Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2147

Search results for: pain intensity

2147 Two Weeks of Multi-Modal Inpatient Treatment: Patients Suffering from Chronic Musculoskeletal Pain for over 12 Months

Authors: D. Schafer, H. Booke, R. Nordmeier

Abstract:

Patients suffering from chronic musculoskeletal pain ( > 12 months) are a challenging clientele for pain specialists. A multimodal approach, characterized by a two weeks inpatient treatment, often is the ultimate therapeutic attempt. The lasting effects of such a multimodal approach were analyzed, especially since two weeks of inpatient therapy, although very intense, often seem too short to make a difference in patients suffering from chronic pain for years. The study includes 32 consecutive patients suffering from chronic pain over years who underwent a two weeks multimodal inpatient treatment of pain. Twelve months after discharge, each patient was interviewed to objectify any lasting effects. Pain was measured on admission and 12 months after discharge using the numeric rating scale (NRS). For statistics, a paired students' t-test was used. Significance was defined as p < 0.05. The average intensity of pain on admission was 8,6 on the NRS. Twelve months after discharge, the intensity of pain was still reduced by an average of 48% (average NRS 4,4), p < 0.05. Despite this significant improvement in pain severity, two thirds (66%) of the patients still judge their treatment as not sufficient. In conclusion, inpatient treatment of chronic pain has a long-lasting effect on the intensity of pain in patients suffering from chronic musculoskeletal pain for more than 12 months.

Keywords: chronic pain, inpatient treatment, multimodal pain treatment, musculoskeletal pain

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2146 Patterns of Change in Perception of Imagined and Physically Induced Pain over the Course of Repeated Thermal Stimulations

Authors: Boroka Gács, Tibor Szolcsányi, Árpad Csathó

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Background: Individuals frequently show habituation to repeated noxious heat. However, given the defensive function of human pain processing, it is reasonable to assume that individuals imagine that they would become increasingly sensitive to repeated thermal pain stimuli. To the best of the authors' knowledge, no previous studies have, however, been addressed to this assumption. Therefore, in the current study, we investigated how healthy human individuals imagine the intensity of repeated thermal pain stimulations, and compared this with the intensity ratings given after physically induced thermal pain trials. Methods: Healthy participants (N = 20) gave pain intensity ratings in two conditions: imagined and real thermal pain. In the real pain condition thermal pain stimuli of two intensities (minimal and moderate pain) were delivered in four consecutive trials. The duration of the peak temperature was 20s, and stimulation was always delivered to the same location. In each trial, participants rated the pain intensity twice, 5s and 15s after the onset of the peak temperature. In the imagined pain condition, participants were subjected to a reference pain stimulus and then asked to imagine and rate the same sequence of stimulations as in the induced pain condition. Results: Ratings of imagined pain and physically induced pain followed opposite courses over repeated stimulation: Ratings of imagined pain indicated sensitization whereas ratings for physically induced pain indicated habituation. The findings were similar for minimal and moderate pain intensities. Conclusions: The findings suggest that, rather than habituating to pain, healthy individuals imagine that they would become increasingly sensitive to repeated thermal pain stimuli.

Keywords: habituation, imagined pain, pain perception, thermal stimulation

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2145 Pain Intensity, Functional Disability and Physical Activity among Elderly Individuals with Chronic Mechanical Low Back Pain

Authors: Adesola Odole, Nse Odunaiya, Samuel Adewale

Abstract:

Chronic Mechanical Low Back Pain (CMLBP) is prevalent in the aging population; some studies have documented the association among pain intensity, functional disability and physical activity in the general population but very few studies in the elderly. This study was designed to investigate the association among pain intensity, functional disability and physical activity of elderly individuals with CMLBP in the University College Hospital (UCH), Ibadan, Nigeria and also to determine the difference in physical activity, pain intensity and functional disability between males and females. A total of 96 participants diagnosed with CMLBP participated in this cross-sectional survey. They were conveniently sampled from selected units in the UCH, Ibadan, Nigeria. Data on sex, marital status, occupation and duration of onset of pain of participants were obtained from the participants. The Physical Activity Scale for the Elderly, Visual Analogue Scale and Oswestry Disability Questionnaire were used to measure the physical activity, pain intensity and functional disability of the participants respectively. Data was analysed using Spearman correlation, independent t-test; and α was set at 0.05. Participants (25 males, 71 females) were aged 69.64±7.43 years. The majority (76.0%) of the participants were married, and over half (55.2%) were retirees. Participants’ mean pain intensity score was 5.21±2.03 and mean duration of onset of low back pain was 63.63 ± 90.01 months. The majority (67.6%) of the participants reported severe to crippled functional disability. Their mean functional disability was 46.91 ± 13.99. Participants’ mean physical activity score was 97.47 ± 82.55. There was significant association between physical activity and pain intensity (r = -0.21, p = 0.04). There was significant association between physical activity and functional disability (r = -0.47, p = 0.00). Male (87.26 ± 79.94) and female (101.07 ± 83.71) participants did not differ significantly in physical activity (t = 0.00, p = 0.48). In addition, male (5.48 ± 2.06) and female (5.11 ± 2.02) participants’ pain intensity were comparable (t = 0.26, p = 0.44). There was also no significant difference in functional disability (t = 0.05, p = 0.07) between male (42.56 ±13.85) and female (48.45 ± 13.81) participants. It can be concluded from this study that majority of the elderly individuals with chronic mechanical low back pain had a severe to crippled functional disability. Those who reported increased physical activity had reduced pain intensity and functional disability. Male and female elderly individuals with chronic mechanical low back pain are comparable in their pain intensity, functional disability, and physical activity. Elderly individuals with CMLBP should be educated on the importance of participating in physical activity which could reduce their pain symptoms and improve functional disability.

Keywords: elderly, functional disability, mechanical low back pain, pain intensity, physical activity

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2144 Pain Analysis in Musicians Using Digital Pain Drawings

Authors: Cinzia Cruder, Deborah Falla, Francesca Mangili, Laura Azzimonti, Liliana Araujo, Aaron Williamon, Marco Barbero

Abstract:

Background and aims: According to the existing literature, musicians are at risk to experience a range of musculoskeletal painful conditions. Recently, digital technology has been developed to investigate pain location and pain extent. The aim of this study was to describe pain location and pain extent in musicians using a digital method for pain drawing analysis. Additionally, the association between pain drawing (PD) variables and clinical features in musicians with pain were explored. Materials and Methods: One hundred fifty-eight musicians (90 women and 68 men; age 22.4±3.6 years) were recruited from Swiss and UK conservatoires. Participants were asked to complete a survey including both background musical information and clinical features, the Quick Dash (QD) questionnaire and the digital PDs. Results: Of the 158 participants, 126 musicians (79.7%) reported having pain, with more prevalence in the areas of the neck and shoulders, the lower back and the right arm. The mean of pain extent was 3.1% ±6.5. The mean of QD was larger for musicians showing the presence of pain than for those without pain. Additionally, the results indicated a positive correlation between QD score and pain extent, and there were significant correlations between age and pain intensity, as well as between pain extent and pain intensity. Conclusions: The high prevalence of pain among musicians has been confirmed using a digital PD. In addition, positive correlations between pain extent and upper limb disability has been demonstrated. Our findings highlight the need for effective prevention and treatment strategies for musicians.

Keywords: pain location, pain extent, musicians, pain drawings

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2143 A Theoretical Study on Pain Assessment through Human Facial Expresion

Authors: Mrinal Kanti Bhowmik, Debanjana Debnath Jr., Debotosh Bhattacharjee

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A facial expression is undeniably the human manners. It is a significant channel for human communication and can be applied to extract emotional features accurately. People in pain often show variations in facial expressions that are readily observable to others. A core of actions is likely to occur or to increase in intensity when people are in pain. To illustrate the changes in the facial appearance, a system known as Facial Action Coding System (FACS) is pioneered by Ekman and Friesen for human observers. According to Prkachin and Solomon, a set of such actions carries the bulk of information about pain. Thus, the Prkachin and Solomon pain intensity (PSPI) metric is defined. So, it is very important to notice that facial expressions, being a behavioral source in communication media, provide an important opening into the issues of non-verbal communication in pain. People express their pain in many ways, and this pain behavior is the basis on which most inferences about pain are drawn in clinical and research settings. Hence, to understand the roles of different pain behaviors, it is essential to study the properties. For the past several years, the studies are concentrated on the properties of one specific form of pain behavior i.e. facial expression. This paper represents a comprehensive study on pain assessment that can model and estimate the intensity of pain that the patient is suffering. It also reviews the historical background of different pain assessment techniques in the context of painful expressions. Different approaches incorporate FACS from psychological views and a pain intensity score using the PSPI metric in pain estimation. This paper investigates in depth analysis of different approaches used in pain estimation and presents different observations found from each technique. It also offers a brief study on different distinguishing features of real and fake pain. Therefore, the necessity of the study lies in the emerging fields of painful face assessment in clinical settings.

Keywords: facial action coding system (FACS), pain, pain behavior, Prkachin and Solomon pain intensity (PSPI)

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2142 Association of Preoperative Pain Catastrophizing with Postoperative Pain after Lower Limb Trauma Surgery

Authors: Asish Subedi, Krishna Pokharel, Birendra Prasad Sah, Pashupati Chaudhary

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Objectives: To evaluate an association between preoperative Nepali pain catastrophizing scale (N-PCS) scores and postoperative pain intensity and total opioid consumption. Methods: In this prospective cohort study we enrolled 135 patients with an American Society of Anaesthesiologists physical status I or II, aged between 18 and 65 years, and scheduled for surgery for lower-extremity fracture under spinal anaesthesia. Maximum postoperative pain reported during the 24 h was classified into two groups, no-mild pain group (Numeric rating scale [NRS] scores 1 to 3) and a moderate-severe pain group (NRS 4-10). The Spearman correlation coefficient was used to compare the association between the baseline N-PCS scores and outcome variables, i.e., the maximum NRS pain score and the total tramadol consumption within the first 24 h after surgery. Logistic regression models were used to identify the predictors for the intensity of postoperative pain. Results: As four patients violated the protocol, the data of 131 patients were analysed. Mean N-PCS scores reported by the moderate-severe pain group was 27.39 ±9.50 compared to 18.64 ±10 mean N-PCS scores by the no-mild pain group (p<0.001). Preoperative PCS scores correlated positively with postoperative pain intensity (r =0.39, [95% CI 0.23-0.52], p<0.001) and total tramadol consumption (r =0.32, [95% CI 0.16-0.47], p<0.001). An increase in catastrophizing scores was associated with postoperative moderate-severe pain (odds ratio, 1.08 [95% confidence interval, 1.02-1.15], p=0.006) after adjusting for gender, ethnicity and preoperative anxiety. Conclusion: Patients who reported higher pain catastrophizing preoperatively were at increased risk of experiencing moderate-severe postoperative pain.

Keywords: nepali, pain catastrophizing, postoperative pain, trauma

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2141 Comparison of Sports Massage and Stretching along the Cold on Pain Intensity in Elite Female Volleyball Players with Trigger Points in Shoulder Girdle Region

Authors: Sahar Mohammadyari Ghareh Bolagh, Behnaz Seyedi Aghdam, Jalal Shamlou

Abstract:

This study was done to compare the effects of sports massage and stretching along the cold on pain intensity in elite female volleyball players with trigger points in shoulder girdle region. This study was conducted on 32 female volleyball players with latent trigger points in shoulder girdle region. Patients were randomly assigned to three groups: sports massage (n=11) stretching along the cold (n=11) and control group (n=10). One session treatment program during 15 minutes was performed. Pain intensity with VAS + algometer was assessed before and after intervention and improved in both of massage and cold groups. After treatment there were no significant difference between two treatment groups (P < 0. 050). Results of present research showed sports massage and stretching along the cold were effective on pain intensity of myofascial trigger points.

Keywords: sports massage، stretching along the cold، pain intensity، trigger points, elite, volleyball players, shoulder girdle region

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2140 Vertebral Pain Features in Women of Different Age Depending on Body Mass Index

Authors: Vladyslav Povoroznyuk, Tetiana Orlуk, Nataliia Dzerovych

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Introduction: Back pain is an extremely common health care problem worldwide. Many studies show a link between an obesity and risk of lower back pain. The aim is to study correlation and peculiarities of vertebral pain in women of different age depending on their anthropometric indicators. Materials: 1886 women aged 25-89 years were examined. The patients were divided into groups according to age (25-44, 45-59, 60-74, 75-89 years old) and body mass index (BMI: to 18.4 kg/m2 (underweight), 18.5-24.9 kg/m2 (normal), 25-30 kg/m2 (overweight) and more than 30.1 kg/m2 (obese). Methods: The presence and intensity of pain was evaluated in the thoracic and lumbar spine using a visual analogue scale (VAS). BMI is calculated by the standard formula based on body weight and height measurements. Statistical analysis was performed using parametric and nonparametric methods. Significant changes were considered as p <0.05. Results: The intensity of pain in the thoracic spine was significantly higher in the underweight women in the age groups of 25-44 years (p = 0.04) and 60-74 years (p=0.005). The intensity of pain in the lumbar spine was significantly higher in the women of 45-59 years (p = 0.001) and 60-74 years (p = 0.0003) with obesity. In the women of 45-74 years BMI was significantly positively correlated with the level of pain in the lumbar spine. Obesity significantly increases the relative risk of pain in the lumbar region (RR=0.07 (95% CI: 1.03-1.12; p=0.002)), while underweight significantly increases the risk of pain in the thoracic region (RR=1.21 (95% CI: 1.00-1.46; p=0.05)). Conclusion: In women, vertebral pain syndrome may be related to the anthropometric characteristics (e.g., BMI). Underweight may indirectly influence the development of pain in the thoracic spine and increase the risk of pain in this part by 1.21 times. Obesity influences the development of pain in the lumbar spine increasing the risk by 1.07 times.

Keywords: body mass index, age, pain in thoracic and lumbar spine, women

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2139 Relationship Between Pain Intensity at the Time of the Hamstring Muscle Injury and Hamstring Muscle Lesion Volume Measured by Magnetic Resonance Imaging

Authors: Grange Sylvain, Plancher Ronan, Reurink Guustav, Croisille Pierre, Edouard Pascal

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The primary objective of this study was to analyze the potential correlation between the pain experienced at the time of a hamstring muscle injury and the volume of the lesion measured on MRI. The secondary objectives were to analyze a correlation between this pain and the lesion grade as well as the affected hamstring muscle. We performed a retrospective analysis of the data collected in a prospective, multicenter, non-interventional cohort study (HAMMER). Patients with suspected hamstring muscle injury had an MRI after the injury and at the same time were evaluated for their pain intensity experienced at the time of the injury with a Numerical Pain Rating Scale (NPRS) from 0 to 10. A total of 61 patients were included in the present analysis. MRIs were performed in an average of less than 8 days. There was a significant correlation between pain and the injury volume (r=0.287; p=0.025). There was no significant correlation between the pain and the lesion grade (p>0.05), nor between the pain and affected hamstring muscle (p>0.05). Pain at the time of injury appeared to be correlated with the volume of muscle affected. These results confirm the value of a clinical approach in the initial evaluation of hamstring injuries to better select patients eligible for further imaging.

Keywords: hamstring muscle injury, MRI, volume lesion, pain

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2138 Development of a Pain Detector Using Microwave Radiometry Method

Authors: Nanditha Rajamani, Anirudhaa R. Rao, Divya Sriram

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One of the greatest difficulties in treating patients with pain is the highly subjective nature of pain sensation. The measurement of pain intensity is primarily dependent on the patient’s report, often with little physical evidence to provide objective corroboration. This is also complicated by the fact that there are only few and expensive existing technologies (Functional Magnetic Resonance Imaging-fMRI). The need is thus clear and urgent for a reliable, non-invasive, non-painful, objective, readily adoptable, and coefficient diagnostic platform that provides additional diagnostic information to supplement its current regime with more information to assist doctors in diagnosing these patients. Thus, our idea of developing a pain detector was conceived to take a step further the detection and diagnosis of chronic and acute pain.

Keywords: pain sensor, microwave radiometery, pain sensation, fMRI

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2137 Phantom Phenomena in Subjects after Limb Amutation Who Regularly Practice High Intensity Sports

Authors: Jolanta Uszko, Tomasz Wloch, Aneta Pirowska, Roman Nowobilski

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Introduction: Phantom phenomena are often reported by subjects who have undergone limb amputation. Mostly, patients feel the amputated part of the limb as if it was still attached to the body. Two types of phantom phenomena: painless (phantom sensation) and painful (phantom pain) were described. Triggers of phantom sensations and phantom pain, as well as fully effective treatment, have not been clearly described yet. Purpose: To assess the influence of psychosocial factors and some clinical conditions on the occurrence of phantom phenomena in amputee athletes. Subjects: 21 men (age: 31 years, SD = 7.5 years) after lower or upper extremity amputation, who regularly performed high-intensity sports (Amp Football Team Players) were included to the study. Method and equipment: In the research, the following method and tools were used: Questionnaire [Pirowska] adapted for athletes with disabilities, Numerical Rating Scale (NRS) - for phantom pain assessment, McGill Pain Assessment Questionnaire (short version), Beck's Depression Inventory (BDI), State Trait Anxiety Inventory (STAI): X-1 and X-2, shortened version of The World Health Organization Quality of Life (WHOQOLBREFF). Results: In the study group, the lower leg amputations with traumatic etiology were predominant. Phantom sensations were present in all subjects. Half of the respondents claimed to experience phantom sensations at least once a day, paroxysmally. There was a prevalence of phantom sensations characterized as incomplete, immobile limb. Phantom pain was reported by over 85% of respondents. The nature of phantom pain was frequently described as stabbing, squeezing, shooting, pulsing, tiring. There was a significant correlation between phantom pain intensity and anxiety, quality of life, depressive tendencies, perception of phantom pain as the obstacle in daily functioning and intensity of the limb pain before amputation. Conclusions: The etiology of phantom phenomena is complex. Psychological factors seem to have a significant influence on the intensity of the phantom pain. Particular attention should be paid to patients who complain about persistent limb pain before the amputation. These are patients with an increased risk of the phantom pain of relatively high intensity.

Keywords: amputation, phantom pain, phantom sensations, adaptive sports

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2136 Effects of Additional Pelvic Floor Exercise on Sexual Function, Quality of Life and Pain Intensity in Subjects with Chronic Low Back Pain

Authors: Emel Sonmezer, Hayri Baran Yosmaoglu

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The negative impact of chronic pain syndromes on sexual function has been reported in several studies; however, the influences of treatment strategies on sexual dysfunction have not been evaluated widely. The aim of this study was to determine the effects of pelvic floor exercise on sexual dysfunction in female patients with chronic low back pain. Forty-two patient with chronic low back pain were enrolled this study. Subjects were divided into two groups. Group 1 received conventional physiotherapy consist of heat therapy, ergonomic education, William flexion exercise during 6 weeks. Group 2 received pelvic floor exercises in addition to conventional physiotherapy. Female Sexual Function Index (FSFI) was used for the assessment of sexual function. Pain intensity was assessed with Visual Analogue Scale. Quality of life was assessed with World Health Organization Quality of Life Scale. All measurements were taken before and after treatment. In conventional physiotherapy group; there were significant improvement in pain intensity (p= 0,003), physical health (p=0,011), psychological health (p=0,042) subscales of quality of life scale, arousal (p=0,042), lubrication (p=0,028) and pain (p= 0,034) subscales of FSFI. In additional pelvic floor exercise group; there were significant improvement in pain intensity (p= 0,005), physical health (p=0,012) psychological health (p=0,039) subscales of quality of life scale, arousal (p=0,024), lubrication (p=0,011), orgasm (p=0,035) and pain (p= 0,015) subscales and total score (p=0,016) of FSFI. Total FSFI score (p=0,025) and orgasm (p=0,017) subscale of FSFI were significantly higher for the additional pelvic floor exercise group than the conventional physiotherapy group.The outcome of this study suggested that conventional physiotherapy may contribute to improve pain, quality of life and some parameters of the sexual function in patients with low back pain. Although additional pelvic floor exercise did not reveal more treatment effect in terms of quality of life and pain intensity, it caused significant improvement in sexual function. It is recommended that pelvic floor exercise should be added to treatment programs in order to manage sexual dysfunction more effectively in patients with chronic low back pain.

Keywords: physiotherapy, chronic pain, sexual dysfunction, pelvic floor

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2135 Experimental Pain Study Investigating the Distinction between Pain and Relief Reports

Authors: Abeer F. Almarzouki, Christopher A. Brown, Richard J. Brown, Anthony K. P. Jones

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Although relief is commonly assumed to be a direct reflection of pain reduction, it seems to be driven by complex emotional interactions in which pain reduction is only one component. For example, termination of a painful/aversive event may be relieving and rewarding. Accordingly, in this study, whether terminating an aversive negative prediction of pain would be reflected in a greater relief experience was investigated, with a view to separating apart the effects of the manipulation on pain and relief. We use aversive conditioning paradigm to investigate the perception of relief in an aversive (threat) vs. positive context. Participants received positive predictors of a non-painful outcome which were presented within either a congruent positive (non-painful) context or an incongruent threat (painful) context that had been previously conditioned; trials followed by identical laser stimuli on both conditions. Participants were asked to rate the perceived intensity of pain as well as their perception of relief in response to the cue predicting the outcome. Results demonstrated that participants reported more pain in the aversive context compared to the positive context. Conversely, participants reported more relief in the aversive context compares to the neutral context. The rating of relief in the threat context was not correlated with pain reports. The results suggest that relief is not dependant on pain intensity. Consistent with this, relief in the threat context was greater than that in the positive expectancy condition, while the opposite pattern was obtained for the pain ratings. The value of relief in this study is better appreciated in the context of an impending negative threat, which is apparent in the higher pain ratings in the prior negative expectancy compared to the positive expectancy condition. Moreover, the more threatening the context (as manifested by higher unpleasantness/higher state anxiety scores), the more the relief is appreciated. The importance of the study highlights the importance of exploring relief and pain intensity in monitoring separately or evaluating pain-related suffering. The results also illustrate that the perception of painful input may largely be shaped by the context and not necessarily stimulus-related.

Keywords: aversive context, pain, predictions, relief

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2134 A Computational Model of the Thermal Grill Illusion: Simulating the Perceived Pain Using Neuronal Activity in Pain-Sensitive Nerve Fibers

Authors: Subhankar Karmakar, Madhan Kumar Vasudevan, Manivannan Muniyandi

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Thermal Grill Illusion (TGI) elicits a strong and often painful sensation of burn when interlacing warm and cold stimuli that are individually non-painful, excites thermoreceptors beneath the skin. Among several theories of TGI, the “disinhibition” theory is the most widely accepted in the literature. According to this theory, TGI is the result of the disinhibition or unmasking of the pain-sensitive HPC (Heat-Pinch-Cold) nerve fibers due to the inhibition of cold-sensitive nerve fibers that are responsible for masking HPC nerve fibers. Although researchers focused on understanding TGI throughexperiments and models, none of them investigated the prediction of TGI pain intensity through a computational model. Furthermore, the comparison of psychophysically perceived TGI intensity with neurophysiological models has not yet been studied. The prediction of pain intensity through a computational model of TGI can help inoptimizing thermal displays and understanding pathological conditions related to temperature perception. The current studyfocuses on developing a computational model to predict the intensity of TGI pain and experimentally observe the perceived TGI pain. The computational model is developed based on the disinhibition theory and by utilizing the existing popular models of warm and cold receptors in the skin. The model aims to predict the neuronal activity of the HPC nerve fibers. With a temperature-controlled thermal grill setup, fifteen participants (ten males and five females) were presented with five temperature differences between warm and cold grills (each repeated three times). All the participants rated the perceived TGI pain sensation on a scale of one to ten. For the range of temperature differences, the experimentally observed perceived intensity of TGI is compared with the neuronal activity of pain-sensitive HPC nerve fibers. The simulation results show a monotonically increasing relationship between the temperature differences and the neuronal activity of the HPC nerve fibers. Moreover, a similar monotonically increasing relationship is experimentally observed between temperature differences and the perceived TGI intensity. This shows the potential comparison of TGI pain intensity observed through the experimental study with the neuronal activity predicted through the model. The proposed model intends to bridge the theoretical understanding of the TGI and the experimental results obtained through psychophysics. Further studies in pain perception are needed to develop a more accurate version of the current model.

Keywords: thermal grill Illusion, computational modelling, simulation, psychophysics, haptics

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2133 The Effects of Functionality Level on Gait in Subjects with Low Back Pain

Authors: Vedat Kurt, Tansel Koyunoglu, Gamze Kurt, Ozgen Aras

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Low back pain is one of the most common health problem in public. Common symptoms that can be associated with low back pain include; pain, functional disability, gait disturbances. The aim of the study was to investigate the differences between disability scores and gait parameters in subjects with low back pain. Sixty participants are included in our study, (35 men, 25 women, mean age: 37.65±10.02 years). Demographic characteristics of participants were recorded. Pain (visual analog scale) and disability level (Oswestry Disability Index(ODI)) were evaluated. Gait parameters were measured with Zebris-FDM-2 platform. Independent samples t-test was used to analyse the differences between subjects with under 40 points (n=31, mean age:35.8±11.3) and above 40 points (n=29, mean age:39.6±8.1) of ODI scores. Significant level in statistical analysis was accepted as 0.05. There was no significant difference between the ODI scores and groups’ ages. Statistically significant differences were found in step width between subjects with under 40 points of ODI and above 40 points of ODI score(p < 0.05). But there were non-significant differences with other gait parameters (p > 0.05). The differences between gait parameters and pain scores were not statistically significant (p > 0.05). Researchers generally agree that individuals with LBP walk slower and take shorter steps and have asymmetric step lengths when compared with than their age-matched pain-free counterparts. Also perceived general disability may have moderate correlation with walking performance. In the current study, the patients classified as minimal/moderate and severe disability level by using ODI scores. As a result, a patient with LBP who have higher disability level tends to increase support surface. On the other hand, we did not find any relation between pain intensity and gait parameters. It may be caused by the classification system of pain scores. Additional research is needed to investigate the effects of functionality level and pain intensity on gait in subjects with low back pain under different classification types.

Keywords: functionality, low back pain, gait, pain

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2132 Effectiveness of Office-Based Occupational Therapy for Office Workers with Low Back Pain: A Public Health Approach

Authors: Dina Jalalvand, Joshua A. Cleland

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This double-blind, randomized control trial with parallel groups aimed to examine the effectiveness of office-based occupational therapy for office workers with low back pain on the intensity of pain and range of motion. Seventy-two male office workers (age: 20-50 years) with chronic low back pain (more than three months with at least two symptoms of chronic low back pain) satisfied eligibility criteria and agreed to participate in this study. The absence of joint burst following magnetic resonance imagining (MRI) was considered as an important inclusion criterion as well. Subjects were randomly assigned to a control or experimental group. The experimental group received the modified package of exercise-based occupational therapy, which included 11 simple exercise movements (derived from Williams and McKenzie), and the control group just received the conventional therapy, which included their routine physiotherapy sessions. The subjects completed the exercises three times a week for a duration of six weeks. Each exercise session was 10-15 minutes. Pain intensity and range of motion were the primary outcomes and were measured at baseline, 6 weeks, and 12 weeks after the end of the intervention using the numerical rating scale (NRS) and goniometer accordingly. Repeated measure ANOVA was used for analyzing data. The results of this study showed that significant decreases in pain intensity (p ≤ 0.05) and an increase in range of motion (p ≤ 0.001) in the experimental group in comparison with the control group after 6 and 12 weeks of intervention (between-group comparisons). In addition, there was a significant decrease in intensity of the pain (p ≤ 0.05) and an increase (p ≤ 0.001) in range of motion in the intervention group in comparison with baseline after 6 and 12 weeks (within-group comparison). This showed a positive effect of exercise-based occupational therapy that could potentially be used with low cost among office workers who suffer from low back pain. In addition, it should be noted that the introduced package of exercise training is easy to do, and there is not a need for a specific introduction.

Keywords: public health, office workers, low back pain, occupational therapy

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2131 Chronic and Sub-Acute Lumbosacral Radiculopathies Behave Differently to Repeated Back Extension Exercises

Authors: Sami Alabdulwahab

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Background: Repeated back extension exercises (RBEEs) are among the management options for symptoms associated with lumbosacral radiculopathy (LSR). RBEEs have been reported to cause changes in the distribution and intensity of radicular symptoms caused by possible compression/decompression of the compromised nerve root. Purpose: The purpose of this study was to investigate the effects of the RBEEs on the neurophysiology of the compromised nerve root and on standing mobility and pain intensity in patients with sub-acute and chronic LSR. Methods: A total of 40 patients with unilateral sub-acute/chronic lumbosacral radiculopathy voluntarily participated in the study; the patients performed 3 sets of 10 RBEEs in the prone position with 1 min of rest between the sets. The soleus H-reflex, standing mobility and pain intensity were recorded before and after the RBEEs. Results: The results of the study showed that the RBEEs significantly improved the H-reflex, standing mobility and pain intensity in patients with sub-acute LSR (p<0.01); there was not a significant improvement in the patients with chronic LSR (p<0.61). Conclusion: RBEEs in prone position is recommended for improving the neurophysiological function of the compromised nerve root and standing mobility in patients with sub-acute LSR. Implication: Sub-acute and chronic LSR responded differently to RBEEs. Sub-acute LSR appear to have flexible and movable disc structures, which could be managed with RBEEs.

Keywords: h-reflex, back extension, lumbosacral radiculopathy, pain

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2130 Outcomes of Pain Management for Patients in Srinagarind Hospital: Acute Pain Indicator

Authors: Chalermsri Sorasit, Siriporn Mongkhonthawornchai, Darawan Augsornwan, Sudthanom Kamollirt

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Background: Although knowledge of pain and pain management is improving, they are still inadequate to patients. The Nursing Division of Srinagarind Hospital is responsible for setting the pain management system, including work instruction development and pain management indicators. We have developed an information technology program for monitoring pain quality indicators, which was implemented to all nursing departments in April 2013. Objective: To study outcomes of acute pain management in process and outcome indicators. Method: This is a retrospective descriptive study. The sample population was patients who had acute pain 24-48 hours after receiving a procedure, while admitted to Srinagarind Hospital in 2014. Data were collected from the information technology program. 2709 patients with acute pain from 10 Nursing Departments were recruited in the study. The research tools in this study were 1) the demographic questionnaire 2) the pain management questionnaire for process indicators, and 3) the pain management questionnaire for outcome indicators. Data were analyzed and presented by percentages and means. Results: The process indicators show that nurses used pain assessment tool and recorded 99.19%. The pain reassessment after the intervention was 96.09%. The 80.15% of the patients received opioid for pain medication and the most frequency of non-pharmacological intervention used was positioning (76.72%). For the outcome indicators, nearly half of them (49.90%) had moderate–severe pain, mean scores of worst pain was 6.48 and overall pain was 4.08. Patient satisfaction level with pain management was good (49.17%) and very good (46.62%). Conclusion: Nurses used pain assessment tools and pain documents which met the goal of the pain management process. Patient satisfaction with pain management was at high level. However the patients had still moderate to severe pain. Nurses should adhere more strictly to the guidelines of pain management, by using acute pain guidelines especially when pain intensity is particularly moderate-high. Nurses should also develop and practice a non-pharmacological pain management program to continually improve the quality of pain management. The information technology program should have more details about non-pharmacological pain techniques.

Keywords: outcome, pain management, acute pain, Srinagarind Hospital

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2129 Effect of Rehabilitative Nursing Program on Pain Intensity and Functional Status among Patients with Discectomy

Authors: Amal Shehata

Abstract:

Low back pain related to disc prolapse is localized in the lumbar area and it may be radiated to the lower extremities, starting from neurons near or around the spinal canal. Most of the population may be affected with disc prolapse within their lifetime and leads to lost productivity, disability and loss of function. The study purpose was to examine the effect of rehabilitative nursing program on pain intensity and functional status among patients with discectomy. Design: Aquasi experimental design was utilized. Setting: The study was carried out at neurosurgery department and out patient's clinic of Menoufia University and Teaching hospitals at Menoufia governorate, Egypt. Instrument of the study: Five Instruments were used for data collection: Structured interviewing questionnaire, Functional assessment instrument, Observational check list, Numeric rating Scale and Oswestry low back pain disability questionnaire. Results: There was an improvement in mean total knowledge score about disease process, discectomy and rehabilitation program in study group (25.32%) than control group (7.32%). There was highly statistically significant improvement in lumbar flexibility among study group (80%) than control group (30%) after rehabilitation program than before. Also there was a decrease in pain score in study group (58% no pain) than control group (28% no pain) after rehabilitation program. There was an improvement in total disability score of study group (zero %) regarding effect of pain on the activity of daily living after rehabilitation program than control group (16%). Conclusion: Application of rehabilitative nursing program for patient with discectomy had proven a positive effect in relation to knowledge score, pain reduction, activity of daily living and functional abilities. Recommendation: A continuous rehabilitative nursing program should be carried out for all patients immediately after discectomy surgery on regular basis. Also A colored illustrated booklet about rehabilitation program should be available and distributed for all patients before surgery.

Keywords: discectomy, rehabilitative nursing program, pain intensity, functional status

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2128 A Comparative Study on the Effectiveness of Conventional Physiotherapy Program, Mobilization and Taping with Proprioceptive Training for Patellofemoral Pain Syndrome

Authors: Mahesh Mitra

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Introduction and Purpose: Patellofemoral Pain Syndrome [PFPS] is characterized by pain or discomfort seemingly originating from the contact of posterior surface of Patella with Femur. Given the multifactorial causes and high prevalence there is a need of proper management technique. Also a more comprehensive and best possible Physiotherapy treatment approach has to be devised to enhance the performance of the individual with PFPS. Purpose of the study was to: - Prevalence of PFPS in various sports - To determine if there exists any relationship between the Body Mass Index[BMI] and Pain Intensity in the person playing a sport. - To evaluate the effect of conventional Physiotherapy program, Mobilization and Taping with Proprioceptive training on PFPS. Hypothesis 1. Prevalence is not the same with different sporting activities 2. There is a relationship between BMI and Pain intensity. 3. There is no significant difference in the improvement with the different treatment approaches. Methodology: A sample of 200 sports men were tested for the prevalence of PFPS and their anthropometric measurements were obtained to check for the correlation between BMI vs Pain intensity. Out of which 80 diagnosed cases of PFPS were allotted into three treatment groups and evaluated for Pain at rest and at activity and KUJALA scale. Group I were treated with conventional Physiotherapy that included TENS application and Exercises, Group II were treated with compression mobilization along with exercises, Group III were treated with Taping and Proprioceptive exercises. The variables Pain on rest, activity and KUJALA score were measured initially, at 1 week and at the end of 2 weeks after respective treatment. Data Analysis - Prevalence percentage of PFPS in each sport - Pearsons Correlation coefficient to find the relationship between BMI and Pain during activity. - Repeated measures analysis of variance [ANOVA] to find out the significance during Pre, Mid and Post-test difference among - Newman Kuel Post hoc Test - ANCOVA for the difference amongst group I, II and III. Results and conclusion It was concluded that PFPS was more prevalent in volley ball players [80%] followed by football and basketball [66%] players, then in hand ball and cricket players [46.6%] and 40% in tennis players. There was no relationship between BMI of the individual and Pain intensity. All the three treatment approaches were effective whereas mobilization and taping were more effective than Conventional Physiotherapy program.

Keywords: PFPS, KUJALA score, mobilization, proprioceptive training

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2127 A Study of Gender Differences in Expressing Pain

Authors: A. Estaji

Abstract:

The first part of the present paper studies the role of language in expressing pain. Pain is usually described as a personal and mental experience, so language has an important role in describing, expressing and measuring pain and sometimes it is believed that language is the only device for accessing this personal experience. The second part of this paper studies gender differences in expressing pain. Considering the biological, psychological and social differences between men and women, we raise this question whether men and women express their pain in the same way or differently. To answer this question, we asked 44 Farsi speaking participants to write about the most painful experience they had in the past. Qualitative analysis of the data shows that women, have expressed their pain more severely, have expressed their feelings about pain instead of describing the pain itself, have made their pain more personal and have given more details about the circumstances in which they experienced pain, while men have given a more neutral description of their pain and have given a description of their pain by distancing themselves from the painful event. Knowing these gender differences in expressing pain can help medical practitioners in assessing the pain level.

Keywords: discourse analysis, expressing pain, measuring pain, gender

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2126 Parsonage Turner Syndrome PTS, Case Report

Authors: A. M. Bumbea, A. Musetescu, P. Ciurea, A. Bighea

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Objectives: The authors present a Parsonage Turner syndrome, a rare disease characterized by onset in apparently healthy person with shoulder and/or arm pain, sensory deficit, motor deficit. The causes are not established, could be determinate by vaccination, postoperative, immunologic disease, post traumatic etc. Methods: The authors present a woman case, 32 years old, (in 2006), no medical history, with arm pain and no other symptom. The onset was sudden with pain at very high level quantified as 10 to a 0 to 10 scale, with no response to classical analgesic and corticoids. The only drugs which can reduce the intensity of pain were oxycodone hydrochloride, 60 mg daily and pregabalinum150 mg daily. After two weeks the intensity of pain was reduced to 5. The patient started a rehabilitation program. After 6 weeks the patient associated sensory and motor deficit. We performed electromyography for upper limb that showed incomplete denervation with reduced neural transmission speed. The patient receives neurotrophic drugs and painkillers for a long period and physical and kinetic therapy. After 6 months the pain was reduced to level 2 and the patient maintained only 150 mg pregabalinum for another 6 months. Then, the evaluation showed no pain but general amiotrophy in upper limb. Results: At the evaluation in 2009, the patient developed a rheumatoid syndrome with tender and swelling joints, but no positive inflammation test, no antibodies or rheumatoid factor. After two years, in 2011 the patient develops an increase of antinuclear antibodies. This context certifies the diagnosis of lupus and the patient receives the specific therapy. Conclusions: This case is not a typical case of onset of lupus with PTS, but the onset of PTS could include the onset of an immune disease.

Keywords: lupus, arm pain, patient, swelling

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2125 Cognitive Fusion and Obstacles to Valued Living: Beyond Pain-Specific Events in Chronic Pain

Authors: Sergio A. Carvalho, Jose Pinto-Gouveia, David Gillanders, Paula Castilho

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The role of psychological processes has long been recognized as crucial factors in depressive symptoms in chronic pain (CP). Although some studies have explored the negative impact of being entangled with internal experiences (e.g., thoughts, emotions, physical sensations) – cognitive fusion, it is not extensively explored 1) whether these are pain-related or rather general difficult experiences, and 2) how they relate to experiencing obstacles in committing to valued actions. The current study followed a cross-sectional design in a sample of 231 participants with CP, in which a mediational model was tested through path analyses in AMOS software. The model presented a very good model fit (Χ²/DF = 1.161; CFI = .999; TLI = .996; RMSEA = .026, PCLOSE = .550.), and results showed that pain intensity was not directly related to depressive symptoms (β = .055; p = .239) but was mediated by cognitive fusion with both general and pain-related internal experiences (β = .181, 95%CI [.097; .271]; p = .015). Additionally, results showed that only general cognitive fusion (but not pain-specific fusion) was associated with experiencing obstacles to living a meaningful life, which mediated its impact on depressive symptoms (β = .197, 95%CI [.102; .307]; p = .001). Overall, this study adds on current literature by suggesting that psychological interventions to pain management should not be focused only on management of pain-related experiences, but also on developing more effective ways of relating to overall internal experiences.

Keywords: cognitive fusion, chronic pain, depressive symptoms, valued living

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2124 Determining the Effect of Tdcs in Pain and Quality of Life in Patients with Fibromyalgia

Authors: Farid Rezaei, Zahra Reza Soltani, Behrouz Tavana, Afsaneh Dadarkhah, Masoume Bahrami Asl, S. Alireza Mirghasemi

Abstract:

Introduction: Fibromyalgia is a syndrome comprised of a group of symptoms. The primary symptom of fibromyalgia is pain propagation is associated by Secondary symptoms include fatigue, cognitive disorders, sleep disorders and hypersensitivity to painful stimuli. Recent studies have shown that there is a direct relationship between fibromyalgia and certain changes in brain activity. Aim: The aim of this study is determining the effect of tDCS in pain and quality of life in patients with fibromyalgia. Method: 68 patients with fibromyalgia who had inclusion criterias were randomly divided into two groups of case and control. Groups were matched in terms of gender, age, education, duration of pain and PMS. Patient groups treated with tDCS device manufacture by Enraf company made in Netherlands (M1 anodal stimulation, 2 mA constant current, 20 minutes, for 10 sessions (3 days a week)). Also the protocol was done for control group, in sham mode of tDCS device that had no current, for 10 sessions of 20 minutes. Before treatment, immediately after the end of 10 sessions treatment (short-term) and 10 week later (long-term effect), pain intensity questionnaires (VAS) and quality of life in fibromyalgia patients questionnaire was completed by the patient. Results: Pain intensity were significantly lower in the treatment group than the sham group 2 weeks and 10 weeks after treatment than before treatment (P < 0.001). Although the quality of life of patients 2 weeks after treatment showed no significant change, but ten weeks after treatment were more than sham group (P < 0.0001). Conclusion: Our results suggest that tDCS is a safe and effective in treating fibromyalgia patients and an important effect in reducing pain and increasing quality of their life.

Keywords: fibromyalgia, tDCS, quality of life, VAS score

Procedia PDF Downloads 275
2123 Socio-Demographic and Work Related Variables as Predictor of Persistence of Back Pain and Disability among Civil Servants Receiving Physiotherapy in Tertiary Health Institutions in Kano State, Nigeria

Authors: Abdullah Abdulsalam, Adamu Balami, Olajide Olubanji Olowe, Maryam Abdu Abdulkadir

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The development and persistence of low back pain may be influenced by several factors which include lifestyle factors, previous pain symptoms, psychological factors, workplace factors as well as socio-demographic variables. The focus of this study was to determine the socio-demographic and work related variables as a predictor of persistence of back pain and disability among civil servants receiving physiotherapy in tertiary health institutions in Kano, Nigeria. One hundred and twenty nine newly referred low back pain patients for physiotherapy participated in the study. This study was a cross sectional study involving patients that were newly diagnosed of back pain, referred and received physiotherapy. The convenience sampling technique was used to select the patients based on the inclusion criteria. The data obtained was analysed using simple percentage and multiple regression for stated hypothesis at 0.05 level of significance. The findings reveal that all the variables are not significant predictor of persistence of back pain and disability. The study recommended that determinants of low back pain recovery by clinician should include other clinical factors not only reduction in pain intensity.

Keywords: socio-demographic, work related variables, Kano state, back pain and disability

Procedia PDF Downloads 222
2122 Combining Patients Pain Scores Reports with Functionality Scales in Chronic Low Back Pain Patients

Authors: Ivana Knezevic, Kenneth D. Candido, N. Nick Knezevic

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Background: While pain intensity scales remain generally accepted assessment tool, and the numeric pain rating score is highly subjective, we nevertheless rely on them to make a judgment about treatment effects. Misinterpretation of pain can lead practitioners to underestimate or overestimate the patient’s medical condition. The purpose of this study was to analyze how the numeric rating pain scores given by patients with low back pain correlate with their functional activity levels. Methods: We included 100 consecutive patients with radicular low back pain (LBP) after the Institutional Review Board (IRB) approval. Pain scores, numeric rating scale (NRS) responses at rest and in the movement,Oswestry Disability Index (ODI) questionnaire answers were collected 10 times through 12 months. The ODI questionnaire is targeting a patient’s activities and physical limitations as well as a patient’s ability to manage stationary everyday duties. Statistical analysis was performed by using SPSS Software version 20. Results: The average duration of LBP was 14±22 months at the beginning of the study. All patients included in the study were between 24 and 78 years old (average 48.85±14); 56% women and 44% men. Differences between ODI and pain scores in the range from -10% to +10% were considered “normal”. Discrepancies in pain scores were graded as mild between -30% and -11% or +11% and +30%; moderate between -50% and -31% and +31% and +50% and severe if differences were more than -50% or +50%. Our data showed that pain scores at rest correlate well with ODI in 65% of patients. In 30% of patients mild discrepancies were present (negative in 21% and positive in 9%), 4% of patients had moderate and 1% severe discrepancies. “Negative discrepancy” means that patients graded their pain scores much higher than their functional ability, and most likely exaggerated their pain. “Positive discrepancy” means that patients graded their pain scores much lower than their functional ability, and most likely underrated their pain. Comparisons between ODI and pain scores during movement showed normal correlation in only 39% of patients. Mild discrepancies were present in 42% (negative in 39% and positive in 3%); moderate in 14% (all negative), and severe in 5% (all negative) of patients. A 58% unknowingly exaggerated their pain during movement. Inconsistencies were equal in male and female patients (p=0.606 and p=0.928).Our results showed that there was a negative correlation between patients’ satisfaction and the degree of reporting pain inconsistency. Furthermore, patients talking opioids showed more discrepancies in reporting pain intensity scores than did patients taking non-opioid analgesics or not taking medications for LBP (p=0.038). There was a highly statistically significant correlation between morphine equivalents doses and the level of discrepancy (p<0.0001). Conclusion: We have put emphasis on the patient education in pain evaluation as a vital step in accurate pain level reporting. We have showed a direct correlation with patients’ satisfaction. Furthermore, we must identify other parameters in defining our patients’ chronic pain conditions, such as functionality scales, quality of life questionnaires, etc., and should move away from an overly simplistic subjective rating scale.

Keywords: pain score, functionality scales, low back pain, lumbar

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2121 Payment for Pain: Differences between Hypothetical and Real Preferences

Authors: J. Trarbach, S. Schosser, B. Vogt

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Decision-makers tend to prefer the first alternative over subsequent alternatives which is called the primacy effect. To reliably measure this effect, we conducted an experiment with real consequences for preference statements. Therefore, we elicit preferences of subjects using a rating scale, i.e. hypothetical preferences, and willingness to pay, i.e. real preferences, for two sequences of pain. Within these sequences, both overall intensity and duration of pain are identical. Hence, a rational decision-maker should be indifferent, whereas the primacy effect predicts a stronger preference for the first sequence. What we see is a primacy effect only for hypothetical preferences. This effect vanishes for real preferences.

Keywords: decision making, primacy effect, real incentives, willingness to pay

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2120 Disability and Quality of Life in Low Back Pain: A Cross-Sectional Study

Authors: Zarina Zahari, Maria Justine, Kamaria Kamaruddin

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Low back pain (LBP) is a major musculoskeletal problem in global population. This study aimed to examine the relationship between pain, disability and quality of life in patients with non-specific low back pain (LBP). One hundred LBP participants were recruited in this cross-sectional study (mean age = 42.23±11.34 years old). Pain was measured using Numerical Rating Scale (11-point). Disability was assessed using the revised Oswestry low back pain disability questionnaire (ODQ) and quality of life (QoL) was evaluated using the SF-36 v2. Majority of participants (58%) presented with moderate pain and 49% experienced severe disability. Thus, the pain and disability were found significant with negative correlation (r= -0.712, p<0.05). The pain and QoL also showed significant and positive correlation with both Physical Health Component Summary (PHCS) (r= .840, p<0.05) and Mental Health Component Summary (MHCS) (r= 0.446, p<0.05). Regression analysis indicated that pain emerged as an indicator of both disability and QoL (PHCS and MHCS) accounting for 51%, 71% and 21% of the variances respectively. This indicates that pain is an important factor in predicting disability and QoL in LBP sufferers.

Keywords: disability, low back pain, pain, quality of life

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2119 The Use of Complementary and Alternative Medicine for Pain Relief in the Elderly: An Investigational Analysis of Seniors Residing in an Independent/Assisted Seniors’ Living Facility

Authors: Carol Cameletti

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The goal of this study was to perform a pilot survey to assess pain frequency and intensity in an elderly population and to assess treatment options for chronic pain that include complementary and alternative medicines (CAM). Ten participants were recruited from an independent and supportive living housing facility in Northern Ontario and asked to complete two questionnaires: 1) a self-assessment on pain, and 2) the use of CAM for pain. Results from our study show that 80% of the participants experienced pains other than the regular everyday pains such as minor headaches, sprains or toothaches. Although participants stated that on average the highest level of pain they experienced within the past 24 hours had a score of 6.5 (0=no pain, 10=worst pain imaginable) the level of pain they experienced moderately interfered with their daily activities. Unfortunately, participants stated that they were only able to attain minimal levels of pain relief using treatments or medications causing some of the participants to seek alternative therapies or self-help practices. The most commonly used CAMs were vitamins/minerals, herbs and supplements, and self-help practices such as meditation, prayer, visualization and relaxation techniques. Although some of the participants stated that they had received complementary treatments directly from their physician, four of the nine participants said that they had not disclosed CAM use to their physician thereby indicating a need to open the lines of communication between healthcare providers and patients with regards to CAM use. It is our hope that the data generated from this study will serve as the platform for a pain management clinic that is client-centered, consumer-driven and truly integrative and tailored in order to meet the unique needs of older adults in Great Sudbury, Ontario.

Keywords: alternative, complementary, elderly, medicine

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2118 Relation between Chronic Mechanical Low Back Pain and Hip Rotation

Authors: Mohamed M. Diab, Koura G. Mohamed, A. Balbaa, Radwan Sh. Ahamed

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Background: Chronic mechanical low back pain (CMLBP) is the most common complaint of the working-age population. Mechanical low back pain is often a chronic, dull, aching pain of varying intensity that affects the lower spine. In the current proposal the hip rotation-CMLBP relationship is based on that limited hip motion will be compensated by motion in the lumbopelvic region and this increase force translates to the lumbar spine. The purpose of this study was to investigate if there a relationship between chronic mechanical low back pain (CMLBP) and hip medial and lateral rotation (peak torque and Range of motion (ROM) in patients with CMLBP. Methods: Sixty patients with CMLBP diagnosed by an orthopedist participated in the current study after signing a consent form. Their mean of age was (23.76±2.39) years, mean of weight (71.8±12.7) (Kg), mean of height (169.65±7.49) (Cm) and mean of BMI (25.5±3.86) (Kg/m2). Visual Analogue Scale (VAS) was used to assess pain. Fluid Filled Inclinometer was used to measure Hip rotation ROM (medial and lateral). Isokinetic Dynamometer was used to measure peak torque of hip rotators muscles (medial and lateral), concentric peak torque with tow Isokinetic speeds (60ᵒ/sec and 180ᵒ/sec) was selected to measure peak torque. Results: The results of this study demonstrated that there is poor relationship between pain and hip external rotation ROM, also there is poor relation between pain and hip internal rotation ROM. There is poor relation between pain and hip internal rotators peak torque and hip external rotators peak torque in both speeds. Conclusion: Depending on the current study it is not recommended to give an importance to hip rotation in treating Chronic Mechanical Low Back Pain.

Keywords: hip rotation ROM, hip rotators strength, low back pain, chronic mechanical

Procedia PDF Downloads 232