in sensory strategies for postural control. Optokinetic stimulation (OKS) of optic flow has been widely applied to study its effect on vision, but has not been applied to LBP. Here we used OKS on different surfaces to investigate the characteristics of chronic nonspecific LBP (CNLBP) posture control, so as to provide new theoretical and experimental data for further recognizing CNLBP and enriching its treatment. Fifteen individuals with CNLBP (age range 25-40 years) and 15 age and gender-matched control subjects were recruited. Each subject, while standing on a stable or soft surface, was exposed to random-dot patterns projected on a large screen, with the dots displaying expansion (+) and contraction (-) and velocities including 80°, 40°, and 20° per second. The visual stimulus used a "stimuli-interval" pattern. The peak velocity, different phases' standard deviation (SD) of the anterior-posterior centre of pressure (COP) displacements and the total length of the medial-lateral COP sway (LML) for stable surface and soft surface were recorded by force platform. The main effect of surface on all parameters was significant, while the main effect of group and OKS showed no significance with the exception of peak velocity (F(3, 95) = 3.6, P = 0.01) and A2 (F(5, 140) = 9.34, P A2 (F(5, 140) = 3.65, P < 0.01) and group by surface by OKS (F(5,140) = 2.83, P = 0.02), and surface by OKS of A1 and A3 (P < 0.05) were significant. It was reported that significantly more SD in amplitude in the T2 phase was seen in persons with CNLBP when confronting the + 40 stimuli on the soft surface (P < 0.05) compared to healthy individuals. There was no significance between persons with CNLBP and healthy people when using the stable surface. Subjects with LBP showed decreased efficiency of postural adjustment when exposed to more complicated tasks and environments

  5. Myotubes from severely obese type 2 diabetic subjects accumulate less lipids and show higher lipolytic rate than myotubes from severely obese non-diabetic subjects.

    Directory of Open Access Journals (Sweden)

    Siril S Bakke

    Full Text Available About 80% of patients with type 2 diabetes are classified as overweight. However, only about 1/3 of severely obese subjects have type 2 diabetes. This indicates that several severely obese individuals may possess certain characteristics that protect them against type 2 diabetes. We therefore hypothesized that this apparent paradox could be related to fundamental differences in skeletal muscle lipid handling. Energy metabolism and metabolic flexibility were examined in human myotubes derived from severely obese subjects without (BMI 44±7 kg/m2 and with type 2 diabetes (BMI 43±6 kg/m2. Lower insulin sensitivity was observed in myotubes from severely obese subjects with type 2 diabetes. Lipolysis rate was higher, and oleic acid accumulation, triacylglycerol content, and fatty acid adaptability were lower in myotubes from severely obese subjects with type 2 diabetes compared to severely obese non-diabetic subjects. There were no differences in lipid distribution and mRNA and protein expression of the lipases HSL and ATGL, the lipase cofactor CGI-58, or the lipid droplet proteins PLIN2 and PLIN3. Glucose and oleic acid oxidation were also similar in cells from the two groups. In conclusion, myotubes established from severely obese donors with established type 2 diabetes had lower ability for lipid accumulation and higher lipolysis rate than myotubes from severely obese donors without diabetes. This indicates that a difference in intramyocellular lipid turnover might be fundamental in evolving type 2 diabetes.

  6. Beliefs about back pain predict the recovery rate over 52 consecutive weeks.

    Science.gov (United States)

    Elfering, Achim; Mannion, Anne F; Jacobshagen, Nicola; Tamcan, Oezguer; Müller, Urs

    2009-12-01

    This study examined the course of low-back pain over 52 weeks following current pain at baseline. Initial beliefs about the inevitability of the pain's negative consequences and fear avoidance beliefs were examined as potential risk factors for persistent low-back pain. On a weekly basis over a period of one year, 264 participants reported both the intensity and frequency of their low-back pain and the degree to which it impaired their work performance. In a multilevel regression analysis, predictor variables included initial low-back pain intensity, age, gender, body mass index, anxiety/depression, participation in sport, heavy workload, time (1-52 weeks), and scores on the "back beliefs" and "fear-avoidance beliefs" questionnaires. The group mean values for both the intensity and frequency of weekly low-back pain, and the impairment of work performance due to such pain showed a recovery within the first 12 weeks. In a multilevel regression of 9497 weekly measurements, greater weekly low-back pain and impairment were predicted by higher levels of work-related fear avoidance beliefs. A significant interaction between time and the scores on both the work-related fear-avoidance and back beliefs questionnaires indicated faster recovery and pain relief over time in those who reported less fear-avoidance and fewer negative beliefs. Negative beliefs about the inevitability of adverse consequences of low-back pain and work-related, fear-avoidance beliefs are independent risk factors for poor recovery from low-back pain.

  7. Strain Rate Dependent Deformation of a Polymer Matrix Composite with Different Microstructures Subjected to Off-Axis Loading

    National Research Council Canada - National Science Library

    Zhu, Xiaojun; Chen, Xuefeng; Zhai, Zhi; Yang, Zhibo; Li, Xiang; He, Zhengjia

    2014-01-01

    ... are often subjected to complex loadings under extreme circumstances [3, 4] in which the properties of the PMCs exhibit highly nonlinear and rate dependence, so it is necessary for structural design and an...

  8. Local weather is associated with rates of online searches for musculoskeletal pain symptoms.

    Directory of Open Access Journals (Sweden)

    Scott Telfer

    Full Text Available Weather conditions are commonly believed to influence musculoskeletal pain, however the evidence for this is mixed. This study aimed to examine the relationship between local meteorological conditions and online search trends for terms related to knee pain, hip pain, and arthritis. Five years of relative online search volumes for these terms were obtained for the 50 most populous cities in the contiguous United States, along with corresponding local weather data for temperature, relative humidity, barometric pressure, and precipitation. Methods from the climate econometrics literature were used to assess the casual impact of these meteorological variables on the relative volumes of searches for pain. For temperatures between -5°C and 30°C, search volumes for hip pain increased by 12 index points, and knee pain increased by 18 index points. Precipitation had a negative effect on search volumes for these terms. At temperatures >30°C, search volumes for arthritis related pain decreased by 7 index points. These patterns were not seen for pain searches unrelated to the musculoskeletal system. In summary, selected local weather conditions are significantly associated with online search volumes for specific musculoskeletal pain symptoms. We believe the predominate driver for this to be the relative changes in physical activity levels associated with meteorological conditions.

  9. Local weather is associated with rates of online searches for musculoskeletal pain symptoms.

    Science.gov (United States)

    Telfer, Scott; Obradovich, Nick

    2017-01-01

    Weather conditions are commonly believed to influence musculoskeletal pain, however the evidence for this is mixed. This study aimed to examine the relationship between local meteorological conditions and online search trends for terms related to knee pain, hip pain, and arthritis. Five years of relative online search volumes for these terms were obtained for the 50 most populous cities in the contiguous United States, along with corresponding local weather data for temperature, relative humidity, barometric pressure, and precipitation. Methods from the climate econometrics literature were used to assess the casual impact of these meteorological variables on the relative volumes of searches for pain. For temperatures between -5°C and 30°C, search volumes for hip pain increased by 12 index points, and knee pain increased by 18 index points. Precipitation had a negative effect on search volumes for these terms. At temperatures >30°C, search volumes for arthritis related pain decreased by 7 index points. These patterns were not seen for pain searches unrelated to the musculoskeletal system. In summary, selected local weather conditions are significantly associated with online search volumes for specific musculoskeletal pain symptoms. We believe the predominate driver for this to be the relative changes in physical activity levels associated with meteorological conditions.

  10. Effects of short and prolonged transcutaneous vagus nerve stimulation on heart rate variability in healthy subjects.

    Science.gov (United States)

    De Couck, M; Cserjesi, R; Caers, R; Zijlstra, W P; Widjaja, D; Wolf, N; Luminet, O; Ellrich, J; Gidron, Y

    2017-03-01

    The vagus nerve is strategically located in the body, and has multiple homeostatic and health-promoting effects. Low vagal activity predicts onset and progression of diseases. These are the reasons to activate this nerve. This study examined the effects of transcutaneous vagus nerve stimulation (t-VNS) on a main index of vagal activity, namely heart rate variability (HRV). In Study 1, we compared short (10min) left versus right ear t-VNS versus sham (no stimulation) in a within-subjects experimental design. Results revealed significant increases in only one HRV parameter (standard deviation of the RR intervals (SDNN)) following right-ear t-VNS. Study 2 examined the prolonged effects of t-VNS (1h) in the right ear. Compared to baseline, right-t-VNS significantly increased the LF and LF/HF components of HRV, and SDNN in women, but not in men. These results show limited effects of t-VNS on HRV, and are discussed in light of neuroanatomical and statistical considerations and future directions are proposed. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. Subjective and clinical assessment criteria suggestive for five clinical patterns discernible in nonspecific neck pain patients. A Delphi-survey of clinical experts.

    Science.gov (United States)

    Dewitte, Vincent; Peersman, Wim; Danneels, Lieven; Bouche, Katie; Roets, Arne; Cagnie, Barbara

    2016-12-01

    Nonspecific neck pain patients form a heterogeneous group with different musculoskeletal impairments. Classifying nonspecific neck pain patients into subgroups based on clinical characteristics might lead to more comprehensive diagnoses and can guide effective management. To establish consensus among a group of experts regarding the clinical criteria suggestive of a clinical dominance of 'articular', 'myofascial', 'neural', 'central' and 'sensorimotor control' dysfunction patterns distinguishable in patients with nonspecific neck pain. Delphi study. A focus group with 10 academic experts was organized to elaborate on the different dysfunction patterns discernible in neck pain patients. Consecutively, a 3-round online Delphi-survey was designed to obtain consensual symptoms and physical examination findings for the 5 distinct dysfunction patterns resulting from the focus group. A total of 21 musculoskeletal physical therapists from Belgium and the Netherlands experienced in assessing and treating neck pain patients completed the 3-round Delphi-survey. Respectively, 33 (response rate, 100.0%), 27 (81.8%) and 21 (63.6%) respondents replied to rounds 1, 2 and 3. Eighteen 'articular', 16 'myofascial', 20 'neural', 18 'central' and 10 'sensorimotor control' clinical indicators reached a predefined ≥80% consensus level. These indicators suggestive of a clinical dominance of 'articular', 'myofascial', 'neural', 'central', and 'sensorimotor control' dysfunction patterns may help clinicians to assess and diagnose patients with nonspecific neck pain. Future validity testing is needed to determine how these criteria may help to improve the outcome of physical therapy interventions in nonspecific neck pain patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. [Assessment of the Effect of Pain on Autonomic Nervous System in Human Body Using Heart Rate Variability Analysis].

    Science.gov (United States)

    Fu, Qingbiao; Liu, Chunlin; Zhang, Fang; Fang, Yi; Shen, Dai; Zhang, Jian

    2015-12-01

    The purpose of this study is to discuss the feasibility of establishing capsaicin pain model and the possibility to evaluate different degrees of pain by the heart rate variability (HRV). It also aims to investigate the changes of autonomic nervous activity of volunteers during the process of pain caused by capsaicin. A total of 30 volunteers were selected, who were physically and mentally healthy, into the study. To assess the effects of capsaicin on the healthy volunteers, we recorded the Visual Analogue Scale (VAS) scores after the capsaicin stimulus. Additionally, the electrocardiogram signals and HRV analysis index before and after stimulating were also recorded, respectively. More specifically, the HRV analysis indexes included the time domain index, the frequency domain index, and the nonlinear analysis index. The results demonstrated that the activity of the autonomic nerves was enhanced in the process of capsaicin stimulus, especially for the sympathetic nerve, which exhibited a significantly differences in HRV. In conclusion, the degree of pain can be reflected by the HRV. It is feasible to establish a capsaicin pain model. And in further experiments, HRV analysis could be used as a reference index for quantitative evaluation of pain.

  13. Use of Heart Rate Variability and Photoplethysmograph-Derived Parameters as Assessment Signals of Radiofrequency Therapy Efficacy for Chronic Pain.

    Science.gov (United States)

    Ye, Jing-Jhao; Chuang, Chiung-Cheng; Tai, Yu-Ting; Lee, Kuan-Ting; Hung, Kuo-Sheng

    2017-09-01

    Radiofrequency therapy (RFT) generates molecular motion and produces heat and electromagnetic effects on tissues, which attenuate pain sensation and thereby relieve pain. This study was to observe the altering trend of physiological parameters after RFT for chronic cervical or lumbar pain. This study recruited 66 patients with chronic cervical or lumbar pain and recorded their physiological parameters before and after RFT using heart rate variability (HRV) and photoplethysmography (PPG) to explore the feasibility of RFT efficacy assessment. The patients' visual analog scale scores significantly decreased after RFT and the HRV parameters that represented parasympathetic activity significantly changed (HR decreased, and R-R interval and low- and high-frequency power increased significantly). Meanwhile, the PPG parameters that represented sympathetic activity also increased (PPG amplitude and autonomic nervous system state significantly decreased). This study showed significant efficacy of RFT in patients with chronic cervical or lumbar pain. The changes of HRV and PPG parameters may explain part of the mechanisms of RFT. © 2016 World Institute of Pain.

  14. Clinical evaluation of the efficacy and safety of a constant rate infusion of dexmedetomidine for postoperative pain management in dogs

    NARCIS (Netherlands)

    Valtolina, C.|info:eu-repo/dai/nl/412503034; Robben, J.H.|info:eu-repo/dai/nl/266740790; Uilenreef, J.J.|info:eu-repo/dai/nl/30483095X; Murrell, J.C.; Aspegrén, J.; McKusick, B.C.; Hellebrekers, L.J.|info:eu-repo/dai/nl/073499234

    2009-01-01

    Vet Anaesth Analg. 2009 Jul;36(4):369-83. Epub 2009 May 12. Clinical evaluation of the efficacy and safety of a constant rate infusion of dexmedetomidine for postoperative pain management in dogs. Valtolina C, Robben JH, Uilenreef J, Murrell JC, Aspegrén J, McKusick BC, Hellebrekers LJ. Department

  15. Auricular Acupressure to Improve Menstrual Pain and Menstrual Distress and Heart Rate Variability for Primary Dysmenorrhea in Youth with Stress

    Directory of Open Access Journals (Sweden)

    Yu-Jen Wang

    2013-01-01

    Full Text Available Background. Dysmenorrhea and accompanying symptoms can have a negative impact on academic achievement, physical activity and functioning, and quality of life. Unfortunately, stress increases the sensitivity and severity of pain, activating sympathetic responses while inhibiting parasympathetic responses. Objective. This study used objective, physiological measurements to evaluate the effects of auricular acupressure on menstrual pain and menstrual distress in young college students with primary dysmenorrhea across two menstrual cycles. The aim was to determine if significant differences could be detected between the intervention and follow-up phases after controlling life stress. Design. A one-group experimental research design was used, and repeated measurements and followups were done. Thirty-two women completed questionnaires and physiological parameters were measured. Results. Significant differences between the intervention and follow-up phases were found for high frequency (HF and blood pressure on day 1 and no significant differences in menstrual pain and menstrual distress, heart rate variability, low frequency (LF, LF/HF ratio, or heart rate. Conclusion. Auricular acupressure effectively increases parasympathetic activity to maintain autonomic function homeostasis in young women with primary dysmenorrhea and may have a value in alleviating menstrual pain and menstrual distress in a high-stress life. Future studies should consider stress, stimulus dose of auricular acupressure, severity of menstrual pain, and a longitudinal research design.

  16. Effects of cervical mobilization and exercise on pain, movement and function in subjects with temporomandibular disorders: a single group pre-post test.

    Science.gov (United States)

    Calixtre, Letícia Bojikian; Grüninger, Bruno Leonardo da Silva; Haik, Melina Nevoeiro; Alburquerque-Sendín, Francisco; Oliveira, Ana Beatriz

    2016-01-01

    To investigate the effect of a rehabilitation program based on cervical mobilization and exercise on clinical signs and mandibular function in subjects with temporomandibular disorder (TMD). Single-group pre-post test, with baseline comparison. Twelve women (22.08±2.23 years) with myofascial pain and mixed TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders. Subjects were evaluated three times: twice before (baseline phase) and once after intervention. Self-reported pain, jaw function [according to the Mandibular Functional Impairment Questionnaire (MFIQ)], pain-free maximum mouth opening (MMO), and pressure pain thresholds (PPTs) of both masseter and temporalis muscles were obtained. Baseline and post-intervention differences were investigated, and effect size was estimated through Cohen's d coefficient. Jaw function improved 7 points on the scale after the intervention (P=0.019), and self-reported pain was significantly reduced (P=0.009). Pain-free MMO varied from 32.3±8.8 mm to 38±8.8 mm and showed significant improvement (P=0.017) with moderate effect size when compared to the baseline phase. PPT also increased with moderate effect size, and subjects had the baseline values changed from 1.23±0.2 kg/cm2 to 1.4±0.2 kg/cm2 in the left masseter (P=0.03), from 1.31±0.28 kg/cm2 to 1.51±0.2 kg/cm2 in the right masseter (P>0.05), from 1.32±0.2 kg/cm2 to 1.46±0.2 kg/cm2 in the left temporalis (P=0.047), and from 1.4±0.2 kg/cm2 to 1.67±0.3 kg/cm2 in the right temporalis (P=0.06). The protocol caused significant changes in pain-free MMO, self-reported pain, and functionality of the stomatognathic system in subjects with myofascial TMD, regardless of joint involvement. Even though these differences are statistically significant, their clinical relevance is still questionable.

  17. 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

  18. Differences in subjective and objective respiratory parameters in patients with chronic obstructive pulmonary disease with and without pain

    Directory of Open Access Journals (Sweden)

    Bentsen SB

    2012-02-01

    Full Text Available Signe Berit Bentsen1,2, Tone Rustøen3,4, Christine Miaskowski51Stord/Haugesund University College, Department of Health Education, Haugesund, Norway; 2Haugesund Hospital, Department of Research, Haugesund, Norway; 3Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Ullevål, Oslo, Norway; 4Lovisenberg Diaconal University College, Oslo, Norway; 5Department of Physiological Nursing, School of Nursing, University of California, San Francisco, California, USABackground: Few studies have evaluated the associations between respiratory parameters and pain in chronic obstructive pulmonary disease (COPD. The purpose of this study is to evaluate the differences in respiratory parameters between COPD patients who did and did not have pain.Methods: In this cross-sectional study respiratory parameters were measured by spirometry and the St Georges Respiratory Questionnaire. Patients responded to a single question that asked if they were generally bothered by pain.Results: Of the 100 patients, 45% reported that they were generally bothered by pain. Patients who had pain reported a higher number of comorbidities (P < 0.001 and higher breathlessness scores (P = 0.003. Physical dimensions of breathlessness were significantly associated with pain (P ≤ 0.03. The results of logistic regression analysis determined that a higher number of comorbidities (OR = 0.28; P = 0.026 and higher breathlessness scores (OR = 1.03; P = 0.003 made significant unique contributions to the prediction of pain group membership.Conclusions: Comorbidity and breathlessness were risk factors for pain and the physical dimensions of breathlessness were associated with pain.Keywords: COPD, pain, comorbidity, lung function, breathlessness

  19. Hypersensitivity to pain in congenital blindness

    DEFF Research Database (Denmark)

    Slimani, Hocine; Danti, Sabrina; Ricciardi, Emiliano

    2013-01-01

    and responses to suprathreshold heat stimuli in 2 groups of congenitally blind and matched normal-sighted participants. We also assessed detection thresholds for innocuous warmth and cold, and participants' attitude toward painful encounters in daily life. Our results show that, compared to sighted subjects......, congenitally blind subjects have lower heat pain thresholds, rate suprathreshold heat pain stimuli as more painful, and have increased sensitivity for cold pain stimuli. Thresholds for nonpainful thermal stimulation did not differ between groups. The results of the pain questionnaires further indicated...... that blind subjects are more attentive to signals of external threats. These findings indicate that the absence of vision from birth induces a hypersensitivity to painful stimuli, lending new support to a model of sensory integration of vision and pain processing....

  20. Load rating and retrofit testing of bridge timber piles subjected to eccentric loading.

    Science.gov (United States)

    2012-11-01

    This report first evaluated the load rating procedure currently in use by the Illinois Department of Transportation (IDOT) for rating timber : piles supporting multiple-span, simply supported bridges. For simplicity, these piles are often rated under...

  1. Question order sensitivity of subjective well-being measures: focus on life satisfaction, self-rated health, and subjective life expectancy in survey instruments.

    Science.gov (United States)

    Lee, Sunghee; McClain, Colleen; Webster, Noah; Han, Saram

    2016-10-01

    This study examines the effect of question context created by order in questionnaires on three subjective well-being measures: life satisfaction, self-rated health, and subjective life expectancy. We conducted two Web survey experiments. The first experiment (n = 648) altered the order of life satisfaction and self-rated health: (1) life satisfaction asked immediately after self-rated health; (2) self-rated health immediately after life satisfaction; and (3) two items placed apart. We examined their correlation coefficient by experimental condition and further examined its interaction with objective health. The second experiment (n = 479) asked life expectancy before and after parental mortality questions. Responses to life expectancy were compared by order using ANOVA, and we examined interaction with parental mortality status using ANCOVA. Additionally, response time and probes were examined. Correlation coefficients between self-rated health and life satisfaction differed significantly by order: 0.313 (life satisfaction first), 0.508 (apart), and 0.643 (self-rated health first). Differences were larger among respondents with chronic conditions. Response times were the shortest when self-rated health was asked first. When life expectancy asked after parental mortality questions, respondents reported considering parents more for answering life expectancy; and respondents with deceased parents reported significantly lower expectancy, but not those whose parents were alive. Question context effects exist. Findings suggest placing life satisfaction and self-rated health apart to avoid artificial attenuation or inflation in their association. Asking about parental mortality prior to life expectancy appears advantageous as this leads respondents to consider parental longevity more, an important factor for true longevity.

  2. Criterion validation of the rate of recovery, a single alphanumeric measure, in patients with shoulder pain.

    Science.gov (United States)

    O'Halloran, Bryan; Wright, Alexis; Cook, Chad E

    2013-12-01

    The aim of this study was to identify the minimal clinically important threshold score for rate of recovery (RoR) using the Patient Acceptable Symptom State (PASS) as an anchor measure, and to measure the association of the RoR with the raw and percentage change scores of the QuickDASH and the Numeric Pain Rating Scale (NPRS). Threshold measures for RoR and the PASS were examined using a Receiver Operating Characteristic (ROC) Curve. Participants were dichotomized to those who stated "yes" and those who stated "no" on the PASS. Pearson correlation coefficients were performed to determine the relationship between the NPRS and QuickDASH raw and percentage change scores and the RoR at discharge. ROC curve statistics suggest that a cut-point of greater than 87% on the self-report RoR (SN=0.62, SP=0.73; +LR=2.26: -LR=0.56) corresponded to the patient considering their state acceptable. No significant associations existed between either the raw NPRS or the raw QuickDASH, and the RoR scores although percentage change scores were associated with the RoR (QuickDASH r=0.29; p=0.02; NPRS = r=0.30; p=0.02). Patients reporting greater than or equal to 87% on RoR are likely to have met the Patient Acceptable Symptom State. Although statistically significant, the lack of strong association between RoR and change scores for the NPRS and QuickDASH suggests that the measures capture different constructs. Level 2C.

  3. Impact of retrograde shear rate on brachial and superficial femoral artery flow-mediated dilation in older subjects.

    NARCIS (Netherlands)

    Schreuder, T.H.A.; Green, D.J.; Hopman, M.T.E.; Thijssen, D.H.

    2015-01-01

    An inverse, dose-dependent relationship between retrograde shear rate and brachial artery endothelial function exists in young subjects. This relationship has not been investigated in older adults, who have been related to lower endothelial function, higher resting retrograde shear rate and higher

  4. Differences in muscle pain and plasma creatine kinase activity after ...

    African Journals Online (AJOL)

    for a complete 30-second increment prior to fatigue. HRmax was recorded as the highest heart rate during the last 30 seconds of the treadmill test. Muscle pain. Muscle pain was measured daily for 1 day before, and for 7 days after the Comrades marathon. Muscle pain was measured subjec- tively, where subjects rated ...

  5. Postoperative groin pain and success rates following transobturator midurethral sling placement: TVT ABBREVO® system versus TVT™ obturator system.

    Science.gov (United States)

    Canel, Virginie; Thubert, Thibault; Wigniolle, Ingrid; Fernandez, Hervé; Deffieux, Xavier

    2015-10-01

    Placement of a transobturator midurethral sling (MUS) is the standard surgical treatment for stress urinary incontinence. Most recent MUS procedures have been poorly evaluated. We compared the results using a "new" device expected to reduce postoperative pain, the TVT ABBREVO® system (TVT-Abb), with those using the TVT™ obturator system (TVT-O). This was a retrospective study comparing the use of the TVT-Abb (in 50 patients) and the TVT-O (in 50 patients). The main outcomes were the amount of postoperative pain, the success rate (no reported urinary leakage and negative cough test) with both MUS procedures, and the prevalence of complications. The mean follow-up time was 12 months. The preoperative characteristics of the two groups were comparable. There was less postoperative pain (VAS, 0 to 100) in the TVT-Abb group than in the TVT-O group (12.2 vs. 24.4, p TVT-Abb group and the TVT-O group (8 % vs. 12 %, p = 0.74). The prevalences of perioperative and postoperative complications (bladder/urethral injury, haemorrhage) in the two groups were equal. The success rates were similar at 12 months after surgery (88 % vs. 78 %, p = 0.29). The success rates with TVT-Abb and TVT-O were equal at 12 months after surgery, but there was less immediate postoperative pain with TVT-Abb.

  6. Cut-Off Points for Mild, Moderate, and Severe Pain on the Numeric Rating Scale for Pain in Patients with Chronic Musculoskeletal Pain: Variability and Influence of Sex and Catastrophizing.

    Science.gov (United States)

    Boonstra, Anne M; Stewart, Roy E; Köke, Albère J A; Oosterwijk, René F A; Swaan, Jeannette L; Schreurs, Karlein M G; Schiphorst Preuper, Henrica R

    2016-01-01

    Objectives: The 0-10 Numeric Rating Scale (NRS) is often used in pain management. The aims of our study were to determine the cut-off points for mild, moderate, and severe pain in terms of pain-related interference with functioning in patients with chronic musculoskeletal pain, to measure the variability of the optimal cut-off points, and to determine the influence of patients' catastrophizing and their sex on these cut-off points. Methods: 2854 patients were included. Pain was assessed by the NRS, functioning by the Pain Disability Index (PDI) and catastrophizing by the Pain Catastrophizing Scale (PCS). Cut-off point schemes were tested using ANOVAs with and without using the PSC scores or sex as co-variates and with the interaction between CP scheme and PCS score and sex, respectively. The variability of the optimal cut-off point schemes was quantified using bootstrapping procedure. Results and conclusion: The study showed that NRS scores ≤ 5 correspond to mild, scores of 6-7 to moderate and scores ≥8 to severe pain in terms of pain-related interference with functioning. Bootstrapping analysis identified this optimal NRS cut-off point scheme in 90% of the bootstrapping samples. The interpretation of the NRS is independent of sex, but seems to depend on catastrophizing. In patients with high catastrophizing tendency, the optimal cut-off point scheme equals that for the total study sample, but in patients with a low catastrophizing tendency, NRS scores ≤ 3 correspond to mild, scores of 4-6 to moderate and scores ≥7 to severe pain in terms of interference with functioning. In these optimal cut-off schemes, NRS scores of 4 and 5 correspond to moderate interference with functioning for patients with low catastrophizing tendency and to mild interference for patients with high catastrophizing tendency. Theoretically one would therefore expect that among the patients with NRS scores 4 and 5 there would be a higher average PDI score for those with low

  7. Determination of moderate-to-severe postoperative pain on the numeric rating scale: a cut-off point analysis applying four different methods.

    Science.gov (United States)

    Gerbershagen, H J; Rothaug, J; Kalkman, C J; Meissner, W

    2011-10-01

    Cut-off points (CPs) of the numeric rating scale (NRS 0-10) are regularly used in postoperative pain treatment. However, there is insufficient evidence to identify the optimal CP between mild and moderate pain. A total of 435 patients undergoing general, trauma, or oral and maxillofacial surgery were studied. To determine the optimal CP for pain treatment, four approaches were used: first, patients estimated their tolerable postoperative pain intensity before operation; secondly, 24 h after surgery, they indicated if they would have preferred to receive more analgesics; thirdly, satisfaction with pain treatment was analysed, and fourthly, multivariate analysis was used to calculate the optimal CP for pain intensities in relation to pain-related interference with movement, breathing, sleep, and mood. The estimated tolerable postoperative pain before operation was median (range) NRS 4.0 (0-10). Patients who would have liked more analgesics reported significantly higher average pain since surgery [median NRS 5.0 (0-9)] compared with those without this request [NRS 3.0 (0-8)]. Patients satisfied with pain treatment reported an average pain intensity of median NRS 3.0 (0-8) compared with less satisfied patients with NRS 5.0 (2-9). Analysis of average postoperative pain in relation to pain-related interference with mood and activity indicated pain categories of NRS 0-2, mild; 3-4, moderate; and 5-10, severe pain. Three of the four methods identified a treatment threshold of average pain of NRS≥4. This was considered to identify patients with pain of moderate-to-severe intensity. This cut-off was indentified as the tolerable pain threshold.

  8. Evaluation of 21-numbered circle and 10-centimeter horizontal line visual analog scales for physician and parent subjective ratings in juvenile idiopathic arthritis.

    Science.gov (United States)

    Filocamo, Giovanni; Davì, Sergio; Pistorio, Angela; Bertamino, Marta; Ruperto, Nicolino; Lattanzi, Bianca; Consolaro, Alessandro; Magni-Manzoni, Silvia; Galasso, Roberta; Varnier, Giulia Camilla; Martini, Alberto; Ravelli, Angelo

    2010-07-01

    To evaluate the measurement properties of 21-numbered circle visual analog scales (VAS) and traditional 10-cm horizontal line VAS for physician and parent subjective ratings in children with juvenile idiopathic arthritis (JIA). We studied 2 patient samples in whom physician global rating of overall disease activity, parent global rating of the child's overall well-being, and parent rating of intensity of child's pain were performed using traditional 10-cm horizontal line VAS (n = 397) or 21-numbered circle VAS (n = 471). The measurement performances of the 2 VAS formats were examined by assessing construct validity, score distribution, responsiveness to change over time, and minimal clinically important difference (MCID). Most Spearman correlations with other JIA outcome measures yielded by 21-numbered circle VAS were greater than those obtained with 10-cm horizontal line VAS, revealing that the circle VAS format has better construct validity. Ceiling effects (i.e., score = 0) for physician and parent global ratings were 43.7% and 32.9%, respectively, on 21-numbered circle VAS, and 31.6% and 35.3%, respectively, on 10-cm horizontal line VAS. Responsiveness of 21-numbered circle VAS was good (standardized response mean > 0.8) or moderate (standardized response mean > 0.6) among patients classified as improved or worsened, respectively, by the physician or the parent. Overall, MCID values for 21-numbered circle VAS tended to be greater for worsening than for improvement. The 21-numbered circle VAS are a suitable alternative to the 10-cm horizontal line VAS and may facilitate incorporation of physician and parent subjective ratings in standard clinical practice.

  9. Influence of living environment and subjective economic hardship on new-onset of low back pain for survivors of the Great East Japan Earthquake.

    Science.gov (United States)

    Yabe, Yutaka; Hagiwara, Yoshihiro; Sekiguchi, Takuya; Sugawara, Yumi; Sato, Mari; Kanazawa, Kenji; Koide, Masashi; Itaya, Nobuyuki; Tsuchiya, Masahiro; Tsuji, Ichiro; Itoi, Eiji

    2017-01-01

    The Great East Japan Earthquake and subsequent tsunami devastated the northeastern part of Japan. Low back pain is thought to increase after a natural disaster and is related to various factors. The aim of this study was to examine the influencing factors of "Living environment" and "Subjective economic hardship" on new-onset of low back pain in the chronic phase for the survivors of the earthquake evaluated by a self-report questionnaire. A panel study was conducted with the Great East Japan Earthquake survivors at 2 and 3 years after the disaster. New-onset of low back pain was defined as low back pain absent at the 1st period (2 years after the earthquake) and present at the 2nd period (3 years after the earthquake). Living environment was divided into 4 categories (1. Living in the same house as before the earthquake, 2. Living in a prefabricated house, 3. Living in a new house, 4. Others: Living in an apartment, house of relatives or acquaintance). Subjective economic hardship was obtained using the following self-report question: "How do you feel about the current economic situation of your household?" The response alternatives were "Normal", "A little bit hard", "Hard", and "Very hard". A univariate and multivariate logistic regression models were used. 1357 survivors consented to join this study. There was no significant association between new-onset of low back pain and living environment. There was significant association between new-onset of low back pain and "A little hard" (OR = 1.6, 95% CI = 1.07-2.40), "Hard" (OR = 2.2, 95% CI = 1.56-3.74), and "Very hard" (OR = 3.19, 95% CI = 1.84-5.53) in subjective economic hardship. Subjective economic hardship was significantly associated with new-onset of low back pain in the chronic phase for survivors of the Great East Japan Earthquake. Copyright © 2016. Published by Elsevier B.V.

  10. Reliability and validity of observer ratings of pain using the visual analog scale (VAS) in infants undergoing immunization injections.

    Science.gov (United States)

    Taddio, Anna; O'Brien, Lisa; Ipp, Moshe; Stephens, Derek; Goldbach, Morton; Koren, Gideon

    2009-12-15

    We tested the reliability and validity of observer-rated pain in infants undergoing immunization using the visual analog scale (VAS). Pain was assessed in real time and later, from videotapes, in 120 1-year-old infants participating in a double-blind randomized controlled trial of amethocaine vs. placebo. Altogether, 2 (1 physician, 1 non-physician) of 4 raters [2 physicians, 2 non-physicians (nurse and graduate student)] independently assessed baseline and vaccine injection pain using a 100mm unmarked VAS line. Intra- and inter-rater reliability, assessed using the intra-class correlation coefficient (ICC), ranged from 0.69 to 0.91 and 0.55 to 0.97, respectively. Bland-Altman plots demonstrated no evidence of bias between real time and video assessments. When scores were dichotomized into 2 groups (no pain and pain) using a cut-off of >or=30mm, intra-rater reliability ranged from 0.35 to 0.92. The percent of scores deviating by >20mm was 4.5-14.29%. Criterion validity was demonstrated by correlations between the VAS and Modified Behavioural Pain Scale, a validated observational measure; (rho: 0.81-0.94). Injection scores were lower in the amethocaine group, when comparing difference (baseline-injection) or dichotomized scores; significance (pVAS as an outcome measure for acute procedural pain in infants. However, different conclusions may be reached about the effectiveness of analgesic interventions depending on the rater. Sources of variability include use of multiple raters, rater focus (procedure vs. child) and experience level.

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

    OpenAIRE

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

    2014-01-01

    Objectives: 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. Materials and methods: 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 calcu...

  12. Changes of postural control and muscle activation pattern in response to external perturbations after neck flexor fatigue in young subjects with and without chronic neck pain.

    Science.gov (United States)

    Cheng, Chih-Hsiu; Chien, Andy; Hsu, Wei-Li; Yen, Ling-Wei; Lin, Yang-Hua; Cheng, Hsin-Yi Kathy

    2015-03-01

    Previous studies have identified sensorimotor disturbances and greater fatigability of neck muscles in patients with neck pain. The purpose of this study was to investigate the effect of neck pain and neck flexor fatigue on standing balance following postural perturbations. Twenty patients with chronic neck pain (CNP) (24.7±3.6 year-old) and 20 age-matched asymptomatic subjects (22.1±2.2 year-old) were recruited. Subjects stood barefoot on a force plate and experienced backward perturbations before and after neck flexor fatigue. Center of pressure, electromyography of cervical and lumbar muscles, and head/trunk accelerations were recorded. Two-way ANOVA (pain×fatigue) was used for statistical analysis. CNP group showed larger body sway during quiet standing but not during perturbed standing compared with asymptomatic adults. In both groups, neck flexor fatigue resulted in greater body sway during the quiet standing but smaller body sway during perturbed standing, increased neck muscle activations and decreased lumbar muscle activations, as well as increased time to maximal head acceleration. Disturbed balance control was observed in CNP patients during the quiet standing. However, a rigid strategy was used to minimize the postural sway and to protect the head against backward perturbations in both CNP and asymptomatic young adults after neck flexor fatigue. The results facilitate the understanding of how the subjects with chronic neck pain and with neck muscle fatigue deal with the challenging condition. Further studies are needed to verify if such phenomenon could be changed after the intervention of specific flexor muscle retraining and balance control exercises. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Racial discrimination's influence on smoking rates among American Indian Alaska Native two-spirit individuals: does pain play a role?

    Science.gov (United States)

    Johnson-Jennings, Michelle D; Belcourt, Annie; Town, Matthew; Walls, Melissa L; Walters, Karina L

    2014-11-01

    High rates of racial discrimination and non-ceremonial tobacco smoking exist among American Indian/Alaska Native (AIAN) Two-Spirit/LGBT (Lesbian, Gay, Bisexual, Transgender) populations. The authors examined whether or not pain mediates between racial discrimination and smoking among Two-Spirits. Two-Spirit adults (n=447) from seven urban U.S. locations were surveyed during the HONOR project. The Indigenist stress coping model was used as framework in which to conduct descriptive, bivariate and regression analyses. A majority of the participants reported smoking (45.2%) and pain (57%). Pain was found to mediate the association between racial discrimination and smoking. Racial discrimination appears to be a significant factor influencing tobacco smoking and health behaviors within Two-Spirit populations. Effective tobacco cessation and/or prevention planning for Two-Spirits and others who experience frequent racial discrimination, stress, and trauma should also consider the influence of pain. Pain may serve as the embodiment of discrimination, and this possibility requires future research

  14. The reliability of one vs. three trials of pain-free grip strength in subjects with rheumatoid arthritis.

    Science.gov (United States)

    Kennedy, Donna; Jerosch-Herold, Christina; Hickson, Mary

    2010-01-01

    Measurement Reliability. The purpose of the study was to evaluate the test-retest reliability of one vs. the mean of three trials of pain-free grip strength in participants with rheumatoid arthritis (RA). The study used was a repeated-measures, crossover design. Pain-free grip strength was measured with the Biometric E-Link Evaluation System V900S (Unit 25, Nine Mile Point Ind. Est., Gwent UK NP11 7HZ), pain levels recorded before and after grip tests with visual analog scale. High levels of test-retest reliability (intraclass correlation coefficient≥0.91) were found for both one trial and the mean of three trials of pain-free grip strength testing. Median values of grip strength for both methods produced comparable results. Clinically small but statistically significant increases in pain (p≤0.01) were found. One trial of pain-free grip strength is reliable and may save valuable clinical time while reducing the assessment burden placed on patients with RA. N/A. Copyright © 2010 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  15. An observational study of agreement between percentage pain reduction calculated from visual analog or numerical rating scales versus that reported by parturients during labor epidural analgesia.

    Science.gov (United States)

    Pratici, E; Nebout, S; Merbai, N; Filippova, J; Hajage, D; Keita, H

    2017-05-01

    This study aimed to determine the level of agreement between calculated percentage pain reduction, derived from visual analog or numerical rating scales, and patient-reported percentage pain reduction in patients having labor epidural analgesia. In a prospective observational study, parturients were asked to rate their pain intensity on a visual analog scale and numerical rating scale, before and 30min after initiation of epidural analgesia. The percentage pain reduction 30min after epidural analgesia was calculated by the formula: 100×(score before epidural analgesia-score 30min after epidural analgesia)/score before epidural analgesia. To evaluate agreement between calculated percentage pain reduction and patient-reported percentage pain reduction, we computed the concordance correlation coefficient and performed Bland-Altman analysis. Ninety-seven women in labor were enrolled in the study, most of whom were nulliparous, with a singleton fetus and in spontaneous labor. The concordance correlation coefficient with patient-reported percentage pain reduction was 0.76 (95% CI 0.6 to 0.8) and 0.77 (95% CI 0.6 to 0.8) for the visual analog and numerical rating scale, respectively. The Bland-Altman mean difference between calculated percentage pain reduction and patient-reported percentage pain reduction for the visual analog and numerical rating scales was -2.0% (limits of agreement at 29.8%) and 0 (limits of agreement at 28.2%), respectively. The agreement between calculated percentage pain reduction from a visual analog or numerical rating scale and patient-reported percentage pain reduction in the context of labor epidural analgesia was moderate. The difference could range up to 30%. Patient-reported percentage pain reduction has advantages as a measurement tool for assessing pain management for childbirth but differences compared with other assessment methods should be taken into account. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. The Impact of Employment and Self-Rated Economic Condition on the Subjective Well-Being of Older Korean Immigrants.

    Science.gov (United States)

    Kim, Bum Jung; Lee, Yura; Sangalang, Cindy; Harris, Lesley M

    2015-09-01

    Extensive research has demonstrated a relationship between socioeconomic factors and health among older adults, yet fewer studies have explored this relationship with older immigrants. This study aims to examine the influence of employment and self-rated economic condition on the subjective well-being of older Korean immigrants in the United States. Data were drawn from a cross-sectional study of 205 older Korean immigrants, aged 65 to 90, in Los Angeles County. Hierarchical regression was employed to explore the independent and interactive effects of employment status and self-rated economic condition. The study found that employment and self-rated economic status were positively associated with subjective well-being. Also, the interaction between employment and self-rated economic status was significantly associated with higher levels of subjective well-being, such that the influence of self-rated economic condition was stronger for unemployed older Korean immigrants compared with those who were employed. This population-based study provides empirical evidence that employment and self-rated economic condition are directly associated with subjective well-being for older Korean immigrants. © The Author(s) 2015.

  17. High variability of the subjective visual vertical test of vertical perception, in some people with neck pain - Should this be a standard measure of cervical proprioception?

    Science.gov (United States)

    Treleaven, Julia; Takasaki, Hiroshi

    2015-02-01

    Subjective visual vertical (SVV) assesses visual dependence for spacial orientation, via vertical perception testing. Using the computerized rod-and-frame test (CRFT), SVV is thought to be an important measure of cervical proprioception and might be greater in those with whiplash associated disorder (WAD), but to date research findings are inconsistent. The aim of this study was to investigate the most sensitive SVV error measurement to detect group differences between no neck pain control, idiopathic neck pain (INP) and WAD subjects. Cross sectional study. Neck Disability Index (NDI), Dizziness Handicap Inventory short form (DHIsf) and the average constant error (CE), absolute error (AE), root mean square error (RMSE), and variable error (VE) of the SVV were obtained from 142 subjects (48 asymptomatic, 36 INP, 42 WAD). The INP group had significantly (p proprioception in neck pain and more research is required before the SVV can be considered an important measure and utilized clinically. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  18. From beat rate variability in induced pluripotent stem cell-derived pacemaker cells to heart rate variability in human subjects.

    Science.gov (United States)

    Ben-Ari, Meital; Schick, Revital; Barad, Lili; Novak, Atara; Ben-Ari, Erez; Lorber, Avraham; Itskovitz-Eldor, Joseph; Rosen, Michael R; Weissman, Amir; Binah, Ofer

    2014-10-01

    We previously reported that induced pluripotent stem cell-derived cardiomyocytes manifest beat rate variability (BRV) resembling heart rate variability (HRV) in the human sinoatrial node. We now hypothesized the BRV-HRV continuum originates in pacemaker cells. To investigate whether cellular BRV is a source of HRV dynamics, we hypothesized 3 levels of interaction among different cardiomyocyte entities: (1) single pacemaker cells, (2) networks of electrically coupled pacemaker cells, and (3) the in situ sinoatrial node. We measured BRV/HRV properties in single pacemaker cells, induced pluripotent stem cell-derived contracting embryoid bodies (EBs), and electrocardiograms from the same individual. Pronounced BRV/HRV was present at all 3 levels. The coefficient of variance of interbeat intervals and Poincaré plot indices SD1 and SD2 for single cells were 20 times greater than those for EBs (P heart (the latter two were similar; P > .05). We also compared BRV magnitude among single cells, small EBs (~5-10 cells), and larger EBs (>10 cells): BRV indices progressively increased with the decrease in the cell number (P heart rhythm. The decreased BRV magnitude in transitioning from the single cell to the EB suggests that the HRV of in situ hearts originates from the summation and integration of multiple cell-based oscillators. Hence, complex interactions among multiple pacemaker cells and intracellular Ca(2+) handling determine HRV in humans and cardiomyocyte networks. Copyright © 2014 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  19. Single-subject research design: recommendations for levels of evidence and quality rating.

    Science.gov (United States)

    Romeiser Logan, Lynne; Hickman, Robbin R; Harris, Susan R; Heriza, Carolyn B

    2008-02-01

    The aim of this article is to present a set of evidence levels, accompanied by 14 quality or rigor questions, to foster a critical review of published single-subject research articles. In developing these guidelines, we reviewed levels of evidence and quality/rigor criteria that are in wide use for group research designs, e.g. randomized controlled trials, such as those developed by the Treatment Outcomes Committee of the American Academy for Cerebral Palsy and Developmental Medicine. We also reviewed methodological articles on how to conduct and critically evaluate single-subject research designs (SSRDs). We then subjected the quality questions to interrater agreement testing and refined them until acceptable agreement was reached. We recommend that these guidelines be implemented by clinical researchers who plan to conduct single-subject research or who incorporate SSRD studies into systematic reviews, and by clinicians who aim to practise evidence-based medicine and who wish to critically review pediatric single-subject research.

  20. Subjective rating and objective evaluation of the acoustic and indoor climate conditions in video conferencing rooms

    DEFF Research Database (Denmark)

    Hauervig-Jørgensen, Charlotte; Jeong, Cheol-Ho; Toftum, Jørn

    2017-01-01

    Today, face-to-face meetings are frequently replaced by video conferences in order to reduce costs and carbon footprint related to travels and to increase the company efficiency. Yet, complaints about the difficulty of understanding the speech of the participants in both rooms of the video...... conference occur. The aim of this study is to find out the main causes of difficulties in speech communication. Correlation studies between subjective perceptions were conducted through questionnaires and objective acoustic and indoor climate parameters related to video conferencing. Based on four single......-room and three combined-room measurements, it was found that the traditional measure of speech, such as the speech transmission index, was not correlated with the subjective classifications. Thus, a correlation analysis was conducted as an attempt to find the hidden factors behind the subjective perceptions...

  1. Approximate entropy and point correlation dimension of heart rate variability in healthy subjects

    DEFF Research Database (Denmark)

    Storella, R J; Wood, H W; Mills, K M

    1999-01-01

    The contribution of nonlinear dynamics to heart rate variability in healthy humans was examined using surrogate data analysis. Several measures of heart rate variability were used and compared. Heart rates were recorded for three hours and original data sets of 8192 R-R intervals created. For each...... original data set (n = 34), three surrogate data sets were made by shuffling the order of the R-R intervals while retaining their linear correlations. The difference in heart rate variability between the original and surrogate data sets reflects the amount of nonlinear structure in the original data set....... Heart rate variability was analyzed by two different nonlinear methods, point correlation dimension and approximate entropy. Nonlinearity, though under 10 percent, could be detected with both types of heart rate variability measures. More importantly, not only were the correlations between...

  2. An oral TRPV1 antagonist attenuates laser radiant-heat-evoked potentials and pain ratings from UV(B)-inflamed and normal skin.

    Science.gov (United States)

    Schaffler, Klaus; Reeh, Peter; Duan, W Rachel; Best, Andrea E; Othman, Ahmed A; Faltynek, Connie R; Locke, Charles; Nothaft, Wolfram

    2013-02-01

    Laser (radiant-heat) evoked potentials (LEPs) from vertex-EEG peak-to-peak (PtP) amplitude were used to determine acute antinociceptive/antihyperalgesic efficacy of ABT-102, a novel TRPV1 antagonist efficacious in preclinical pain models, compared with active controls and placebo in normal and UV(B)-inflamed skin. This was a randomized, placebo- and active-controlled, double-blind, intra-individual, crossover trial. Twenty-four healthy subjects received six sequences of single doses of ABT-102 (0.5, 2, 6 mg), etoricoxib 90 mg, tramadol 100 mg and placebo. Painful stimuli were induced by CO(2) -laser on normal and UV(B) -inflamed skin. LEPs and visual analogue scale (VAS-pain) ratings were taken at baseline and hourly up to 8 h post-dose from both skin types. Compared with placebo, significant mean decreases in the primary variable of LEP PtP-amplitude from UV(B)-inflamed skin were observed with ABT-102 6 mg (P < 0.001), ABT-102 2 mg (P = 0.002), tramadol 100 mg (P < 0.001), and etoricoxib 90 mg (P = 0.001) over the 8 h period; ABT-102 0.5 mg was similar to placebo. ABT-102 6 mg was superior to active controls over the 8 h period (P < 0.05) whereas ABT-102 2 mg was comparable. Improvements in VAS scores compared with placebo were observed with ABT-102 6 mg (P < 0.001) and ABT-102 2 mg (P = 0.002). ABT-102 average plasma concentrations were 1.3, 4.4 and 9.4 ng ml(-1) for the 0.5, 2 and 6 mg doses, respectively. There were no clinically significant safety findings. TRPV-1 antagonism appears promising in the management of clinical pain, but requires further investigation. © 2012 Abbott. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society.

  3. Reliability of MR-Based Volumetric 3-D Analysis of Pelvic Muscles among Subjects with Low Back with Leg Pain and Healthy Volunteers.

    Science.gov (United States)

    Skorupska, Elżbieta; Keczmer, Przemysław; Łochowski, Rafał M; Tomal, Paulina; Rychlik, Michał; Samborski, Włodzimierz

    2016-01-01

    Lately, the diagnostic value of magnetic resonance imaging, Lasègue sign and classic neurological signs have been considered not accurate enough to distinguish the radicular from non-radicular low back with leg pain (LBLP) and a calculation of the symptomatic side muscle volume has been indicated as a probable valuable marker. However, only the multifidus muscle volume has been calculated so far. The main objective of the study was to verify whether LBLP subjects presented symptomatic side pelvic muscle atrophy compared to healthy volunteers. The second aim was to assess the inter-rater reliability of 3-D manual method for segmenting and measuring the volume of the gluteus maximus, gluteus medius, gluteus minimus and piriformis muscles in both LBLP patients and healthy subjects. Two independent raters analyzed MR images of LBLP and healthy subjects towards muscle volume of four pelvic muscles, i.e. the piriformis, gluteus minimus, gluteus medius and gluteus maximus. For both sides, the MR images of the muscles without adipose tissue infiltration were manually segmented in 3-D medical images. Symptomatic muscle atrophy was confirmed in only over 50% of LBLP subjects (gluteus maximus (ppelvic muscles in both healthy and LBLP subjects. To answer the question of what kind of muscle atrophy is indicative of radicular or non-radicular pain further studies are required.

  4. Optimal protruding node length of bicycle seats determined using cycling postures and subjective ratings.

    Science.gov (United States)

    Chen, Yi-Lang; Liu, Yi-Nan

    2014-07-01

    This study examined body posture, subjective discomfort, and stability, requiring the participants to ride a stationary bicycle for 20 min (cadence: 60 rpm; workrate: 120 W), using various combinations of two handle heights and five seat-protruding node lengths (PNLs). The results indicated that bicycle handle height significantly influenced body posture, and that seat PNL caused differences in the riders' subjective discomfort and stability scores. The various PNLs affected only the trunk angle (approximately 6°), but had significantly positive (r = 0.994, p bicycle seat designs. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  5. A Comparison of Recurrent Non-specific Low Back Pain Patients and Healthy Subjects in Variability of Anticipatory Postural Adjustments

    Directory of Open Access Journals (Sweden)

    Rozita Hedayati

    2010-10-01

    Full Text Available Objective: The purpose of this study was to ivestigate of the postural strategies variability in low back pain patients, as a criterion in the adaptability evaluation of this system to the environmental demands and comparison of patients with healthy persons and also the importance of psychological factors associated with pain as an effective factor in postural disturbances was assessed. Materials & Methods: This analytical, cross-sectional and case-control study was performed on twenty one recurrent non-specific low back pain patients whom had been selected simply and conveniently and twenty one healthy persons whom had been matched with patients. The electromyographic activity of Deltoid, External Oblique, Transverse Abdominis / Internal Oblique and Erector Spinae muscles of each person was recorded in 75 rapid arm flexion with maximum acceleration. To study the patient’s avoidance belief and disability, two standard tools Fear-Avoidance Belief Questionnaire (FABQ and Roland-Morris Questionnaire were used respectively. Data were analyzed by MANOVA and Pearson correlation coefficient. Results: The results showed that chronic low back pain patients exhibit less variability in their anticipatory postural adjustments than the control group(P=0.047. However, the decrease in variability of the timing of anticipatory postural adjustments of External Oblique(P=0.45 and Erector Spinae(P=0.6 muscles was not significant. The correlation between the timing variability of anticipatory postural adjustments and fear-avoidance belief questionnaire scores was significant(P=0.006, however there was no significant correlation between this variable and disability(P=0.09 in the patients. Conclusion: There is a decrease in variability of postural control system of recurrent non-specific low back pain patients that can result in the persistence of pain and chronicity by decreasing the adaptability to environmental demands. The restoration of variability to

  6. The spatial preference map of Dutch entrepreneurs : Subjective rating of locations, 1983, 1993 and 2003

    NARCIS (Netherlands)

    Meester, Wilhelm J.; Pellenbarg, Pieter H.

    2006-01-01

    Location decisions are often based on inaccurate information about potential locations. Decision-makers seem to be guided by their subjective interpretation of reality, not so much by reality itself. Twenty years ago this fundamental idea was the starting point for a research programme of the

  7. Effects of air pollutants on the carbon dioxide (CO2) emission rate of human subjects

    DEFF Research Database (Denmark)

    Bako-Biro, Zsolt; Wargocki, Pawel; Wyon, David

    2004-01-01

    Several laboratory studies have shown the negative effects of emissions from typical indoor pollution sources on perceived air quality, SBS symptoms and the performance of office work. The subjects performed typical office tasks at their own pace while they were exposed for several hours...

  8. 29 CFR 4.118 - Contracts for carriage subject to published tariff rates.

    Science.gov (United States)

    2010-07-01

    ... Application of the McNamara-O'Hara Service Contract Act Specific Exclusions § 4.118 Contracts for carriage..., railway line or oil or gas pipeline where published tariff rates are in effect”. In order for this... is actually governed by published tariff rates in effect pursuant to State or Federal law for such...

  9. Neuroimaging of chronic pain: phantom limb and musculoskeletal pain.

    Science.gov (United States)

    Wiech, K; Preissl, H; Birbaumer, N

    2000-01-01

    New developments in brain imaging lead to a better understanding of cortical and subcortical processes involved in pain perception and the establishment of chronic pain. For different forms of chronic pain long-term changes in cortical structures have been described. In patients with phantom limb pain and back pain alterations in the somatotopic organization of the primary somatosensory (SI) could be observed. The amount of this reorganization is correlated with the subjective pain rating. These changes, which are based on processes of neuronal plasticity, can partially be reversed by analgesic interventions. For the investigation of cortical processes concerning reorganization, EEG and MEG methods are most suitable because of their high temporal and spatial resolution. In conclusion, these findings open a new way for therapeutic interventions to prevent the development of chronic pain.

  10. Effects of alprazolam and clonidine on carbon dioxide-induced increases in anxiety rating in healthy human subjects

    Energy Technology Data Exchange (ETDEWEB)

    Woods, S.W.; Krystal, J.H.; Heninger, G.R.; Charney, D.S.

    1989-01-01

    In order to investigate possible neurobiologic mechanisms underlying carbon dioxide-induced anxiety, the effects of oral alprazolam 0.75 mg and intravenous clonidine 2 mcg/kg on CO/sub 2/-induced increases in ratings of subjective anxiety, pulse rate, and ventilation were measured in healthy human subjects. Pretreatment with alprazolam but not with clonidine significantly reduced the CO/sub 2/-induced increases in ratings of anxiety. Neither drug altered CO/sub 2/-induced increases in pulse rate or ventilatory responses. Clonidine did produce potent sedative and hypotensive effects. The behavioral data suggest that the mechanisms through which CO/sub 2/ induces anxiety-like effects involve neural systems regulated by benzodiazepine receptors and, secondly, that they appear not to require normal functioning of noradrenergic systems. Carbon dioxide may provide a useful model system for identification of new drugs with anxiolytic properties.

  11. Unsteady-state human-body exergy consumption rate and its relation to subjective assessment of dynamic thermal environments

    DEFF Research Database (Denmark)

    Schweiker, Marcel; Kolarik, Jakub; Dovjak, Mateja

    2016-01-01

    Few examples studied applicability of exergy analysis on human thermal comfort. These examples relate the human-body exergy consumption rate with subjectively obtained thermal sensation votes and had been based on steady-state calculation methods. However, humans are rarely exposed to steady...... between the human-body exergy consumption rate and subjective assessment of thermal environment represented by thermal sensation as well as to extend the investigation towards thermal acceptability votes. Comparison of steady-state and unsteady-state model showed that results from both models were...... of the present study confirmed previously indicated trends that lowest human body exergy consumption rate is associated with thermal sensation close to neutrality. Moreover, higher acceptability was in general associated with lower human body exergy consumption rate. (C) 2016 Elsevier B.V. All rights reserved....

  12. Miotic and subject-rated effects of therapeutic doses of tapentadol, tramadol, and hydromorphone in occasional opioid users.

    Science.gov (United States)

    Stoops, William W; Glaser, Paul E A; Rush, Craig R

    2013-07-01

    Tapentadol is a novel analgesic that activates mu-opioid receptors and blocks norepinephrine reuptake. There is very little information available regarding the non-analgesic pharmacodynamic effects of tapentadol. This outpatient study evaluated the physiological, subject-rated, and performance effects of therapeutic doses of tapentadol compared to two control drugs in humans. This double-blind, within-subject study examined the effects of oral placebo, tapentadol (25, 50, and 75 mg), tramadol (50, 100, and 150 mg), and hydromorphone (2, 4, and 6 mg). Nine occasional opioid users completed the study. Pharmacodynamic drug effects were measured before and for 6 h after drug administration. All three doses of the tested drugs produced comparable, time-dependent decreases in pupil diameter, but the effects were generally not dose dependent. The high dose of tapentadol, as well as all three doses of tramadol and hydromorphone, increased positive subject-rated effects (e.g., "Good Effects" and "Like the Drug") as a function of time. Only tramadol increased negative subject-rated effects (e.g., "Bad Effects" and "Nauseous"); however, these were of low magnitude. The highest tested dose of tapentadol produced a profile of positive effects comparable to that of hydromorphone, whereas tramadol produced positive and negative subject-rated effects. The mixed findings for tramadol are consistent with previous findings indicating that it has a distinct profile of effects relative to prototypic opioids. Future research should examine the effects of higher tapentadol doses, as well as the factors contributing to the different subject-rated profile of effects observed for tramadol relative to tapentadol and hydromorphone.

  13. Patients with complex regional pain syndrome type 1: fractal dynamics of heart rate variability and baroreflex evaluations.

    Science.gov (United States)

    Taneyama, Chikuni; Yokota, Shigeru; Goto, Hiroshi

    2013-11-01

    Patients with complex regional pain syndrome type 1 might have disturbed autonomic function and increased heart rate fractal dynamics with a resultant impaired baroreflex sensitivity (BRS). We hypothesized that these parameters of impaired cardiovascular regulation might improve with a reduction of pain intensity. Ten patients and 10 healthy volunteers entered the study. Power spectral analysis of heart rate (HR) variability was performed by the maximum entropy method. Ratios of low-frequency domain to high-frequency domain (LF/HF) and a fractal slope, the slope of a regression line of power spectral density (1/f), were calculated. BRS was assessed with a head-up tilt test. When the visual analogue scale scores decreased to ≤ 20 mm during treatments, those measurements were repeated. LF/HF and steepness of fractal slope before treatments decreased significantly during treatments when visual analogue scale was ≤ 20 mm (2.23 ± 0.68 to 1.30 ± 0.45, P=0.005 and -1.90 ± 0.35 to -1.16 ± 0.14, P=0.00032, respectively). BRS before treatments was low (-0.28 ± 0.27 bpm/mm Hg) as compared with BRS of volunteers but significantly improved to -0.62 ± 0.48 bpm/mm Hg during treatments (P=0.032). Increased LF/HF ratios likely indicate that patients had an imbalance of the autonomic nervous system. The increased fractal slope suggests that patients developed strong self-similarity of HR variability. The highly predictable HR variability leads to impaired hemodynamic homeostasis, resulting in decreased BRS. The impaired cardiovascular regulation improved with a reduction of pain. Thus, spectral analysis of HR variability may be useful objectively to follow complex regional pain syndrome type 1 patients, not only for pain management but also for the status of cardiovascular stability.

  14. The influence of immediate complete anterior guidance development technique on subjective symptoms in Myofascial pain patients: Verified using digital analysis of occlusion (Tek-scan) for analysing occlusion: A 3 years clinical observation.

    Science.gov (United States)

    Thumati, Prafulla

    2015-01-01

    The purpose of this study is to evaluate the effect of occlusal equilibration using immediate complete anterior guidance development (ICAGD) technique by Kerstein and Farrell on the subjective symptoms of myofascial pain. This technique is the most advanced verifiable and measurable way of digitally analyzing the occlusion using T-scan technology. The primary objective is to reduce the anterior disclusion time to myofascial pain. This study is to assess the reducing effects of subjective symptoms of 100 patients diagnosed as myofascial pain patients treated by ICAGD technique as described by Kerstein and Farrell. The common complaints of the patients were a pain in the masseter and temporal muscles, jaw tiredness in the mornings, night bruxing and difficulty in chewing. In this technique occlusal equilibration involves removal of posterior interferences and establish anterior guidance. The patients were treated over three visits 1-week apart and followed for 3 years with an interval of 3 months for the subsequent visits. A visual analog ordinal scale is used to rate the symptoms. The symptoms reduction occurred for all the patients after the first correction in about 5-10 days. In about a period of 3 years review, no recurrence was seen of the chronic myofascial symptoms. In spite of the chronic nature of the patient's symptoms, symptom reduction occurred in a week's time. This was assessed by the results of the ordinal scale values. This agrees with the studies of Kerstein and Farrell. Equilibration of occlusion using digital analysis by T-scan in which force is quantified against time, should be done to establish free functional movements without any interference; otherwise the disturbances in the excursive movements may lead to muscle dysfunction at later years.

  15. SUBJECTIVE CURE RATES AFTER TVT PROCEDURE FOR TREATMENT OF FEMALE URINARY INCONTINENCE – A QUESTIONNAIRE BASED STUDY

    Directory of Open Access Journals (Sweden)

    Igor But

    2003-12-01

    Full Text Available Background. The aim of this study was to assess the subjective cure rate after the tension-free vaginal tape (TVT procedure in patients with stress (SUI and mixed (MUI urinary incontinence.Methods. This is a questionnaire based study done in 43 patients with SUI and 52 patients with MUI. In the assessement of the subjective cure rate the visual analogue scale and the symptom assessment index (SAI were used. Data were analyzed using nonparametric statistics.Results. The subjective cure rate assessed 19.6 months after TVT amounted to 89.3%. Urinary incontinence after TVT procedure was noted in 26 patients (27.4% and the majority of these women (73.1% were diagnosed with MUI. In patients with SUI and postoperative stable bladder a higher success rate was observed (96.7%. In 18.6% patients with SUI, de novo overactive bladder symptoms occurred. These patients estimated a significantly (p = 0.027 lower cure rate (81.9% after TVT procedure. In patients with MUI, the cure rate after TVT amounted to 85.6%. The subjective cure rate was lower (79.4% in case of persistent overactive bladder symptoms. However, it was significantly higher (97.5% in case of a postoperatively stable bladder (p = 0.016. In the group of MUI patients, the symptoms of overactive bladder disease resolved spontaneously in 17 patients (32.7% postoperatively. The patients were satisfied with TVT and 92.6% would recommend this procedure to others.Conclusions. The TVT procedure is a very effective method of treatment for stress as well as mixed urinary incontinence. The success rate of the procedure is high, however, it is influenced by bladder activity.

  16. Manual therapy for the management of pain and limited range of motion in subjects with signs and symptoms of temporomandibular disorder: a systematic review of randomised controlled trials.

    Science.gov (United States)

    Calixtre, L B; Moreira, R F C; Franchini, G H; Alburquerque-Sendín, F; Oliveira, A B

    2015-11-01

    There is a lack of knowledge about the effectiveness of manual therapy (MT) on subjects with temporomandibular disorders (TMD). The aim of this systematic review is to synthetise evidence regarding the isolated effect of MT in improving maximum mouth opening (MMO) and pain in subjects with signs and symptoms of TMD. MEDLINE(®) , Cochrane, Web of Science, SciELO and EMBASE(™) electronic databases were consulted, searching for randomised controlled trials applying MT for TMD compared to other intervention, no intervention or placebo. Two authors independently extracted data, PEDro scale was used to assess risk of bias, and GRADE (Grading of Recommendations Assessment, Development and Evaluation) was applied to synthetise overall quality of the body of evidence. Treatment effect size was calculated for pain, MMO and pressure pain threshold (PPT). Eight trials were included, seven of high methodological quality. Myofascial release and massage techniques applied on the masticatory muscles are more effective than control (low to moderate evidence) but as effective as toxin botulinum injections (moderate evidence). Upper cervical spine thrust manipulation or mobilisation techniques are more effective than control (low to high evidence), while thoracic manipulations are not. There is moderate-to-high evidence that MT techniques protocols are effective. The methodological heterogeneity across trials protocols frequently contributed to decrease quality of evidence. In conclusion, there is widely varying evidence that MT improves pain, MMO and PPT in subjects with TMD signs and symptoms, depending on the technique. Further studies should consider using standardised evaluations and better study designs to strengthen clinical relevance. © 2015 John Wiley & Sons Ltd.

  17. Assessment of salivary calcium, phosphate, magnesium, pH, and flow rate in healthy subjects, periodontitis, and dental caries

    Directory of Open Access Journals (Sweden)

    K S Rajesh

    2015-01-01

    Full Text Available Aim: This study was conducted to estimate and compare inorganic salivary calcium, phosphate, magnesium, salivary flow rate, and pH of unstimulated saliva and oral hygiene status of healthy subjects, subjects with periodontitis and dental caries, and to correlate salivary calcium level with number of intact teeth. Materials and Methods: The study population consisted of 48 systemically healthy subjects in the age group of 18-55 years, which was further divided into three groups: healthy, periodontitis, and dental caries. Oral hygiene index-simplified, probing pocket depth, clinical attachment level, the number of intact teeth, and active carious lesions were recorded. Estimation of inorganic salivary calcium, phosphate, and magnesium was performed spectrophotometrically using Vitros 5.1 FS. Statistical analysis was performed using the one-way analysis of variance test at 5% significance level. Results: There was a statistically significant increase in inorganic salivary calcium, phosphate, pH, flow rate, and poor oral hygiene status in periodontitis group compared to dental caries and healthy group. Conclusion: Subjects with increased inorganic salivary calcium, phosphate, pH, flow rate, and poor oral hygiene are at a higher risk of developing periodontitis. Since there is increased remineralization potential, these subjects have more number of intact teeth compared to the dental caries group.

  18. Self-reported and behavioral sound avoidance in tinnitus and hyperacusis subjects, and association with anxiety ratings.

    Science.gov (United States)

    Blaesing, Lena; Kroener-Herwig, Birgit

    2012-08-01

    The purpose of the study was to analyse the role of sound avoidance and anxiety in tinnitus subjects with hyperacusis, defined as hypersensitivity to low to moderate intensity sounds. A group of tinnitus subjects with hyperacusis was compared to tinnitus subjects without hyperacusis, and healthy controls. For assessing noise avoidance, a questionnaire was developed (noise avoidance questionnaire, NAQ) and the duration of self-exposure to a pure tone was assessed as a behavioral index. Different self-rating instruments concerning tinnitus (STI, TF-12), hyperacusis (GÜF), and anxiety (BAI, STAI-T) were used, as well as a psychoacoustic indicator of hyperacusis (ULL). Fifty-six tinnitus subjects with/without hyperacusis and 30 controls without tinnitus and hyperacusis participated in the experiment. The findings indicate that subjects with hyperacusis reported significantly more noise-related avoidance in daily life and show significantly shorter exposure to a pure tone than non-hyperacusic subjects, while discomfort was at the same level for each individual. Self-reported avoidance behavior correlated significantly with distress attributed to hyperacusis (r =0.81), and with anxiety ratings. These results suggest that hyperacusis is associated with noise-related avoidance behavior and anxiety. Systematic exposure to sound could play a significant role in the treatment of hyperacusis.

  19. Lumbar and abdominal muscle activity during walking in subjects with chronic low back pain: Support of the ''guarding'' hypothesis?

    NARCIS (Netherlands)

    van der Hulst, M.; Vollenbroek-Hutten, Miriam Marie Rosé; Rietman, Johan Swanik; Hermens, Hermanus J.

    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

  20. Subjective social status, self-rated health and tobacco smoking: Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

    Science.gov (United States)

    Camelo, Lidyane do V; Giatti, Luana; Barreto, Sandhi M

    2014-11-01

    Using baseline data from ELSA-Brasil (N = 15,105), we investigated whether subjective social status, measured using three 10-rung "ladders," is associated with self-rated health and smoking, independently of objective indicators of social position and depression symptoms. Additionally, we explored whether the magnitude of these associations varies according to the reference group. Subjective social status was independently associated with poor self-rated health and weakly associated with former smoking. The references used for social comparison did not change these associations significantly. Subjective social status, education, and income represent distinct aspects of social inequities, and the impact of each of these indicators on health is different. © The Author(s) 2013.

  1. Measuring Cognitive Load during Simulation-Based Psychomotor Skills Training: Sensitivity of Secondary-Task Performance and Subjective Ratings

    Science.gov (United States)

    Haji, Faizal A.; Khan, Rabia; Regehr, Glenn; Drake, James; de Ribaupierre, Sandrine; Dubrowski, Adam

    2015-01-01

    As interest in applying cognitive load theory (CLT) to the study and design of pedagogic and technological approaches in healthcare simulation grows, suitable measures of cognitive load (CL) are needed. Here, we report a two-phased study investigating the sensitivity of subjective ratings of mental effort (SRME) and secondary-task performance…

  2. On a class of adjustable rate mortgage loans subject to a strict balance principle

    DEFF Research Database (Denmark)

    Astrup Jensen, Bjarne

    We describe the background and the basic funding mechanisms for the type of adjustable rate mortgageloans that were introduced in the Danish market in 1996. Each loan is funded separately by tap issuingpass-through mortgage bonds (`strict balance principle'). The novelty is a funding mechanism...... algorithms.The algorithms described here show that the essentials can be reduced to a `back of an envelope' complexity.Keywords: Adjustable rate mortgages, balance principle, patent, yield curve riding...

  3. Frame rate vs resolution: A subjective evaluation of spatiotemporal perceived quality under varying computational budgets

    OpenAIRE

    Debattista, K.; Bugeja, K.; Spina, S.; Bashford-Rogers, T.; V. Hulusic

    2017-01-01

    Maximising performance for rendered content requires making compromises on quality parameters depending on the computational resources available. Yet, it is currently unclear which parameters best maximise perceived quality. This work investigates perceived quality across computational budgets for the primary spatio-temporal parameters of resolution and frame rate. Three experiments are conducted. Experiment 1 (n = 26) shows that participants prefer fixed frame rates of 60 frames per second (...

  4. Frame rate vs resolution : a subjective evaluation of spatiotemporal perceived quality under varying computational budgets

    OpenAIRE

    Debattista, Kurt; Bugeja, Keith; Spina, Sandro; Bashford-Rogers, Thomas; Hulusić, Vedad

    2017-01-01

    Maximizing performance for rendered content requires making compromises on quality parameters depending on the computational resources available . Yet, it is currently unclear which parameters best maximize perceived quality. This work investigates perceived quality across computational budgets for the primary spatiotemporal parameters of resolution and frame rate. Three experiments are conducted. Experiment 1 (n = 26) shows that participants prefer fixed frame rates of 60 frames per second (...

  5. Nocturnal heart rate variability is lower in temporomandibular disorder patients than in healthy, pain-free individuals.

    Science.gov (United States)

    Eze-Nliam, Chete M; Quartana, Phillip J; Quain, Angela M; Smith, Michael T

    2011-01-01

    To determine whether patients with a painful myofascial temporomandibular disorder (TMD) have diminished nocturnal heart rate variability (HRV), a marker of autonomic nervous system (ANS) dysfunction, relative to healthy, pain-free controls. Participants with myofascial TMD and healthy, pain-free volunteers underwent nocturnal polysomnography studies during which HRV indices were measured. Multiple linear regression analyses were used to determine whether TMD status exerted unique effects on HRV. Ninety-five participants (n = 37 TMD; n = 58 controls) were included in the analyses. The TMD group had a lower standard deviation of R-R intervals (89.81 ± 23.54 ms versus 107.93 ± 34.42 ms, P ⋜ .01), a lower root mean squared successive difference (RMSSD) of R-R intervals (54.78 ± 27.37 ms versus 81.88 ± 46.43 ms, P pain-free controls. Further research should focus on processes that address this ANS imbalance, which may potentially lead to effective therapeutic interventions.

  6. Reliability of MR-Based Volumetric 3-D Analysis of Pelvic Muscles among Subjects with Low Back with Leg Pain and Healthy Volunteers.

    Directory of Open Access Journals (Sweden)

    Elżbieta Skorupska

    Full Text Available Lately, the diagnostic value of magnetic resonance imaging, Lasègue sign and classic neurological signs have been considered not accurate enough to distinguish the radicular from non-radicular low back with leg pain (LBLP and a calculation of the symptomatic side muscle volume has been indicated as a probable valuable marker. However, only the multifidus muscle volume has been calculated so far. The main objective of the study was to verify whether LBLP subjects presented symptomatic side pelvic muscle atrophy compared to healthy volunteers. The second aim was to assess the inter-rater reliability of 3-D manual method for segmenting and measuring the volume of the gluteus maximus, gluteus medius, gluteus minimus and piriformis muscles in both LBLP patients and healthy subjects.Two independent raters analyzed MR images of LBLP and healthy subjects towards muscle volume of four pelvic muscles, i.e. the piriformis, gluteus minimus, gluteus medius and gluteus maximus. For both sides, the MR images of the muscles without adipose tissue infiltration were manually segmented in 3-D medical images.Symptomatic muscle atrophy was confirmed in only over 50% of LBLP subjects (gluteus maximus (p<0.001, gluteus minimus (p<0.01 and piriformis (p<0.05. The ICC values indicated that the inter-rater reproducibility was greater than 0.90 for all measurements (LBLP and healthy subjects, except for the measurement of the right gluteus medius muscle in LBLP patients, which was equal to 0.848.More than 50% of LBLP subjects presented symptomatic gluteus maximus, gluteus minimus and piriformis muscle atrophy. 3-D manual segmentation reliably measured muscle volume in all the measured pelvic muscles in both healthy and LBLP subjects. To answer the question of what kind of muscle atrophy is indicative of radicular or non-radicular pain further studies are required.

  7. The functional rating index: reliability and validity of the Persian language version in patients with low back pain.

    Science.gov (United States)

    Ansari, Noureddin Nakhostin; Feise, Ronald J; Naghdi, Soofia; Ebadi, Safoora; Yoosefinejad, Amin Kordi

    2011-11-15

    Crosscultural adaptation and psychometric measurements of the Functional Rating Index (FRI). To develop and investigate the reliability and validity of the Persian version of the FRI when applied to patients with low back pain (LBP). The FRI is a self-report questionnaire designed to assess patient's perception of function and pain. Despite the use of this outcome measure in clinical trials in Iran, it was not translated and culturally adapted. The FRI was translated into Persian language and crossculturally adapted. The Persian FRI was administered to 100 patients with LBP (male patients/female patients = 22/78). A numerical rating scale, the Roland-Morris Disability Questionnaire, the Oswestry Disability Questionnaire, and the Quebec Back Pain Disability Scale were also recorded. The test-retest reliability (time interval = 7 days) was assessed in 50 patients. There were no missing responses and floor or ceiling effects. The examination of discriminative validity showed that the questionnaire discriminated clearly between patients and healthy participants (P < 0.001). The concurrent criterion validity was confirmed by the Spearman rank correlation between the Persian FRI and the numerical rating scale (0.73, P < 0.0001 for test; and 0.77 for retest, P < 0.0001). Evidence for construct validity was found with a significant Pearson correlation between the FRI and the Roland-Morris Disability Questionnaire (r = 0.61; P < 0.0001), the Oswestry Disability Questionnaire (r = 0.75; P < 0.0001), or Quebec Back Pain Disability Scale (r = 0.76; P < 0.0001). Internal consistency reliability estimates (Cronbach α) for the Persian FRI were high, with 0.89 for test and 0.92 for retest. The test-retest reliability for the total score was excellent with an intraclass correlation coefficient (agreement) (ICCagreement) of 0.81 (P < 0.0001). The Persian version of the FRI seems to have an excellent reliability and validity when applied to patients with LBP.

  8. Characterization of a New Fully Recycled Carbon Fiber Reinforced Composite Subjected to High Strain Rate Tension

    Science.gov (United States)

    Meftah, H.; Tamboura, S.; Fitoussi, J.; BenDaly, H.; Tcharkhtchi, A.

    2017-08-01

    The aim of this study is the complete physicochemical characterization and strain rate effect multi-scale analysis of a new fully recycled carbon fiber reinforced composites for automotive crash application. Two composites made of 20% wt short recycled carbon fibers (CF) are obtained by injection molding. The morphology and the degree of dispersion of CF in the matrixes were examined using a new ultrasonic method and SEM. High strain tensile behavior up to 100 s-1 is investigated. In order to avoid perturbation due to inertial effect and wave propagation, the specimen geometry was optimized. The elastic properties appear to be insensitive to the strain rate. However, a high strain rate effect on the local visco-plasticity of the matrix and fiber/matrix interface visco-damageable behavior is emphasized. The predominant damage mechanisms evolve from generalized matrix local ductility at low strain rate regime to fiber/matrix interface debonding and fibers pull-out at high strain rate regime.

  9. Increase in perceived stress is correlated to lower heart rate variability in healthy young subjects

    Directory of Open Access Journals (Sweden)

    Ana Gabriela Câmara Batista da Silva

    2015-06-01

    Full Text Available Emotional stress is a risk factor for cardiovascular disease. Decreased heart rate variability (HRV is associated to increased mortality rates in certain heart diseases. Current study assessed the co-relation between perceived stress and HRV parameters. The correlation between psychological stress, measured by the perceived stress scale (PSS-14, and HRV parameters obtained during 5 min. at rest was evaluated. Data from 35 healthy young volunteers demonstrated a significant correlation between PSS-14 scores and Low Frequency-LF (ms2 by frequency domain HRV analysis. Other variables such as High Frequency and Standard Deviation of R-R intervals had also negative coefficients but did not have any significant correlation with PSS-14. No correlation between PSS-14 and sympathovagal balance parameters was found. Data interpretation demonstrated that increase in perceived stress was correlated to decrease in heart rate variability, which may point out an important mechanism in cardiovascular pathophysiology that should be further investigated.

  10. Microscale consolidation analysis of relaxation behavior of single living chondrocytes subjected to varying strain-rates.

    Science.gov (United States)

    Nguyen, Trung Dung; Oloyede, Adekunle; Singh, Sanjleena; Gu, YuanTong

    2015-09-01

    Besides the elastic stiffness, the relaxation behavior of single living cells is also of interest of various researchers when studying cell mechanics. It is hypothesized that the relaxation response of the cells is governed by both intrinsic viscoelasticity of the solid phase and fluid-solid interactions mechanisms. There are a number of mechanical models have been developed to investigate the relaxation behavior of single cells. However, there is lack of model enable to accurately capture both of the mechanisms. Therefore, in this study, the porohyperelastic (PHE) model, which is an extension of the consolidation theory, combined with inverse Finite Element Analysis (FEA) technique was used at the first time to investigate the relaxation response of living chondrocytes. This model was also utilized to study the dependence of relaxation behavior of the cells on strain-rates. The stress-relaxation experiments under the various strain-rates were conducted with the Atomic Force Microscopy (AFM). The results have demonstrated that the PHE model could effectively capture the stress-relaxation behavior of the living chondrocytes, especially at intermediate to high strain-rates. Although this model gave some errors at lower strain-rates, its performance was acceptable. Therefore, the PHE model is properly a promising model for single cell mechanics studies. Moreover, it has been found that the hydraulic permeability of living chondrocytes reduced with decreasing of strain-rates. It might be due to the intracellular fluid volume fraction and the fluid pore pressure gradients of chondrocytes were higher when higher strain-rates applied. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Subjective Ratings of Annoyance Produced by Rotary-Wing Aircraft Noise

    Science.gov (United States)

    1977-05-01

    nov "is ossoLaTa Unclassified SECURITY CLASSFICATION 5.Frs PARE FW- D Eneredt- 𔃻 5 7 W Unclassified 69CURITY CLASIFICATION OF THIS PAG9(Vhw Da...paths followed during the various maneuvers relative to the location of the observers rendering the ratings. The observers were 25 adults hired on a

  12. Subjective ratings of prospective memory deficits in chronic heavy alcohol users

    OpenAIRE

    Heffernan, Tom; Moss, Mark; Ling, Jonathan

    2002-01-01

    Chronic alcohol abuse has a detrimental effect on retrospective memory. Less is known about its putative effects on everyday memory. This study looked at self-ratings of prospective memory (PM) (memory for future events). After controlling for other drug and strategy use, chronic heavy alcohol users showed global impairments in PM, when compared to matched controls. The underlying mechanisms are discussed.

  13. Effects of Aerobic Exercise Based upon Heart Rate at Aerobic Threshold in Obese Elderly Subjects with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Gian Pietro Emerenziani

    2015-01-01

    Full Text Available In obese diabetic subjects, a correct life style, including diet and physical activity, is part of a correct intervention protocol. Thus, the aim of this study was to evaluate the effects of aerobic training intervention, based on heart rate at aerobic gas exchange threshold (AerTge, on clinical and physiological parameters in obese elderly subjects with type 2 diabetes (OT2DM. Thirty OT2DM subjects were randomly assigned to an intervention (IG or control group (CG. The IG performed a supervised aerobic exercise training based on heart rate at AerTge whereas CG maintained their usual lifestyle. Anthropometric measures, blood analysis, peak oxygen consumption (V˙O2peak, metabolic equivalent (METpeak, work rate (WRpeak, and WRAerTge were assessed at baseline and after intervention. After training, patients enrolled in the IG had significantly higher (P<0.001 V˙O2peak, METpeak, WRpeak, and WRAerTge and significantly lower (P<0.005 weight, BMI, %FM, and waist circumference than before intervention. Both IG and CG subjects had lower glycated haemoglobin levels after intervention period. No significant differences were found for all the other parameters between pre- and posttraining and between groups. Aerobic exercise prescription based upon HR at AerTge could be a valuable physical intervention tool to improve the fitness level and metabolic equilibrium in OT2DM patients.

  14. The effect of thumb splinting on thenar muscles atrophy, pain, and function in subjects with thumb carpometacarpal joint osteoarthritis.

    Science.gov (United States)

    Arazpour, Mokhtar; Soflaei, Mohaddeseh; Ahmadi Bani, Monireh; Madani, Seyed Pezhman; Sattari, Mahsa; Biglarian, Akbar; Mosallanezhad, Zahra

    2017-08-01

    When the first carpometacarpal joint of the wrist is immobilized using an orthosis to combat the effects of osteoarthritis, atrophy of the thenar muscles may occur. The aim of this study was to evaluate the thenar muscle diameter and cross-sectional area, joint function, and pain, before and after being supplied with an orthosis in patients with grades 1 and 2 carpometacarpal osteoarthritis compared to a control group. Randomized clinical trial. A total of 25 volunteer patients were randomized into two groups (an orthosis group and a control group) using a randomization table. A visual analog scale, the Michigan Hand Questionnaire, and ultrasound were used to measure pain, function, and specific muscle cross-sectional areas at baseline and after 4 weeks in both groups. Mean visual analog scale pain scores decreased by 20% after 4 weeks of splinting, while those in the control group decreased by 3%. Changes in scores were significantly different between both groups ( p = 0.001). There was no significant difference between the groups in either the Michigan Hand Questionnaire score or the muscle cross-sectional area. A large and significant effect on perceived pain in patients with first carpometacarpal joint osteoarthritis was observed after 4 weeks of splint use. Differences in treatment effects were found with regard to muscle cross-sectional areas, but these were not significant. Clinical relevance Custom-made splints may be recommended for the treatment of first carpometacarpal joint osteoarthritis. Moderate to large but non-significant treatment effects were found with regard to muscle cross-sectional areas.

  15. Effects of lowering barometric pressure on guarding behavior, heart rate and blood pressure in a rat model of neuropathic pain.

    Science.gov (United States)

    Sato, J; Takanari, K; Omura, S; Mizumura, K

    2001-02-16

    We investigated whether lowering barometric pressure by 20 mmHg (LP) aggravates the guarding behavior suggestive of spontaneous pain following sciatic nerve chronic constriction injury (CCI) in rats. Systemic blood pressure (BP) and heart rate (HR) of unrestrained rats were recorded telemetrically during LP both before and after the CCI surgery. CCI rats showed guarding posture in normopressure conditions, and LP increased the cumulative time of this behavior. Baseline BP but not HR was increased following CCI. LP increased BP and HR of the rats only before the CCI surgery. Animals after CCI surgery showed variable (BP, HR) and transient (HR) responses to LP. These results indicate that (1) LP aggravated spontaneous pain and increased BP and HR in the CCI rats, and (2) CCI surgery influenced BP and HR of rats.

  16. Perioperative psychological and music interventions in elderly patients undergoing spinal anesthesia: effect on anxiety, heart rate variability, and postoperative pain.

    Science.gov (United States)

    Wang, Yisha; Dong, Youjing; Li, Yang

    2014-07-01

    The aim of this study was to evaluate the effects of perioperative psychological and music interventions in elderly patients undergoing elective surgery on anxiety, post-operative pain, and changes in heart rate variability (HRV) to ascertain if perioperative psychological and music interventions can affect overall anxiety levels. Fourty elderly patients undergoing elective surgery were randomized to two groups; one group received psychological and music intervention, and the other was the control. The intervention group underwent psychological intervention and listening to music for 30 min before surgery. The mean change in HRV as determined by low frequency (LF) power measurements. After the intervention, the ratio of mean LF to high frequency (HF) power decreased significantly in the intervention group compared to before the intervention (panxiety score of the intervention group decreased after the procedure compared to before (pmusic interventions can reduce anxiety and postoperative pain in elderly patients.

  17. Error rates of a full-duplex system over EGK fading channels subject to laplacian interference

    KAUST Repository

    Soury, Hamza

    2017-07-31

    This paper develops a mathematical paradigm to study downlink error rates and throughput for half-duplex (HD) terminals served by a full-duplex (FD) base station (BS). Particularly, we study the dominant intra-cell interferer problem that appears between HD users scheduled on the same FD-channel. The distribution of the dominant interference is first characterized via its distribution function, which is derived in closed-form. Assuming Nakagami-m fading, the probability of error for different modulation schemes is studied and a unified closed-form expression for the average symbol error rate is derived. To this end, we show the effective downlink throughput gain, harvested by employing FD communication at a BS that serves HD users, as a function of the signal-to-interference-ratio when compared to an idealized HD interference and noise free BS operation.

  18. Dynamic Evaluation of Acrylonitrile Butadiene Styrene Subjected to High-Strain-Rate Compressive Loads

    Science.gov (United States)

    2014-12-01

    Conclusions 10 5. References 11 Distribution List 13 iv List of Figures Figure 1. ASTM D 638-03 dog bone...1. ASTM D 638-03 dog bone. When designing the specimen for tensile testing, it is important that the tensile specimen be built such that the...2006, 45 (1), 18–24. 8. Lee, W. S.; Lin, C. F. Plastic Deformation and Fracture Behaviour of Ti–6Al–4V Alloy Loaded With High Strain Rate Under

  19. Clearance and synthesis rates of beta 2-microglobulin in patients undergoing hemodialysis and in normal subjects

    Energy Technology Data Exchange (ETDEWEB)

    Floege, J.; Bartsch, A.; Schulze, M.; Shaldon, S.; Koch, K.M.; Smeby, L.C. (Department of Nephrology, University Hospital of Hannover (Germany))

    1991-08-01

    Retention of {beta} 2-microglobulin in patients undergoing hemodialysis is associated with a {beta} 2-microglobulin-derived amyloidosis. Removal of {beta} 2-microglobulin by renal replacement therapy has been proposed for the prevention of this amyloidosis. Currently, however, data on the {beta} 2-microglobulin synthesis rate in patients undergoing hemodialysis are scarce, and consequently it remains speculative how much removal would be necessary to counterbalance synthesis. The plasma kinetics of iodine 131-labeled {beta} 2-microglobulin were therefore examined in 11 patients with anuria who were undergoing long-term hemodialysis. Five healthy persons served as controls. Kinetic modeling of the plasma curves showed that the data fitted a two-pool model (r2 greater than 0.96) consisting of a rapid 2 to 4 hour distribution phase followed by a less steep curve, described by the plasma (metabolic) clearance (Clp). Synthetic rates were calculated from Clp and the {beta} 2-microglobulin steady state plasma concentration (plus {beta} 2-microglobulin removal during hemodialysis in the case of high flux hemodialysis). The results showed a significantly higher Clp in normal controls as compared with patients undergoing hemodialysis (65.5 {plus minus} 12.8 ml/min (mean {plus minus} SD) versus 3.4 {plus minus} 0.7 ml/min). In contrast, the {beta} 2-microglobulin synthesis rate in the patient group (3.10 {plus minus} 0.79 mg/kg/day) was not significantly different from that of normal controls (2.40 {plus minus} 0.67 mg/kg/day), which was due to markedly elevated {beta} 2-microglobulin plasma concentrations in the patients (37.6 {plus minus} 14.1 mg/L vs 1.92 {plus minus} 0.27 mg/L). These findings suggest that the presence of end-stage renal disease does not have a significant impact on the beta 2-microglobulin generation rate.

  20. Effects of alcohol on subjective ratings of prospective and everyday memory deficits

    OpenAIRE

    Ling, Jonathan; Heffernan, Tom; Buchanan, Tom; Rodgers, Jacqui; Scholey, Andrew; Parrott, Andrew

    2003-01-01

    Background: Research has shown that heavy alcohol use has a detrimental effect on retrospective memory. Less is known about the effect of alcohol on everyday memory. Methods: This study examined self-ratings of two aspects of memory performance: prospective memory (for example, forgetting to pass on a message) and everyday memory (measured by cognitive failures, such as telling someone a joke that you have told them before). To ensure anonymity and expand on the numbers of participants used i...

  1. Recommendations for aerobic endurance training based on subjective ratings of perceived exertion in healthy seniors.

    Science.gov (United States)

    Donath, Lars; Zahner, Lukas; Cordes, Mareike; Hanssen, Henner; Schmidt-Trucksäss, Aarno; Faude, Oliver

    2013-01-01

    The study investigated physiological responses during 2-km walking at a certain intensity of a previously performed maximal exercise test where moderate perceived exertion was reported. Twenty seniors were examined by an incremental walking treadmill test to obtain maximal oxygen uptake (VO2max). A submaximal 2-km walking test was applied 1 wk later. The corresponding moderate perceived exertion (4 on the CR-10 scale) during the VO2max test was applied to the 2-km treadmill test. Moderate exertion (mean rating of perceived exertion [RPE]: 4 ± 1) led to 76% ± 8% of VO2max and 79% ± 6% of maximal heart rate. RPE values drifted with a significant time effect (p = .001, η(p) = .58) during the 2-km test from 3 ± 0.7 to 4.6 ± 0.8. Total energy expenditure (EE) was 3.3 ± 0.5 kcal/kg. No gender differences in ventilatory, heart-rate, or EE data occurred. Brisk walking at moderate RPE of 3-5 would lead to a beneficial physiological response during endurance training and a weekly EE of nearly 1,200 kcal when exercising 5 times/wk for 30 min.

  2. Medical students' subjective ratings of stress levels and awareness of student support services about mental health.

    Science.gov (United States)

    Walter, Garry; Soh, Nerissa Li-Wey; Norgren Jaconelli, Sanna; Lampe, Lisa; Malhi, Gin S; Hunt, Glenn

    2013-06-01

    To descriptively assess medical students' concerns for their mental and emotional state, perceived need to conceal mental problems, perceived level of support at university, knowledge and use of student support services, and experience of stresses of daily life. From March to September 2011, medical students at an Australian university were invited to complete an anonymous online survey. 475 responses were received. Students rated study and examinations (48.9%), financial concerns (38.1%), isolation (19.4%) and relationship concerns (19.2%) as very or extremely stressful issues. Knowledge of available support services was high, with 90.8% indicating they were aware of the university's medical centre. Treatment rates were modest (31.7%). Students' concerns about their mental state were generally low, but one in five strongly felt they needed to conceal their emotional problems. Despite widespread awareness of appropriate support services, a large proportion of students felt they needed to conceal mental and emotional problems. Overall treatment rates for students who were greatly concerned about their mental and emotional state appeared modest, and, although comparable with those of similarly aged community populations, may reflect undertreatment. It would be appropriate for universities to address stressors identified by students. Strategies for encouraging distressed students to obtain appropriate assessment and treatment should also be explored. Those students who do seek healthcare are most likely to see a primary care physician, suggesting an important screening role for these health professionals.

  3. Multi-modal intervention for the inpatient management of sickle cell pain significantly decreases the rate of acute chest syndrome.

    Science.gov (United States)

    Reagan, Mary M; DeBaun, Michael R; Frei-Jones, Melissa J

    2011-02-01

    Pain in children with sickle cell disease (SCD) is the leading cause of acute care visits and hospitalizations. Pain episodes are a risk factor for the development of acute chest syndrome (ACS), contributing to morbidity and mortality in SCD. Few strategies exist to prevent this complication. We performed a before-and-after prospective multi-modal intervention. All children with SCD admitted for pain during the 2-year study period were eligible. The multi-modal intervention included standardized admission orders, monthly house staff education, and one-on-one patient and caregiver education. A total of 332 admissions for pain occurred during the study period; 159 before the intervention and 173 during the intervention. The ACS rate declined by 50% during the intervention period 25% (39 of 159) to 12% (21 of 173); P = 0.003. Time to ACS development increased from 0.8 days (0.03-5.2) to 1.7 days (0.03-5.8); P = 0.047. No significant difference was found in patient demographics, intravenous fluid amount administered, frequency of normal saline bolus administration, or cumulative opioid amount delivered in the first 24 hr. Patient controlled analgesia-use was more common after the intervention 52% (82 of 159) versus 73% (126 of 173; P = 0.0001) and fewer patients required changes in analgesic dosing within the first 24 hr after admission (26%, 42 of 159 vs. 16%, 28 of 173; P = 0.015). A multi-modal intervention to educate and subsequently change physician's behavior likely decreased the rate of ACS in the setting of a single teaching hospital. Copyright © 2010 Wiley-Liss, Inc.

  4. Postoperative pain assessment based on numeric ratings is not the same for patients and professionals: A cross-sectional study

    NARCIS (Netherlands)

    van Dijk, J.F.; van Wijck, A.J.M.; Kappen, T.H.; Peelen, L.M.; Kalkman, C.J.; Schuurmans, M.J.

    Background: Numeric pain scores have become important in clinical practice to assess postoperative pain and to help develop guidelines for treating pain. Professionals need the patients’ pain scores to administer analgesic medication. However, do professionals interpret the pain scores in line with

  5. 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...

  6. Effects of vicarious pain on self-pain perception: investigating the role of awareness.

    Science.gov (United States)

    Terrighena, Esslin L; Lu, Ge; Yuen, Wai Ping; Lee, Tatia Mc; Keuper, Kati

    2017-01-01

    The observation of pain in others may enhance or reduce self-pain, yet the boundary conditions and factors that determine the direction of such effects are poorly understood. The current study set out to show that visual stimulus awareness plays a crucial role in determining whether vicarious pain primarily activates behavioral defense systems that enhance pain sensitivity and stimulate withdrawal or appetitive systems that attenuate pain sensitivity and stimulate approach. We employed a mixed factorial design with the between-subject factors exposure time (subliminal vs optimal) and vicarious pain (pain vs no pain images), and the within-subject factor session (baseline vs trial) to investigate how visual awareness of vicarious pain images affects subsequent self-pain in the cold-pressor test. Self-pain tolerance, intensity and unpleasantness were evaluated in a sample of 77 healthy participants. Results revealed significant interactions of exposure time and vicarious pain in all three dependent measures. In the presence of visual awareness (optimal condition), vicarious pain compared to no-pain elicited overall enhanced self-pain sensitivity, indexed by reduced pain tolerance and enhanced ratings of pain intensity and unpleasantness. Conversely, in the absence of visual awareness (subliminal condition), vicarious pain evoked decreased self-pain intensity and unpleasantness while pain tolerance remained unaffected. These findings suggest that the activation of defense mechanisms by vicarious pain depends on relatively elaborate cognitive processes, while - strikingly - the appetitive system is activated in highly automatic manner independent from stimulus awareness. Such mechanisms may have evolved to facilitate empathic, protective approach responses toward suffering individuals, ensuring survival of the protective social group.

  7. Effects of vicarious pain on self-pain perception: investigating the role of awareness

    Science.gov (United States)

    Terrighena, Esslin L; Lu, Ge; Yuen, Wai Ping; Lee, Tatia MC; Keuper, Kati

    2017-01-01

    The observation of pain in others may enhance or reduce self-pain, yet the boundary conditions and factors that determine the direction of such effects are poorly understood. The current study set out to show that visual stimulus awareness plays a crucial role in determining whether vicarious pain primarily activates behavioral defense systems that enhance pain sensitivity and stimulate withdrawal or appetitive systems that attenuate pain sensitivity and stimulate approach. We employed a mixed factorial design with the between-subject factors exposure time (subliminal vs optimal) and vicarious pain (pain vs no pain images), and the within-subject factor session (baseline vs trial) to investigate how visual awareness of vicarious pain images affects subsequent self-pain in the cold-pressor test. Self-pain tolerance, intensity and unpleasantness were evaluated in a sample of 77 healthy participants. Results revealed significant interactions of exposure time and vicarious pain in all three dependent measures. In the presence of visual awareness (optimal condition), vicarious pain compared to no-pain elicited overall enhanced self-pain sensitivity, indexed by reduced pain tolerance and enhanced ratings of pain intensity and unpleasantness. Conversely, in the absence of visual awareness (subliminal condition), vicarious pain evoked decreased self-pain intensity and unpleasantness while pain tolerance remained unaffected. These findings suggest that the activation of defense mechanisms by vicarious pain depends on relatively elaborate cognitive processes, while – strikingly – the appetitive system is activated in highly automatic manner independent from stimulus awareness. Such mechanisms may have evolved to facilitate empathic, protective approach responses toward suffering individuals, ensuring survival of the protective social group. PMID:28831270

  8. Pain and depression in acute traumatic spinal cord injury: origins of chronic problematic pain?

    Science.gov (United States)

    Cairns, D M; Adkins, R H; Scott, M D

    1996-04-01

    To examine the relationship between pain and depression over time during acute phases of traumatic spinal cord injury (SCI). Theoretical models of the pain-depression relationship provided the framework: (1) pain causes depression; (2) depression causes pain; (3) pain and depression are independent sequelae to SCI. Understanding the pain-depression relationship provides treatment implications and hypotheses for origins of chronic pain in SCI. A repeated measures design assessing subjects at admission and discharge from rehabilitation. Subjects were admitted to a large public hospital in Southern California which is a member of the Model Spinal Cord Injury System. Rehabilitation occurred on two 30-bed units. Complete admission and discharge data sets were collected from 68 acute traumatic SCI patients who served as subjects. One hundred twenty-one patients initially agreed to participate in a larger study of adjustments to SCI. Thirty-three did not have pain data at admission, 16 dropped out, and 4 had incomplete discharge data. Subjects volunteered and were paid a fee. A standard rehabilitation program for SCI. Pain assessment used a 101-point numerical rating scale. Depression assessment used the Center for Epidemiological Studies-Depression Scale(CESD). Pain and depression were independent at admission. At discharge, they were significantly related. Changes in pain affected depression more than changes in depression affected pain. Relationships between pain and depression develop over time. Reduced pain will have a greater effect on reducing depression than reduced depression will have on pain. Pain described as "burning" during the acute phase does not represent difficult to treat dysesthetic pain, as it may in chronic SCI pain.

  9. Entropy-rate clustering: cluster analysis via maximizing a submodular function subject to a matroid constraint.

    Science.gov (United States)

    Liu, Ming-Yu; Tuzel, Oncel; Ramalingam, Srikumar; Chellappa, Rama

    2014-01-01

    We propose a new objective function for clustering. This objective function consists of two components: the entropy rate of a random walk on a graph and a balancing term. The entropy rate favors formation of compact and homogeneous clusters, while the balancing function encourages clusters with similar sizes and penalizes larger clusters that aggressively group samples. We present a novel graph construction for the graph associated with the data and show that this construction induces a matroid--a combinatorial structure that generalizes the concept of linear independence in vector spaces. The clustering result is given by the graph topology that maximizes the objective function under the matroid constraint. By exploiting the submodular and monotonic properties of the objective function, we develop an efficient greedy algorithm. Furthermore, we prove an approximation bound of (1/2) for the optimality of the greedy solution. We validate the proposed algorithm on various benchmarks and show its competitive performances with respect to popular clustering algorithms. We further apply it for the task of superpixel segmentation. Experiments on the Berkeley segmentation data set reveal its superior performances over the state-of-the-art superpixel segmentation algorithms in all the standard evaluation metrics.

  10. Relation between food intake and visual analogue scale ratings of appetite and other sensations in healthy older and young subjects.

    Science.gov (United States)

    Parker, B A; Sturm, K; MacIntosh, C G; Feinle, C; Horowitz, M; Chapman, I M

    2004-02-01

    Visual analogue scales are widely used in appetite research, yet the validity of these scales to evaluate appetite and mood has not been assessed in older subjects. The aim of this study was to determine the relations between food intake and visual analogue scale (VAS) ratings of appetite and nonappetite sensations in healthy older and young subjects. Retrospective combined analysis of four single-blind, randomised, controlled appetite studies. All studies were conducted in the University of Adelaide, Department of Medicine, Adelaide, Australia. A total of 45 healthy young men (n=24) and women (n=21) aged 18-35 y and 45 healthy older men (n=24) and women (n=21) aged 65-85 y were recruited by advertisement. Oral, intraduodenal or intravenous administration of treatments which suppressed food intake were compared to control. Up to 90 min after treatment, a test meal was offered and subjects ate freely for between 30 and 60 min. Perceptions were assessed by 100-mm visual analogue scales administered at regular intervals. Food intake at the test meal was positively related to perceptions of hunger, drowsiness, and calmness at both baseline and premeal (r>0.16, P 0.2, P<0.05) in both older and young subjects. Food intake was related to VAS ratings at least as strongly, if not more so, in older as in young subjects. These observations (i) confirm that food intake is related to perceptions of hunger and fullness as assessed by VAS in healthy older and young subjects, and (ii) suggest that sensations, not obviously associated with appetite, including 'drowsiness' and 'calmness', are also associated with food intake.

  11. C-reactive protein, heart rate variability and prognosis in community subjects with no apparent heart disease

    DEFF Research Database (Denmark)

    Sajadieh, A; Nielsen, OW; Rasmussen, Verner

    2006-01-01

    OBJECTIVES: Increased C-reactive protein (CRP) and reduced heart rate variability (HRV) both indicate poor prognosis. An inverse association between HRV and CRP has been reported, suggesting an interaction between inflammatory and autonomic systems. However, the prognostic impact...... of this interaction has not been studied. We thus investigated the prognostic impact of CRP, HRV and their combinations. DESIGN: Population-based study. SUBJECTS: A total of 638 middle-aged and elderly subjects with no apparent heart disease from community. METHODS: All were studied by clinical and laboratory...... of four HRV measures were significantly associated with increased rate of death or myocardial infarction. In a Cox model with CRP >or=2.5 microg mL(-1), standard deviation for the mean value of the time between normal complexes...

  12. Evaluation of nurse accuracy in rating procedural pain among pediatric burn patients using the Face, Legs, Activity, Cry, Consolability (FLACC) Scale.

    Science.gov (United States)

    Shen, Jiabin; Giles, Sheila A; Kurtovic, Kelli; Fabia, Renata; Besner, Gail E; Wheeler, Krista K; Xiang, Huiyun; Groner, Jonathan I

    2017-02-01

    Accurate pain assessment is essential for proper analgesia during medical procedures in pediatric patients. The Faces, Legs, Activity, Cry, and Consolability (FLACC) scale has previously been shown to be a valid and reliable tool for assessing pediatric procedural pain in research labs. However, no study has investigated how rater factors (gender, number of dressing changes performed/week, burn history, having children, nursing experience, stress at home/work) and patient factors (pain intensity) affect the accuracy of FLACC ratings for procedural pain when implemented by bedside care providers. Twenty-four nurses in an ABA verified Pediatric Burn Center watched four videos of dressing changes for pediatric burn patients in random order three times and rated the children's procedural pain using the FLACC scale. The four videos had standard FLACC scores established by an interdisciplinary panel. Descriptive and mixed modeling analysis was conducted to explore nurse rating accuracy and to evaluate the rater and patient factors that influenced the rating accuracy. The highest accuracy was reached when rating high procedural pain (with a FLACC of 6). Nurses underrated both mild and severe procedural pain. Nurses who had less nursing experience demonstrated significantly higher accuracy than those with more experience. The present study is the first study in the literature to systematically examine the factors influencing the accuracy of FLACC rating for pediatric procedural pain among bedside care providers. The findings suggest that nurse clinical experience and patient pain intensity are two significant contributors to rating accuracy. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  13. Glucosamine-containing supplement improves locomotor functions in subjects with knee pain a randomized, double-blind, placebo-controlled study

    Directory of Open Access Journals (Sweden)

    Kanzaki N

    2015-10-01

    Full Text Available Noriyuki Kanzaki,1 Yoshiko Ono,1 Hiroshi Shibata,1 Toshio Moritani2 1Institute for Health Care Science, Suntory Wellness Ltd, Seika-cho, Soraku-gun, 2Graduate School of Human and Environmental Studies, Kyoto University, Sakyo-ku, Kyoto, Japan Background: The aim of this study was to investigate the ability of a glucosamine-containing supplement to improve locomotor functions in subjects with knee pain.Methods: A randomized, double-blind, placebo-controlled, parallel-group comparative study was conducted for 16 weeks in 100 Japanese subjects (age, 51.8±0.8 years with knee pain. Subjects were randomly assigned to one of the two supplements containing 1 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, and 5 µg of vitamin D per day (GCQID group, n=50 or 2 a placebo (placebo group, n=50. Japanese Knee Osteoarthritis Measure, visual analog scale score, normal walking speed, and knee-extensor strength were measured to evaluate the effects of the supplement on knee-joint functions and locomotor functions.Results: In subjects eligible for efficacy assessment, there was no significant group × time interaction, and there were improvements in knee-joint functions and locomotor functions in both groups, but there was no significant difference between the groups. In subjects with mild-to-severe knee pain at baseline, knee-extensor strength at week 8 (104.6±5.0% body weight vs 92.3±5.5% body weight, P=0.030 and the change in normal walking speed at week 16 (0.11±0.03 m/s vs 0.05±0.02 m/s, P=0.038 were significantly greater in the GCQID group than in the placebo group. Further subgroup analysis based on Kellgren–Lawrence (K–L grade showed that normal walking speed at week 16 (1.36±0.05 m/s vs 1.21±0.02 m/s, P<0.05 was significantly greater in the GCQID group than in the placebo group in subjects with K–L grade I. No

  14. Pain dilates time perception

    National Research Council Canada - National Science Library

    Amandine E Rey; George A Michael; Corina Dondas; Marvin Thar; Luis Garcia-Larrea; Stéphanie Mazza

    2017-01-01

    .... We show that being in pain leads to an expansion of subjective time whereby a stronger increase in pain perception relative to non-painful stimulation leads to a stronger time-estimate distortion...

  15. Cortical atrophy rates in Alzheimer's patients and subjects with mild cognitive impairment from the AddNeuroMed data collection

    DEFF Research Database (Denmark)

    Eskildsen, Simon Fristed; Westman, Eric; Gwadry-Sridhar, Femida

    Background: The AddNeuroMed project is a multi-centre European project which aims to identify biomarkers in Alzheimer's disease (AD). In this study we measured the rate of cortical atrophy in AD patients, subjects with mild cognitive impairment (MCI), and healthy controls (HC) using MRI. Methods......: High resolution sagittal 3D T1w MP-RAGE scans were acquired from patients diagnosed with AD (n = 58,MMSE:21.6 ± 4.4), MCI subjects (n = 85,MMSE:27.2 ± 1.6), and HC (n = 75,MMSE:29.0 ± 1.3) at baseline, and at three and 12 months follow-up. Only subjects with three completed scans which all passed...... rates can be found in AD patients compared to HC and MCI. Even three months after baseline accelerated atrophy can be observed in AD compared to HC, however, the results indicate that three months is too short a period to distinguish the atrophy rates in AD and MCI. The results suggest that atrophy...

  16. Acute Consumption of Resistant Starch Reduces Food Intake but Has No Effect on Appetite Ratings in Healthy Subjects.

    Science.gov (United States)

    Ble-Castillo, Jorge L; Juárez-Rojop, Isela E; Tovilla-Zárate, Carlos A; García-Vázquez, Carlos; Servin-Cruz, Magda Z; Rodríguez-Hernández, Arturo; Araiza-Saldaña, Claudia I; Nolasco-Coleman, Ana M; Díaz-Zagoya, Juan C

    2017-07-04

    Previous studies have shown the benefits of native banana starch (NBS) supplementation in improving glucose metabolism and reducing body weight (BW) in humans. However, the effect of this starch on appetite regulation is unknown. The aim of this study was to examine the effects of NBS rich resistant starch on subjective measurements of appetite, energy intake, and appetite hormones in healthy subjects. Postprandial glucose and insulin responses were also assessed. In a randomized, single-blind, crossover study, 28 healthy young subjects consumed a beverage containing either 40 g of NBS or 40 g of digestible corn starch (DCS) on two separate occasions. Effects on appetite were estimated using visual analogue scales (VAS) and satiety hormone responses. At the end of the intervention, participants were provided with a pre-weighed ad libitum homogeneous test meal. After a washout period of 1 week, subjects received the alternative treatment. NBS supplementation induced a reduction in food intake, glucose area under the curve (AUC)-180 min, and insulin AUC-180 min. However, there was no associated effect on the subjective appetite ratings or gut hormones. NBS supplementation may help to reduce meal size and control BW.

  17. Effect on work ability after team evaluation of functioning regarding pain, self-rated disability, and work ability assessment.

    Science.gov (United States)

    Norrefalk, Jan-Rickard; Littwold-Pöljö, Agneta; Ryhle, Leif; Jansen, Gunilla Brodda

    2010-08-26

    To evaluate the effect of a 1-2 week multiprofessional team assessment, without a real rehabilitation effort, 60 patients suffering from long-standing pain and on long-lasting time on sick leave were studied. A questionnaire concerning their daily activities, quality of life, pain intensity, sick-leave level, and their work state was filled out by all patients before starting the assessment and at a 1-year follow-up. The results from the assessment period and the multiprofessional team decision of the patient's working ability were compared with the actual working rate after 1 year. The follow-up showed a significant reduction of sick leave and a higher level of activity (P work. However, the team evaluation of the patient's work ability did not correlate to predict the actual outcome. The patient's pain intensity, life satisfaction, gender, age, ethnic background, and time absent from work before the start of the evaluation showed no correlation to reduction on time on sickness benefit level. These parameters could not be used as predictors in this study.

  18. Tailored skills training for practitioners to enhance assessment of prognostic factors for persistent and disabling back pain: four quasi-experimental single-subject studies.

    Science.gov (United States)

    Demmelmaier, Ingrid; Denison, Eva; Lindberg, Per; Åsenlöf, Pernilla

    2012-07-01

    The well-known gap between guidelines and behaviour in clinical practice calls for effective behaviour change interventions. One example showing this gap is physiotherapists' insufficient assessment of psychosocial prognostic factors in back pain (i.e., yellow flags). The present study aimed to evaluate an educational model by performing a tailored skills training intervention for caregivers and studying changes over time in physiotherapists' assessment of prognostic factors in telephone consultations. A quasi-experimental single-subject design over 36 weeks was used, with repeated measurements during baseline, intervention, and postintervention phases. Four physiotherapists in primary health care audiorecorded a total of 63 consultations with patients. The tailored intervention included individual goal setting, skills training, and feedback on performance. The primary outcome was the number of assessed prognostic factors (0-10). Changes were seen in all four participants. The amount of assessed prognostic factors increased from between 0 and 2 at baseline to between 6 and 10 at postintervention. Time spent on assessment of psychosocial factors increased, and time spent on discussions about biomedical pain symptoms decreased. Knowledge and biopsychosocial attitudes toward back pain were congruent with guidelines at inclusion and did not change markedly during the intervention. Self-efficacy for assessment of cognitive and emotional prognostic factors increased during the study phases. The results suggest that a tailored skills training intervention using behaviour change techniques, such as individual goal setting, skills training, and feedback on performance, is effective in producing change in specific clinical behaviours in physiotherapists.

  19. Reversibility of stress-echo induced ST-segment depression by long-term oral n-3 PUFA supplementation in subjects with chest pain syndrome, normal wall motion at stress-echo and normal coronary angiogram

    Directory of Open Access Journals (Sweden)

    Ziacchi Vigilio

    2004-03-01

    Full Text Available Abstract Background Normal coronary arteries may coexist with abnormal coronary and systemic endothelial function in patients with chest pain. Recent work by the renowned Pisa echo-group elegantly suggests that isolated ST-segment depression during stress-echo (SE can be used as a marker of coronary endothelial dysfunction, in the absence of stress-inducible wall motion abnormalities and in the absence of angiographically-significant coronary artery disease (CAD. The long chain n-3 polyunsaturated fatty acids (PUFAs have been reported to possess several properties that may positively influence vascular function. The present study's hypothesis is that a 4 month-course of oral supplementation with n-3 PUFAs can reverse endothelial dysfunction. Methods Subjects were selected on the basis of the following criteria: 1 reported chest pain syndrome, 2 significant ST-segment depression during an otherwise normal SE, 3 absence of angiographically-significant CAD. Subjects underwent a 4-month course of oral supplementation with commercially available n-3 PUFA, 1 g once a day. Normalization of endothelial dysfunction was defined, at the end of the supplementation period, by the absence of significant ST-segment depression during repeat SE. We tested the aforementioned hypothesis in a very small series of consecutive subjects, with the intent to produce a hypothesis-generating study. Results Seven out of the total nine subjects enrolled (77.8% had normal ST-segment during repeat SE performed after the 4 month course of therapy. Conclusions A striking rate of reversion of SE-induced ST-segment depression after oral n-3 PUFAs suggests reversion of coronary endothelial dysfunction; nonetheless these data need to be validated in larger, placebo-controlled studies.

  20. Pain can produce systematic distortions of autobiographical memory.

    Science.gov (United States)

    Meyer, Patric; Karl, Anke; Flor, Herta

    2015-05-01

    Cognitive-behavioral models highlight the role of learning and memory biases in the development and maintenance of chronic pain. However, the extent to which a memory bias is a consequence of the clinical state of being a chronic pain subject is unknown. This article presents a study which delineates the influence of chronic and acute pain on autobiographical memory retrieval. 16 healthy controls and 16 individuals with chronic pain participated in an autobiographical memory task during two sessions (a current pain and a pain-free session for the chronic pain subjects) and received neutral words that served as a cue for the retrieval of past life events. The valence of remembered life events in individuals with chronic pain was more negative when they were in pain compared to pain-free states. Conversely, both groups did not differ in their ratings of the reported memories during the pain-free condition. In addition, no significant relationship between mood and the valence of retrieved memories was found. The present data demonstrate that current pain but not chronic pain per se can exert specific influences on remembering in participants with chronic pain. This memory bias could be a predisposition for the development of chronic pain but could also be a pain-maintaining consequence of painful experiences. This should be addressed in longitudinal studies. Wiley Periodicals, Inc.

  1. ACTIVATION OF VASTUS MEDIALIS OBLIQUES AT DIFFERENT KNEE ANGLES IN CLOSED KINETIC CHAIN AND OPEN KINETIC CHAIN POSITION IN SUBJECTS WITH PATELLO FEMORAL PAIN SYNDROME

    Directory of Open Access Journals (Sweden)

    Ujwal Bhattacharya

    2015-06-01

    Full Text Available Background: Patello femoral pain syndrome is one of the most common musculoskeletal disorders and is reported to affect 15% - 33% of an active adult population and 21%-45% of adolescents thereby decreasing the work capacity of an individual. Patello femoral pain syndrome as implicated is due to inappropriate neural control of the quadriceps femoris muscle. Since Vastus medialis muscle is regarded as the dynamic medial stabilizer of patella so it’s important to understand the activation of Vastus Medialis Oblique’s in patients with patello femoral pain syndrome The purpose of this study is to assess the activation of Vastus Medialis Oblique’s at different knee angles between closed kinetic chain position and open kinetic chain position and the information thus gained can be used to design training program aimed at controlling patello femoral joint dysfunction. Methods: Thirty subjects with patello femoral pain syndrome (assessed through history and examination were assigned to two groups. Group A was made to perform open kinetic chain activity(i.e. sitting on high plinth and Group B was made to perform a closed kinetic chain activity(i.e. standing The outcome measure were amplitude and duration. Analyses were performed using independent t-Test. Results: Significant difference was found between the groups for amplitude and duration at varying angles. Amplitude: 0 degree (p=0.004, 60 degrees (p=0.015, 90 degrees (p=0.004. Duration: 0 degree (p=0.007, 60 degrees (p=0.008,90 degrees (p=0.002 Conclusion: Based on the outcome of the study it’s concluded that there is greater activation of Vastus Medialis Oblique’s muscle while performing close kinetic chain activity than in open kinetic chain.

  2. 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.

  3. Short-term effect of spinal manipulation on pain perception, spinal mobility, and full height recovery in male subjects with degenerative disk disease: a randomized controlled trial.

    Science.gov (United States)

    Vieira-Pellenz, Felipe; Oliva-Pascual-Vaca, Angel; Rodriguez-Blanco, Cleofás; Heredia-Rizo, Alberto Marcos; Ricard, François; Almazán-Campos, Ginés

    2014-09-01

    To evaluate the short-term effect on spinal mobility, pain perception, neural mechanosensitivity, and full height recovery after high-velocity, low-amplitude (HVLA) spinal manipulation (SM) in the lumbosacral joint (L5-S1). Randomized, double-blind, controlled clinical trial with evaluations at baseline and after intervention. University-based physical therapy research clinic. Men (N=40; mean age ± SD, 38 ± 9.14 y) with diagnosed degenerative lumbar disease at L5-S1 were randomly divided into 2 groups: a treatment group (TG) (n=20; mean age ± SD, 39 ± 9.12 y) and a control group (CG) (n=20; mean age ± SD, 37 ± 9.31 y). All participants completed the intervention and follow-up evaluations. A single L5-S1 SM technique (pull-move) was performed in the TG, whereas the CG received a single placebo intervention. Measures included assessing the subject's height using a stadiometer. The secondary outcome measures included perceived low back pain, evaluated using a visual analog scale; neural mechanosensitivity, as assessed using the passive straight-leg raise (SLR) test; and amount of spinal mobility in flexion, as measured using the finger-to-floor distance (FFD) test. The intragroup comparison indicated a significant improvement in all variables in the TG (Pperceived pain, spinal mobility in flexion, hip flexion during the passive SLR test, and subjects' full height. Future studies should include women and should evaluate the long-term results. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  4. Unsteady-state human-body exergy consumption rate and its relation to subjective assessment of dynamic thermal environments

    DEFF Research Database (Denmark)

    Schweiker, Marcel; Kolarik, Jakub; Dovjak, Mateja

    2016-01-01

    Few examples studied applicability of exergy analysis on human thermal comfort. These examples relate the human-body exergy consumption rate with subjectively obtained thermal sensation votes and had been based on steady-state calculation methods. However, humans are rarely exposed to steady...... of the present study confirmed previously indicated trends that lowest human body exergy consumption rate is associated with thermal sensation close to neutrality. Moreover, higher acceptability was in general associated with lower human body exergy consumption rate. (C) 2016 Elsevier B.V. All rights reserved.......-state thermal environments. Therefore, the first objective of the current paper was to compare a recently introduced unsteady-state model with previously used steady-state model using data obtained under both constant and transient temperature conditions. The second objective was to explore a relationship...

  5. Predicting self-rated mental and physical health: the contributions of subjective socioeconomic status and personal relative deprivation.

    Science.gov (United States)

    Callan, Mitchell J; Kim, Hyunji; Matthews, William J

    2015-01-01

    Lower subjective socioeconomic status (SSS) and higher personal relative deprivation (PRD) relate to poorer health. Both constructs concern people's perceived relative social position, but they differ in their emphasis on the reference groups people use to determine their comparative disadvantage (national population vs. similar others) and the importance of resentment that may arise from such adverse comparisons. We investigated the relative utility of SSS and PRD as predictors of self-rated physical and mental health (e.g., self-rated health, stress, health complaints). Across six studies, self-rated physical and mental health were on the whole better predicted by measures of PRD than by SSS while controlling for objective socioeconomic status (SES), with SSS rarely contributing unique variance over and above PRD and SES. Studies 4-6 discount the possibility that the superiority of PRD over SSS in predicting health is due to psychometric differences (e.g., reliability) or response biases between the measures.

  6. Relationship Between Pretraining Subjective Wellness Measures, Player Load, and Rating-of-Perceived-Exertion Training Load in American College Football.

    Science.gov (United States)

    Govus, Andrew D; Coutts, Aaron; Duffield, Rob; Murray, Andrew; Fullagar, Hugh

    2018-01-01

    The relationship between pretraining subjective wellness and external and internal training load in American college football is unclear. To examine the relationship of pretraining subjective wellness (sleep quality, muscle soreness, energy, wellness Z score) with player load and session rating of perceived exertion (s-RPE-TL) in American college football players. Subjective wellness (measured using 5-point, Likert-scale questionnaires), external load (derived from GPS and accelerometry), and s-RPE-TL were collected during 3 typical training sessions per week for the second half of an American college football season (8 wk). The relationship of pretraining subjective wellness with player load and s-RPE training load was analyzed using linear mixed models with a random intercept for athlete and a random slope for training session. Standardized mean differences (SMDs) denote the effect magnitude. A 1-unit increase in wellness Z score and energy was associated with trivial 2.3% (90% confidence interval [CI] 0.5, 4.2; SMD 0.12) and 2.6% (90% CI 0.1, 5.2; SMD 0.13) increases in player load, respectively. A 1-unit increase in muscle soreness (players felt less sore) corresponded to a trivial 4.4% (90% CI -8.4, -0.3; SMD -0.05) decrease in s-RPE training load. Measuring pretraining subjective wellness may provide information about players' capacity to perform in a training session and could be a key determinant of their response to the imposed training demands American college football. Hence, monitoring subjective wellness may aid in the individualization of training prescription in American college football players.

  7. The Madrid Affective Database for Spanish (MADS): Ratings of Dominance, Familiarity, Subjective Age of Acquisition and Sensory Experience.

    Science.gov (United States)

    Hinojosa, José A; Rincón-Pérez, Irene; Romero-Ferreiro, M Verónica; Martínez-García, Natalia; Villalba-García, Cristina; Montoro, Pedro R; Pozo, Miguel A

    2016-01-01

    The current study presents ratings by 540 Spanish native speakers for dominance, familiarity, subjective age of acquisition (AoA), and sensory experience (SER) for the 875 Spanish words included in the Madrid Affective Database for Spanish (MADS). The norms can be downloaded as supplementary materials for this manuscript from https://figshare.com/s/8e7b445b729527262c88 These ratings may be of potential relevance to researches who are interested in characterizing the interplay between language and emotion. Additionally, with the aim of investigating how the affective features interact with the lexicosemantic properties of words, we performed correlational analyses between norms for familiarity, subjective AoA and SER, and scores for those affective variables which are currently included in the MADs. A distinct pattern of significant correlations with affective features was found for different lexicosemantic variables. These results show that familiarity, subjective AoA and SERs may have independent effects on the processing of emotional words. They also suggest that these psycholinguistic variables should be fully considered when formulating theoretical approaches to the processing of affective language.

  8. Physical activity, heart rate variability-based stress and recovery, and subjective stress during a 9-month study period.

    Science.gov (United States)

    Föhr, T; Tolvanen, A; Myllymäki, T; Järvelä-Reijonen, E; Peuhkuri, K; Rantala, S; Kolehmainen, M; Korpela, R; Lappalainen, R; Ermes, M; Puttonen, S; Rusko, H; Kujala, U M

    2017-06-01

    The aim of this study was to investigate the association between physical activity (PA) and objective heart rate variability (HRV)-based stress and recovery with subjective stress in a longitudinal setting. Working-age participants (n = 221; 185 women, 36 men) were overweight (body mass index, 25.3-40.1 kg/m(2) ) and psychologically distressed (≥3/12 points on the General Health Questionnaire). Objective stress and recovery were based on HRV recordings over 1-3 work days. Subjective stress was assessed with the Perceived Stress Scale and PA level with a questionnaire. Data were collected at three time points: baseline, 10 weeks post intervention, and at the 36-week follow-up. We adopted a latent growth model to investigate the initial level and change in PA, objective stress and recovery, and subjective stress at the three measurement time points. The results showed that initial levels of PA (P stress (P = 0.001) and recovery (P stress. The results persisted after adjustment for intervention group. The present results suggest that high PA and objectively assessed low stress and good recovery have positive effects on changes in subjective stress in the long-term. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Methodological problems in the measurement of pain: a comparison between the verbal rating scale and the visual analogue scale.

    Science.gov (United States)

    Ohnhaus, E E; Adler, R

    1975-12-01

    The effect of analgesics on pathological pain in a double-blind, complete cross-over design was assessed by means of two rating scales, a verbal rating scale (VRS) and visual analogue scale (VAS). The VRS is widely used, but has several disadvantages as compared to the VAS. The results obtained by means of the VRS showed higher F-ratios (analysis of variance and Kruskall-Wallis H-test) than those obtained by means of the VAS. The VRS, which transfers a continuous feeling into a digital system, seems to augment artificially the measurement of effects produced by analgesics, and the VAS seems to assess more closely what a patient actually experiences with respect to change in pain intensities. The correlation between the two scales was highly significant (r = 0.81, P less than 0.001). The calculated regression line (y=-29.6 + 0.55-x) was not similar to the line of identity and showed much lower values for the VAS, supporting our interpretation. The distribution of the variances of the values obtained by means of both scales was not homogenous. This indicates that the homogeneity of the distribution of variances should always be checked and a Kruskall-Wallis H-test used, if they are inhomogenously distributed.

  10. Safety and Efficacy of NEXT-II®, a Novel Water-Soluble, Undenatured Type II Collagen inHealthy Human SubjectsSuffering from Occasional Knee Joint Pain

    Directory of Open Access Journals (Sweden)

    Orie Yoshinari

    2015-07-01

    Full Text Available Background: Oral administration of a novel water-soluble undenatured type II collagen (NEXT-II® has been demonstrated to ameliorate the signs and symptoms of rheumatoid arthritis (RA in animal models. In the present investigation, we conducted a pilot study to examine the efficacy and safety of NEXT-II® in borderline subjects defined as healthy and non-diseased state, but with potential risks in knee joint health. Method: We employed Western Ontario McMaster Index (WOMAC score and Visual Analog Scale (VAS scores to assess the extent of improvement in the knee joints in these volunteers following supplementation of 40 mg NEXT-II® (10 mg as undenatured type II collagen over a period of 12 weeks. Result: The results demonstrated that NEXT-II® treatment significantly reduced WOMAC and VAS scores compared to subjects at baseline. Specifically, in the evaluation using VAS, the borderline subjects at resting, walking, and going up and down the stairs revealed significant improvement when compared to the baseline. Conclusion: The results of the studies demonstrated that NEXT-II® might be an ingredient which is safe and effective in the application of dietary supplement in ameliorating joint pain and symptoms of the borderline subjects without any adverse events.

  11. Three-dimensional kinematic analysis of pelvic and lower extremity differences during trunk rotation in subjects with and without chronic low back pain.

    Science.gov (United States)

    Song, Ah Young; Jo, Hang Jin; Sung, Paul S; Kim, Yoon Hyuk

    2012-06-01

    To investigate three-dimensional angular changes of the pelvis and lower extremities during trunk axial rotation in subjects with and without chronic low back pain (LBP). Repeated-measures design. Thirty volunteers participated in the study (15 with LBP, 15 without LBP). The mean age of the subjects was 44 (standard deviation 15.8) years (range 27 to 63 years). All participants were asked to perform five sets of axial trunk rotation activities with a bar in a standing position. The outcome measures included three-dimensional rotational angles of the pelvis and lower extremities (foot, calf and thigh). The angular change of the pelvis in the sagittal plane differed between subjects with and without LBP (P=0.03). There were no significant differences in angular changes of the lower extremities in the frontal and transverse planes between groups. The angular change of the pelvis in the sagittal plane differed significantly between groups. Further research is needed to investigate the three-dimensional characteristics of biomechanical and neuromuscular aspects in subjects with LBP. Copyright © 2011 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  12. Effect of slump stretching versus lumbar mobilization with exercise in subjects with non-radicular low back pain: a randomized clinical trial

    Science.gov (United States)

    Nagrale, Amit Vinayak; Patil, Shubhangi Pandurang; Gandhi, Rita Amarchand; Learman, Ken

    2012-01-01

    Previous case reports, case series, and pilot studies have suggested that slump stretching may enhance the effects of spinal mobilization and stabilization exercises in patients with non-radicular low back pain (NRLBP). The purpose of this trial was to determine if slump stretching results in improvements in pain, disability, and fear and avoidance beliefs in patients with NRLBP with neural mechanosensitivity. Sixty patients, 18–60 years of age presenting with NRLBP with symptom duration >3 months, were randomized into one of two, 3-week physical therapy programs. Group one received lumbar spinal mobilization with stabilization exercises while group two received slump stretching in addition to lumbar spinal mobilization with exercise. Outcomes including the modified Oswestry disability index (ODI), numeric pain rating scale (NPRS), and the fear–avoidance belief questionnaire (FABQ) were collected at baseline, and at weeks 1, 2, 3, and 6. A doubly multivariate analysis of variance revealed a significant group–time interaction for ODI, NPRS, and FABQ. There were large within-group changes for all outcomes with Pmobilization and stabilization exercises when treating NRLBP. PMID:23372392

  13. Effect of slump stretching versus lumbar mobilization with exercise in subjects with non-radicular low back pain: a randomized clinical trial.

    Science.gov (United States)

    Nagrale, Amit Vinayak; Patil, Shubhangi Pandurang; Gandhi, Rita Amarchand; Learman, Ken

    2012-02-01

    Previous case reports, case series, and pilot studies have suggested that slump stretching may enhance the effects of spinal mobilization and stabilization exercises in patients with non-radicular low back pain (NRLBP). The purpose of this trial was to determine if slump stretching results in improvements in pain, disability, and fear and avoidance beliefs in patients with NRLBP with neural mechanosensitivity. Sixty patients, 18-60 years of age presenting with NRLBP with symptom duration >3 months, were randomized into one of two, 3-week physical therapy programs. Group one received lumbar spinal mobilization with stabilization exercises while group two received slump stretching in addition to lumbar spinal mobilization with exercise. Outcomes including the modified Oswestry disability index (ODI), numeric pain rating scale (NPRS), and the fear-avoidance belief questionnaire (FABQ) were collected at baseline, and at weeks 1, 2, 3, and 6. A doubly multivariate analysis of variance revealed a significant group-time interaction for ODI, NPRS, and FABQ. There were large within-group changes for all outcomes with Pmobilization and stabilization exercises when treating NRLBP.

  14. [Clinical-demographic factors associated with fear-avoidance in subjects with non-specific chronic low back pain in Primary Care: secondary analysis of intervention study].

    Science.gov (United States)

    Díaz-Cerrillo, Juan Luis; Rondón-Ramos, Antonio; Clavero-Cano, Susana; Pérez-González, Rita; Martinez-Calderon, Javier; Luque-Suarez, Alejandro

    2018-01-30

    To describe some sociodemographics and clinical characteristics of subjects with Non-specific Chronic Low Back Pain (NCLBP) in Primary Care, as well as to investigate their association with Fear-Avoidance (FA). Cross-sectional. Secondary analysis of an intervention study. Basic Health Areas in Costa del Sol Health District (Málaga, Spain). An analysis was performed on 147 subjects with NCLBP from a previous intervention study database in Primary Care Physiotherapy (PCP). Characteristics: age 18-65; understanding of the Spanish language; absence of cognitive disorders, fibromyalgia or dorsolumbar surgery, and to be able to perform physical exercise. The main variable was FA level (FABQ and the FABQ-PA and FABQ-W) sub-scales. Clinical variables included: pain (NRPS-11), disability (RMQ), evolution, previous treatments and diagnostic imaging. The sociodemographic variables included: gender, age, educational level, and employment status. Just over half (51.7%) of the subjects had high FA on the FABQ-PA sub-scale. Sick leave (SL) [β=24.45 (P=.009 * ); β=13.03 (P=.016 * ); β=14.04 (P=.011 * ) for FABQ, FABQ-PA and FABQ-W, respectively]; primary studies level [β=15.09 (P=.01 * ); β=9.73 (P=.01 * ) for FABQ and FABQ-PA], and disability [β=1.45 (P<.001); β=0.61 (P<.001); β=0.68 (P<.001) for FABQ, FABQ-PA and FABQ-W, respectively] were associated with FA when they were modeled by multivariate regression. Some sociodemographic and clinical features of the NCLBP population are presented. Imaging tests (81.63%) and previous passive treatments (55.78%) could reflect problems of adherence to recommendations of CPGs. Sick leave, primary studies level, and disability were associated with FA. The findings should be interpreted in the light of possible limitations. Some suggestions for clinical practice are provided. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  15. Crash and traffic violation rates before and after licensure for novice California drivers subject to different driver licensing requirements.

    Science.gov (United States)

    Chapman, Eric A; Masten, Scott V; Browning, Kelly K

    2014-09-01

    How do crash and traffic violation rates for novice 16-17-year-old drivers change over the months before and after licensure under a graduated driver licensing (GDL) program relative to those for older novices who are not subject to GDL? Plots and Poisson regression comparing overall rates and subtypes of crashes and traffic violations among California novice drivers ages 16 to 35 years over time before and after unsupervised licensure. Majorities of 16-year-olds (57%) and 17-year-olds (73%) actually hold their learner permits longer than the required 6 months; majorities (67%-81%) of age 18 or older novices hold their learner permits less than 6 months. Crash rates of novice 16- and 17-year-olds-as well as most other age groups-are highest almost immediately after they are licensed to drive unsupervised, after which their rates decline quickly during their first year of licensure and at a slower rate for the second and third years. Novice 16- and 17-year-olds' traffic violation rates reach their zenith long after their total crash rates peak and decline, whereas violation rates for older novices peak during their first year of licensure. Over 70% of 16- and 17-year-old novices are crash-free for the first 3 years of licensure. While novice 16- and 17-year-olds' highest crash rates occur almost immediately after they are licensed, their peak traffic violation rates are delayed until around the time they turn age 18. Both pre-licensure crash rates and post-licensure crash peaks were more pronounced for some older age groups of novices than was the case for 16-17-year-olds. Extending learner permit holding periods for 16-17-year-old novices appears consistent with their actual behavior; requiring older novices-particularly those ages 18 to 20-to hold permits for minimum periods may reduce their initial crash rates. Copyright © 2014 National Safety Council and Elsevier Ltd. All rights reserved.

  16. Changes in pulse rate, respiratory rate, blood oxygenation, perfusion index, skin conductance, and their variability induced during and after grounding human subjects for 40 minutes.

    Science.gov (United States)

    Chevalier, Gaetan

    2010-01-01

    Previous studies have shown that grounding produces quantifiable physiologic changes. This study was set up to reproduce and expand earlier electrophysiologic and physiologic parameters measured immediately after grounding with improved methodology and state-of-the-art equipment. A multiparameter double-blind experiment was conducted with 14 men and 14 women (age range: 18-80) in relatively good health. Subjects were screened for health problems using a commonly used health questionnaire. They were seated in a comfortable recliner and measured during 2-hour grounding sessions, leaving time for signals to stabilize before, during, and after grounding (40 minutes for each period). Sham 2-hour grounding sessions were also recorded with the same subjects as controls. This report presents results for 5 of the 18 parameters measured. The parameters reported here are: skin conductance (SC), blood oxygenation (BO), respiratory rate (RR), pulse rate (PR), and perfusion index (PI). This study was performed in a rented facility in Encinitas, California. The facility was chosen in a quiet area for its very low electromagnetic noise. For each session, statistical analyses were performed on four 10-minute segments: before and after grounding (sham grounding for control session) and before and after ungrounding (sham ungrounding). There was an immediate decrease in SC at grounding and an immediate increase at ungrounding on all subjects. RR increased during grounding, and the effect lasted after ungrounding. RR variance increased immediately after grounding then decreased. BO variance decreased during grounding, followed by a dramatic increase after ungrounding. PR and PI variances increased toward the end of the grounding period, and this change persisted after ungrounding. These results warrant further research to determine how grounding affects the body. Grounding could become important for relaxation, health maintenance and disease prevention.

  17. Clinical measurement of the thoracic kyphosis. A study of the intra-rater reliability in subjects with and without shoulder pain

    Directory of Open Access Journals (Sweden)

    Lewis Jeremy S

    2010-03-01

    Full Text Available Abstract Background Clinical sagittal plane assessment of the thoracic kyphosis angle is considered an essential component of the postural examination of patients presenting with upper body pain syndromes. Cervical headaches and conditions involving the shoulder, such as subacromial pain syndrome, have all been associated with an increase in the thoracic kyphosis. Concomitantly a decrease in the thoracic kyphosis as a result of a stretching and strengthening rehabilitation programme is believed to be associated with a reduction in symptoms and pain and improvement in function. Clinicians generally measure the sagittal plane kyphosis angle visually. There is no certainty that this method is reliable or is capable of measuring angular changes over time or in response to intervention. As such a simple and reliable clinical method of measuring the thoracic kyphosis would enable clinicians to record this information. The aim of this investigation was to determine the intra-tester reliability of measuring the thoracic kyphosis angle using a clinical method Methods Measurements were made in 45 subjects with and 45 subjects without upper body symptoms. Measurements were made with the subjects in relaxed standing. Two gravity dependent inclinometers were used to measure the kyphosis. The first was placed over the region of the 1st and 2nd thoracic spinous processes. The other, over the region of the 12th thoracic and 1st lumbar spinous processes. The angle produced by each inclinometer was measured 3 times in succession. Each set of 3 measurements was made on two occasions (separated by a minimum of 30 minutes and additional data collection involving 46 further measurements of posture and movement on the same and an additional subject before the thoracic kyphosis measurements were re-measured by one rater. The reliability of the measurements was analyzed using 2-way ANOVA intraclass correlation coefficients (ICC, 95% confidence intervals (CI and standard

  18. Post-trauma ratings of pre-collision pain and psychological distress predict poor outcome following acute whiplash trauma: A 12-month follow-up study

    DEFF Research Database (Denmark)

    Carstensen, Tina; Frostholm, Lisbeth; Ørnbøl, Eva

    2008-01-01

    emergency departments or primary care after car accidents in four counties in Denmark. After the collision patients received a questionnaire on psychological distress, unspecified pain and socio-demographics and 12 months later a follow-up on work capability and neck pain was performed. Risk factors were......Patients with acute whiplash trauma were followed to examine if post-trauma ratings of pre-collision pain and psychological distress were associated with reduced work capability and neck pain at 12 months follow-up. The study included 740 consecutive patients (474 females, 266 males) referred from...... identified by multiple logistic regression analysis. Factors associated with affected work capacity at the 12-month follow-up were pre-collision unspecified pain condition (OR = 2.4, p = 0.002) and socio-demographic characteristics: female gender, low educational level, unemployment and blue collar worker...

  19. Post-trauma ratings of pre-collision pain and psychological distress predict poor outcome following acute whiplash trauma: a 12-month follow-up study

    DEFF Research Database (Denmark)

    Carstensen, Tina B W; Frostholm, Lisbeth; Oernboel, Eva

    2008-01-01

    emergency departments or primary care after car accidents in four counties in Denmark. After the collision patients received a questionnaire on psychological distress, unspecified pain and socio-demographics and 12 months later a follow-up on work capability and neck pain was performed. Risk factors were......Patients with acute whiplash trauma were followed to examine if post-trauma ratings of pre-collision pain and psychological distress were associated with reduced work capability and neck pain at 12 months follow-up. The study included 740 consecutive patients (474 females, 266 males) referred from...... identified by multiple logistic regression analysis. Factors associated with affected work capacity at the 12-month follow-up were pre-collision unspecified pain condition (OR=2.4, p=0.002) and socio-demographic characteristics: female gender, low educational level, unemployment and blue collar worker...

  20. Post-trauma ratings of pre-collision pain and psychological distress predict poor outcome following acute whiplash trauma: A 12-month follow-up study

    DEFF Research Database (Denmark)

    Carstensen, Tina

    2008-01-01

    emergency departments or primary care after car accidents in four counties in Denmark. After the collision patients received a questionnaire on psychological distress, unspecified pain and socio-demographics and 12months later a follow-up on work capability and neck pain was performed. Risk factors were......Patients with acute whiplash trauma were followed to examine if post-trauma ratings of pre-collision pain and psychological distress were associated with reduced work capability and neck pain at 12months follow-up. The study included 740 consecutive patients (474 females, 266 males) referred from...... identified by multiple logistic regression analysis. Factors associated with affected work capacity at the 12-month follow-up were pre-collision unspecified pain condition (OR=2.4, p=0.002) and socio-demographic characteristics: female gender, low educational level, unemployment and blue collar worker...

  1. Altered experimental pain perception after cerebellar infarction.

    Science.gov (United States)

    Ruscheweyh, Ruth; Kühnel, Maria; Filippopulos, Filipp; Blum, Bernhard; Eggert, Thomas; Straube, Andreas

    2014-07-01

    Animal studies have suggested that the cerebellum, in addition to its motor functions, also has a role in pain processing and modulation, possibly because of its extensive connections with the prefrontal cortex and with brainstem regions involved in descending pain control. Consistently, human imaging studies have shown cerebellar activation in response to painful stimulation. However, it is presently not clear whether cerebellar lesions affect pain perception in humans. In the present study, we used experimental pain testing to compare acute pain perception and endogenous pain inhibition in 30 patients 1 to 11 years after cerebellar infarction and in 30 sex- and age-matched healthy control subjects. Compared to controls, patients exhibited a significantly increased pain perception in response to acute heat stimuli (44 °C-48 °C, average pain intensity rating for patients 3.4±2.8 and for controls 1.5±1.7 [on a numeric rating scale of 0-10], Ppain intensity rating: 0.0%±15.8% vs. -16.9%±36.3%, Ppain intensity rating: -1.0±1.1 vs. -1.8±1.3 [0-10], Pcontrols. In contrast, heat and pressure pain thresholds were not significantly different between groups. These results show that, after cerebellar infarction, patients perceive heat and repeated mechanical stimuli as more painful than do healthy control subjects and have deficient activation of endogenous pain inhibitory mechanisms (offset and placebo analgesia). This suggests that the cerebellum has a previously underestimated role in human pain perception and modulation. Copyright © 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  2. Resting Metabolic Rate Does Not Change in Response to Different Types of Training in Subjects with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Kristian Karstoft

    2017-06-01

    Full Text Available Background and objectivesAmbiguous results have been reported regarding the effects of training on resting metabolic rate (RMR, and the importance of training type and intensity is unclear. Moreover, studies in subjects with type 2 diabetes (T2D are sparse. In this study, we evaluated the effects of interval and continuous training on RMR in subjects with T2D. Furthermore, we explored the determinants for training-induced alterations in RMR.MethodsData from two studies, both including T2D subjects, were encompassed in this manuscript. Study 1 was a randomized, crossover study where subjects (n = 14 completed three, 2-week interventions [control, continuous walking training (CWT, interval-walking training (IWT] separated by washout periods. Training included 10 supervised treadmill sessions, 60 min/session. CWT was performed at moderate walking speed [aiming for 73% of walking peak oxygen uptake (VO2peak], while IWT was performed as alternating 3-min repetitions at slow (54% VO2peak and fast (89% VO2peak walking speed. Study 2 was a single-arm training intervention study where subjects (n = 23 were prescribed 12 weeks of free-living IWT (at least 3 sessions/week, 30 min/session. Before and after interventions, RMR, physical fitness, body composition, and glycemic control parameters were assessed.ResultsNo overall intervention-induced changes in RMR were seen across the studies, but considerable inter-individual differences in RMR changes were seen in Study 2. At baseline, total body mass (TBM, fat-free mass (FFM, and fat mass were all associated with RMR. Changes in RMR were associated with changes in TBM and fat mass, and subjects who decreased body mass and fat mass also decreased their RMR. No associations were seen between changes in physical fitness, glycemic control, or FFM and changes in RMR.ConclusionNeither short-term continuous or interval-type training, nor longer term interval training affects RMR in subjects with T2D

  3. Resting Metabolic Rate Does Not Change in Response to Different Types of Training in Subjects with Type 2 Diabetes.

    Science.gov (United States)

    Karstoft, Kristian; Brinkløv, Cecilie Fau; Thorsen, Ida Kær; Nielsen, Jens Steen; Ried-Larsen, Mathias

    2017-01-01

    Ambiguous results have been reported regarding the effects of training on resting metabolic rate (RMR), and the importance of training type and intensity is unclear. Moreover, studies in subjects with type 2 diabetes (T2D) are sparse. In this study, we evaluated the effects of interval and continuous training on RMR in subjects with T2D. Furthermore, we explored the determinants for training-induced alterations in RMR. Data from two studies, both including T2D subjects, were encompassed in this manuscript. Study 1 was a randomized, crossover study where subjects (n = 14) completed three, 2-week interventions [control, continuous walking training (CWT), interval-walking training (IWT)] separated by washout periods. Training included 10 supervised treadmill sessions, 60 min/session. CWT was performed at moderate walking speed [aiming for 73% of walking peak oxygen uptake (VO2peak)], while IWT was performed as alternating 3-min repetitions at slow (54% VO2peak) and fast (89% VO2peak) walking speed. Study 2 was a single-arm training intervention study where subjects (n = 23) were prescribed 12 weeks of free-living IWT (at least 3 sessions/week, 30 min/session). Before and after interventions, RMR, physical fitness, body composition, and glycemic control parameters were assessed. No overall intervention-induced changes in RMR were seen across the studies, but considerable inter-individual differences in RMR changes were seen in Study 2. At baseline, total body mass (TBM), fat-free mass (FFM), and fat mass were all associated with RMR. Changes in RMR were associated with changes in TBM and fat mass, and subjects who decreased body mass and fat mass also decreased their RMR. No associations were seen between changes in physical fitness, glycemic control, or FFM and changes in RMR. Neither short-term continuous or interval-type training, nor longer term interval training affects RMR in subjects with T2D when no overall changes in body composition are seen

  4. Level of physical activity, well-being, stress and self-rated health in persons with migraine and co-existing tension-type headache and neck pain.

    Science.gov (United States)

    Krøll, Lotte Skytte; Hammarlund, Catharina Sjödahl; Westergaard, Maria Lurenda; Nielsen, Trine; Sloth, Louise Bönsdorff; Jensen, Rigmor Højland; Gard, Gunvor

    2017-12-01

    The prevalence of migraine with co-existing tension-type headache and neck pain is high in the general population. However, there is very little literature on the characteristics of these combined conditions. The aim of this study was to investigate a) the prevalence of migraine with co-existing tension-type headache and neck pain in a clinic-based sample, b) the level of physical activity, psychological well-being, perceived stress and self-rated health in persons with migraine and co-existing tension-type headache and neck pain compared to healthy controls, c) the perceived ability of persons with migraine and co-existing tension-type headache and neck pain to perform physical activity, and d) which among the three conditions (migraine, tension-type headache or neck pain) is rated as the most burdensome condition. The study was conducted at a tertiary referral specialised headache centre where questionnaires on physical activity, psychological well-being, perceived stress and self-rated health were completed by 148 persons with migraine and 100 healthy controls matched by sex and average age. Semi-structured interviews were conducted to assess characteristics of migraine, tension-type headache and neck pain. Out of 148 persons with migraine, 100 (67%) suffered from co-existing tension-type headache and neck pain. Only 11% suffered from migraine only. Persons with migraine and co-existing tension-type headache and neck pain had lower level of physical activity and psychological well-being, higher level of perceived stress and poorer self-rated health compared to healthy controls. They reported reduced ability to perform physical activity owing to migraine (high degree), tension-type headache (moderate degree) and neck pain (low degree). The most burdensome condition was migraine, followed by tension-type headache and neck pain. Migraine with co-existing tension-type headache and neck pain was highly prevalent in a clinic-based sample. Persons with migraine and co

  5. Relationship between Autonomic Markers of Heart Rate and Subjective Indicators of Recovery Status in Male, Elite Badminton Players

    Directory of Open Access Journals (Sweden)

    Christo A. Bisschoff, Ben Coetzee, Michael R. Esco

    2016-12-01

    Full Text Available The primary aim of the study was to determine if heart rate variability (HRV, and heart rate recovery (HRR are related to several subjective indicators of recovery status (muscle soreness, hydration status, sleep quality and quantity as well as pre-competition mood states for different match periods in male, elite, African, singles badminton players. HRV and HRR were measured in twenty-two badminton players before (pre-match, during (in-match, after (post-match and during rest periods (in-match rest of 46 national and international matches. Muscle soreness, hydration status, and sleep quality and quantity were measured on a daily basis whereas mood states were measured just before each match via questionnaires. Prior to each match warm-up, players were fitted with a Fix Polar Heart Rate Transmitter Belt to record heart rate every second during each match and HRR during service breaks and after matches. Kubios HRV software was used for final HRV analyses from the series of R-R-intervals. A strong, significant canonical correlation (Rc = 0.96, p = 0.014 was found between HRV, HRR and subjective indicators of recovery status for the in-match period, but only strong, non-significant relationships were observed for pre-match (Rc = 0.98, p = 0.626 and post-match periods (Rc = 0.98, p = 0.085 and a low non-significant relationship (Rc = 0.69, p = 0.258 for the in-match rest period. Canonical functions accounted for between 47.89% and 96.43% of the total variation between the two canonical variants. Results further revealed that Ln-HFnu, the energy index and vigour were the most prominent variables in the relationship between the autonomic markers of heart rate and recovery-related variables. In conclusion, this study proved that subjective indicators of recovery status influence HRV and HRR measures obtained in a competitive badminton environment and should therefore be incorporated in protocols that evaluate these ANS-related parameters.

  6. Relationship between Autonomic Markers of Heart Rate and Subjective Indicators of Recovery Status in Male, Elite Badminton Players.

    Science.gov (United States)

    Bisschoff, Christo A; Coetzee, Ben; Esco, Michael R

    2016-12-01

    The primary aim of the study was to determine if heart rate variability (HRV), and heart rate recovery (HRR) are related to several subjective indicators of recovery status (muscle soreness, hydration status, sleep quality and quantity as well as pre-competition mood states) for different match periods in male, elite, African, singles badminton players. HRV and HRR were measured in twenty-two badminton players before (pre-match), during (in-match), after (post-match) and during rest periods (in-match rest) of 46 national and international matches. Muscle soreness, hydration status, and sleep quality and quantity were measured on a daily basis whereas mood states were measured just before each match via questionnaires. Prior to each match warm-up, players were fitted with a Fix Polar Heart Rate Transmitter Belt to record heart rate every second during each match and HRR during service breaks and after matches. Kubios HRV software was used for final HRV analyses from the series of R-R-intervals. A strong, significant canonical correlation (Rc = 0.96, p = 0.014) was found between HRV, HRR and subjective indicators of recovery status for the in-match period, but only strong, non-significant relationships were observed for pre-match (Rc = 0.98, p = 0.626) and post-match periods (Rc = 0.98, p = 0.085) and a low non-significant relationship (Rc = 0.69, p = 0.258) for the in-match rest period. Canonical functions accounted for between 47.89% and 96.43% of the total variation between the two canonical variants. Results further revealed that Ln-HFnu, the energy index and vigour were the most prominent variables in the relationship between the autonomic markers of heart rate and recovery-related variables. In conclusion, this study proved that subjective indicators of recovery status influence HRV and HRR measures obtained in a competitive badminton environment and should therefore be incorporated in protocols that evaluate these ANS-related parameters.

  7. Relationship between heart rate variability, blood pressure and arterial wall properties during air and oxygen breathing in healthy subjects.

    Science.gov (United States)

    Graff, Beata; Szyndler, Anna; Czechowicz, Krzysztof; Kucharska, Wiesława; Graff, Grzegorz; Boutouyrie, Pierre; Laurent, Stephane; Narkiewicz, Krzysztof

    2013-11-01

    Previous studies reported that normobaric hyperoxia influences heart rate, arterial pressure, cardiac output and systemic vascular resistance, but the mechanisms underlying these changes are still not fully understood. Several factors are considered including degeneration of endothelium-derived nitric oxide by reactive oxygen species, the impact of oxygen-free radicals on tissues and alterations of autonomic nervous system function. Recently, new devices for the detailed non-invasive assessment of large and small arteries have been developed. Therefore, the aim of our study was to assess heart rate variability (HRV) as a potential indicator of autonomic balance and its relation to blood pressure and vascular properties during medical air (MAB) and 100% oxygen breathing (OXB) in healthy volunteers. In 12 healthy subjects we assessed heart rate and blood pressure variability, baroreflex sensitivity, respiratory frequency, common carotid artery diameter and its wall distensibility, as well as changes in the digital artery pulse waveform, stroke index and systemic vascular resistance during MAB and OXB. Mean and systolic blood pressure have increased significantly while digital pulse amplitude and carotid artery diameter were significantly lower during hyperoxia. Heart rate variability measures did not differ during MAB and OXB. However, the correlations between spectral HRV components and those hemodynamic parameters which have changed due to hyperoxia varied substantially during MAB (correlated significantly) and OXB (no significant correlations were noted). Our findings suggest that autonomic nervous system might not be the main mediator of the cardiovascular changes during 100% oxygen breathing in healthy subjects. It seems that the direct vascular responses are initial consequences of hyperoxia and other cardiovascular parameter alterations are secondary to them. Copyright © 2013 Elsevier B.V. All rights reserved.

  8. The use of ultrasound imaging of the abdominal drawing-in maneuver in subjects with low back pain.

    Science.gov (United States)

    Teyhen, Deydre S; Miltenberger, Chad E; Deiters, Henry M; Del Toro, Yadira M; Pulliam, Jennifer N; Childs, John D; Boyles, Robert E; Flynn, Timothy W

    2005-06-01

    Randomized controlled trial among patients with low back pain (LBP). (1) Determine the reliability of real-time ultrasound imaging for assessing activation of the lateral abdominal muscles; (2) characterize the extent to which the abdominal drawing-in maneuver (ADIM) results in preferential activation of the transverse abdominis (TrA); and (3) determine if ultrasound biofeedback improves short-term performance of the ADIM in patients with LBP. Ultrasound imaging is reportedly useful for measuring and training patients to preferentially activate the TrA muscle. However, research to support these claims is limited. Thirty patients with LBP referred for lumbar stabilization training were randomized to receive either traditional training (n = 15) or traditional training with biofeedback (n = 15). Ultrasound imaging was used to measure changes in thickness of the lateral abdominal muscles. Differences in preferential changes in muscle thickness of the TrA between groups and across time were assessed using analysis of variance. Intrarater reliability measuring lateral abdominal muscle thickness exceeded 0.93. On average, patients in both groups demonstrated a 2-fold increase in the thickness of the TrA during the ADIM. Performance of the ADIM did not differ between the groups. These data provide construct validity for the notion that the ADIM results in preferential activation of the TrA in patients with LBP. Although, the addition of biofeedback did not enhance the ability to perform the ADIM at a short-term follow-up, our data suggest a possible ceiling effect or an insufficient training stimulus. Further research is necessary to determine if there is a subgroup of patients with LBP who may benefit from biofeedback.

  9. Salivary cortisol, heart rate, electrodermal activity and subjective stress responses to the Mannheim Multicomponent Stress Test (MMST).

    Science.gov (United States)

    Reinhardt, Tatyana; Schmahl, Christian; Wüst, Stefan; Bohus, Martin

    2012-06-30

    The availability of effective laboratory paradigms for inducing psychological stress is an important requirement for experimental stress research. Reliable protocols are scarce, usually laborious and manpower-intensive. In order to develop an economical, easily applicable standardized stress protocol, we have recently tailored the Mannheim Multicomponent Stress Test (MMST). This test has been shown to induce relatively high stress responses without focusing on social-evaluative components. In this study we evaluated changes in electrodermal activity and salivary cortisol in response to the MMST. The MMST simultaneously combines cognitive (mental arithmetic), emotional (affective pictures), acoustic (white noise) and motivational stressors (loss of money). This study comprised two independent experiments. For experiment 1, 80 female subjects were recruited; 30 subjects (15 females) participated in experiment 2. Significant changes in electrodermal activity and salivary cortisol levels in response to MMST exposure were found. Subjective stress and heart rate responses were significantly increased in both experiments. These results indicate that the MMST is an economical stress paradigm which is also applicable in larger cohorts or multicenter studies for investigating stress reactions. As social-evaluative threat is not the main stress component of the MMST, this procedure represents a useful and complementary alternative to other established stress protocols. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Measuring the subjective: revisiting the psychometric properties of three rating scales that assess the acute effects of hallucinogens.

    Science.gov (United States)

    Bouso, José Carlos; Pedrero-Pérez, Eduardo José; Gandy, Sam; Alcázar-Córcoles, Miguel Ángel

    2016-09-01

    In the present study we explored the psychometric properties of three widely used questionnaires to assess the subjective effects of hallucinogens: the Hallucinogen Rating Scale (HRS), the Mystical Experience Questionnaire (MEQ), and the Addiction Research Center Inventory (ARCI). These three questionnaires were administered to a sample of 158 subjects (100 men) after taking ayahuasca, a hallucinogen whose main active component is N,N-dimethyltryptamine (DMT). A confirmatory factorial study was conducted to check the adjustment of previous data obtained via theoretical proposals. When this was not possible, we used an exploratory factor analysis without restrictions, based on tetrachoric and polychoric matrices and correlations. Our results sparsely match the theoretical proposals of the authors, perhaps because previous studies have not always employed psychometric methods appropriate to the data obtained. However, these data should be considered preliminary, pending larger samples to confirm or reject the proposed structures obtained. It is crucial that instruments of sufficiently precise measurement are utilized to make sense of the information obtained in the study of the subjective effects of psychedelic drugs. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  11. Heart Rate Dynamics and their Relation with the Cyclic Alternating Pattern of Sleep in Normal Subjects and NFLE Patients

    Science.gov (United States)

    González, Jose S.; Dorantes, Guadalupe; Alba, Alfonso; Méndez, Martin O.; Camacho, Sergio; Luna-Rivera, Martin; Parrino, Liborio; Riccardi, Silvia; Terzano, Mario G.; Milioli, Giulia

    The aim of this work is to study the behavior of the autonomic system through variations in the heart rate (HR) during the Cyclic Alternating Pattern (CAP) which is formed by A-phases. The analysis was carried out in 10 healthy subjects and 10 patients with Nocturnal Front Lobe Epilepsy (NFLE) that underwent one whole night of polysomnographic recordings. In order to assess the relation of A-phases with the cardiovascular system, two time domain features were computed: the amplitude reduction and time delay of the minimum of the R-R intervals with respect to A-phases onset. In addition, the same process was performed over randomly chosen R-R interval segments during the NREM sleep for baseline comparisons. A non-parametric bootstrap procedure was used to test differences of the kurtosis values of two populations. The results suggest that the onset of the A-phases is correlated with a significant increase of the HR that peaks at around 4s after the A-phase onset, independently of the A-phase subtype and sleep time for both healthy subjects and NFLE patients. Furthermore, the behavior of the reduction in the R-R intervals during the A-phases was significantly different for NFLE patients with respect to control subjects.

  12. Effects of music therapy on subjective sensations and heart rate variability in treated cancer survivors: a pilot study.

    Science.gov (United States)

    Chuang, Chih-Yuan; Han, Wei-Ru; Li, Pei-Chun; Young, Shuenn-Tsong

    2010-10-01

    Data on the effects of music therapy on subjective sensations and the physiological parameters of heart rate variability (HRV) in treated cancer survivors are scarce. The aim of this study was to determine whether or not music therapy affects the sensations of fatigue, comfort, and relaxation in cancer survivors, and affects the activities of the sympathetic and parasympathetic nervous systems as indicated by HRV parameters. Twenty-three patients aged 30-67 years and with cancer that had been treated at least 6 months previously received music therapy for about 2h, which included singing, listening to music, learning the recorder, and performing music. Subjective sensations and electrocardiogram were recorded before and after the music therapy. The low-frequency and high-frequency components of HRV were assessed by the frequency analysis of sequential R wave to R wave intervals of electrocardiogram obtained from 5-min recordings. Subjective sensations were quantitatively assessed using a visual analog mood scale. Two hours of music therapy significantly increased relaxation sensations and significantly decreased fatigue sensation in treated cancer survivors. Moreover, the HRV parameters showed that parasympathetic nervous system activity increased and sympathetic nervous system activity decreased. This study provides preliminary evidence that music therapy may be clinically useful for promoting relaxation sensation and increasing parasympathetic nervous system activity in treated cancer survivors. Copyright © 2010. Published by Elsevier Ltd.

  13. Measuring cognitive load during simulation-based psychomotor skills training: sensitivity of secondary-task performance and subjective ratings.

    Science.gov (United States)

    Haji, Faizal A; Khan, Rabia; Regehr, Glenn; Drake, James; de Ribaupierre, Sandrine; Dubrowski, Adam

    2015-12-01

    As interest in applying cognitive load theory (CLT) to the study and design of pedagogic and technological approaches in healthcare simulation grows, suitable measures of cognitive load (CL) are needed. Here, we report a two-phased study investigating the sensitivity of subjective ratings of mental effort (SRME) and secondary-task performance (signal detection rate, SDR and recognition reaction time, RRT) as measures of CL. In phase 1 of the study, novice learners and expert surgeons attempted a visual-monitoring task under two conditions: single-task (monitoring a virtual patient's heart-rate) and dual-task (tying surgical knots on a bench-top simulator while monitoring the virtual patient's heart-rate). Novices demonstrated higher mental effort and inferior secondary-task performance on the dual-task compared to experts (RRT 1.76 vs. 0.73, p = 0.012; SDR 0.27 vs. 0.97, p instructional design research are discussed.