Pain Endurance Research Articles

Analysis of SCN9A Gene Variants for Acute and Chronic Postoperative Pain and Morphine Consumption After Total Hysterectomy.

Single nucleotide polymorphisms (SNPs) of the voltage-gated sodium channel alpha subunit gene (SCN9A) have been associated with pain in various settings. The aim of this study was to investigate the association of the SNPs to evaluate the influence of common gene variants on chronic postoperative pain (CPSP) and other related pain variables in a cohort of patients who underwent a scheduled hysterectomy. DNA samples from a cohort of 1,075 patients who underwent a scheduled total hysterectomy in our hospital were genotyped for three common SCN9A SNPs using TaqMan assays. Multivariate logistic regression models were used to quantify the association between independent covariates such as pain threshold, pain endurance, pain scores, morphine use, and the presence of chronic pain. Frequencies of the minor alleles were different between the different ethnic groups. There was a statistically significant association of rs16851799 with morphine consumption and self-reported postoperative pain for the 1,038 subjects genotyped, with the TT genotype reporting higher pain and using more morphine. For the subpopulation of 446 subjects with chronic pain data, there was a similar association with self-reported postoperative pain and tolerance of pressure pain. Univariate analysis also showed a statistically significant association of rs16851799 with CPSP, whereas multivariable analysis revealed a similar association of rs4387806 with this outcome. There were three haplotypes with different relative frequencies for the CPSP and non-CPSP groups. Our results showed that SCN9A polymorphisms could play a role in acute pain perception and the susceptibility to chronic pain.

The Contribution of Sociocultural Factors in Shaping Self-Reported Sickness Behavior.

Sickness behavior is an evolutionarily conserved phenomenon found across a diverse range of animals involving a change in motivational priorities to theoretically maximize energetic investment in immune function and recovery. Typical components of sickness behavior include reduced sociability and activity, changes in diet, and depressed affect. Importantly, however, sickness behavior appears to be subject to other demands of life history in animal models, including reproduction and offspring survival. Thus, “feeling sick” is often context dependent with possible effects on morbidity and mortality. While humans may not always face the same life history trade-offs, sociocultural norms and values may similarly shape sickness behavior by establishing internalized parameters for “socially appropriate sickness.” We explore the role of these factors in shaping sickness behavior by surveying a national U.S. sample (n = 1,259). Self-reported and recalled sickness behavior was measured using the SicknessQ instrument, which has previously been validated against experimentally induced sickness behavior. After post-stratification weighting and correction for Type I error, generalized linear models showed that sickness behavior is significantly affected by various factors across sex and racial/ethnic groupings. Income below the national mean (b = 1.85, adj. p = 0.025), stoic endurance of pain and discomfort (b = 1.61, adj. p < 0.001), and depressive symptomology (b = 0.53, adj. p < 0.001) were each associated with greater sickness behavior scores. Familism (b = 1.59, adj. p = 0.008) was positively associated with sickness behavior in men, but not women. Endurance of pain and discomfort was associated with greater sickness behavior in Whites only (b = 1.94, adj. p = 0.002), while familism approached significance in African Americans only (b = 1.86, adj. p = 0.057). These findings may reflect different social contexts of sickness across demographic groups, which may in turn have important implications for pathogen transmission and recovery times, potentially contributing to health disparities.

The Effect of Eight-Week Corrective Exercises Carried out in Water on Pain, Neck Flexors Endurance and Upper Extremity Range of Motion in Patient with Upper Crossed Syndrome

Introduction: Lifestyle and the constant use of communication technologies have led to the upper crossed syndrome. The purpose of this study was to investigate of the effect of comprehensive corrective exercises carried out in water on pain, neck flexors muscles endurance and neck and upper extremity Range of Motion (ROM) in the patients with upper crossed syndrome (UCS). Methods: In this semi-experimental study, after initial screening, 30 students with upper crossed syndrome were selected and assigned randomly into experimental (n=14) and control (n=16) groups. Before and after the intervention, measurements performed to measure the level of pain by VAS scale, neck and shoulder ROM by inclinometer and neck flexors endurance by deep neck flexors endurance test. To analyze the data, SPSS Inc., Chicago, IL; version 18 software was used. The significance level was 0.05. Paired sample t-test was used to compare the mean of the pretest to posttest and independent t-test was used to compare the differences between groups. Results: The experimental group had significant improvement for endurance of neck flexors (P&lt; 0.0001), neck ROM (P&lt; 0.0001), shoulder ROM (P&lt; 0.0001) and neck pain (P&lt; 0.0001). Moreover, the results showed that there were significant differences for endurance of neck flexors (P&lt; 0.0001), neck ROM (P&lt; 0.0001), shoulder ROM (P&lt; 0.0001), and neck pain (P&lt; 0.0001) between groups. Conclusion: According to the results, we can say using water-based corrective exercises could have additional effect on increasing muscles endurance, upper extremity ROM and pain reduction in the patients with upper crossed syndrome, and could be as an effective method for the specialist

Correlation between Functional Disorders of Temporomadibular Joint and Upper Crossed Syndrome

Research background. The imbalance between the jaw and neck muscle activity occurs as a compensatory mechanism in order to stabilize the jaw and neck structural parts in temporomandibular joint (TMJ) disorders (Ries et al., 2008). Changes occur in posture control system if any biomechanical unit varies (Ritzel et al., 2007). One system compensates the unusually active other body system in upper cross syndrome (UCS) (Tharcher et al., 2011). This syndrome is characterized by shortened upper trapezius, pectoralis major and romboids and week middle and lower trapezius, serratus anterior and deep neck flexors (Moore, 2004; Tharcher et al., 2011). Thus, it is believed that there may be a direct link between the upper cross syndrome and temporomandibular joint dysfunction. Purpose. Explore relationship between temporomandibular joint dysfunction and upper crossed syndrome in women. Methods. Thirty female volunteers participated in the study, and they were divided into groups according to trigger points in the shoulder and neck muscles: group 1 – painful shoulder and neck muscles (32.65 ± 12.34 years), group 2 – painless shoulder and neck muscles (34.5 ± 10.95 years). Survey was carried out assessing TMJ function during observation, palpation, evaluation of the sagittal craniovertebral angle, the neck and shoulder muscle length, strength, pain and deep neck muscle endurance was examined. Results. It was found that TMJ function was strongly associated with the UCS: trapezius pain as well as upper trapezius and scalenus length. TMJ disorders were associated with headache in both groups. Weak connection between deep neck muscle endurance and TMJ dysfunction was identifed. Conclusions. TMJ mobility is partly related to UCS, and TMJ functional disorders related to headache and sagittal craniovertebral angle. UCS specifc changes, such as pectoralis muscle length changes and impaired deep neck muscle endurance are not related to TMJ dysfunction.Keywords: temporomandibular joint, the upper crossed syndrome, muscle length, headache.

Effect of Acceptance Versus Attention on Pain Tolerance: Dissecting Two Components of Mindfulness

Previous studies have shown that brief mindfulness trainings can have significant analgesic effects. However, the effects of the various components of mindfulness on pain analgesia are not well understood. The objective of this study was to examine the effects of two components of mindfulness interventions - attention and acceptance on pain analgesia. One hundred and nineteen healthy college students without prior mindfulness experience underwent a cold pressor test to measure pain tolerance before and after the training. Pain intensity, tolerance, distress, threshold and endurance time were also tested. Participants were randomly assigned to one of four conditions: (1) acceptance of pain, (2) attention to pain, (3) acceptance of and attention to pain, or (4) control. The results showed that both the acceptance strategy and the combined acceptance and attention group increased pain endurance and tolerance after training. Furthermore, acceptance group had longer pain endurance time and tolerance time than attention group and control group. These results suggest that acceptance of pain is more important than attention to pain. Study limitations and future research directions are discussed.

Towards an Archaeology of Pain? Assessing the Evidence from Later Prehistoric Bog Bodies

SummaryThis paper highlights the potential for what could be termed an ‘archaeology of pain’, reflecting on the potential significance and role of the infliction, suffering, endurance and observation of pain by individuals in the past. It presents a case study of ‘bog bodies’, human remains recovered from wetland which, due to the anoxic, waterlogged conditions, preserves human flesh and associated evidence, including injuries and cause of death. The central argument is that evidence from pathological investigations of certain later prehistoric bodies provides hitherto neglected information concerning the embodied experience of pain, in particular its duration and intensity, which may be central to the interpretation of these events. This understanding can be framed not only in terms of the experience of pain by the victims, but also in the potential perception of pain and suffering by those inflicting these and potentially by any observers of the final moments of these individuals.

War Magic: Religion, Sorcery, and Performance ed. by Douglas S. Farrer

Reviewed by: War Magic: Religion, Sorcery, and Performance ed. by Douglas S. Farrer Bradley M. Johnson douglas s. farrer, ed. War Magic: Religion, Sorcery, and Performance. New York: Berghahn Books, 2016. Pp. x + 170. This edited volume explores a variety of practices categorized as "war magic" scattered across several different regions of the world. Each essay (with the exception of Sinclair's chapter on Buddhist battle magic that focuses on historical texts) showcases the results of in-depth, ethnographic research on the cosmologies, societal structures, and uses of offensive and defensive magic in specific communities, while providing pertinent background information and often introducing the readers to key informants and practitioners. Farrer takes care to develop key terms at the beginning of the book, briefly referencing major debates concerning the distinctions between "religion" and "magic," as well as the connotations of "sorcery" and "witchcraft." He and the other contributors are cognizant of the oversimplifications that plague earlier investigations of war magic, whether it was Frazer and Tylor adopting evolutionist, hierarchical interpretations of magic that reduced its users to a primitive mindset, or later thinkers who sometimes whitewashed the darker aspects while also trapping their subjects in the ethnographic present. The book contains seven essays after the introduction, including one cowritten by Farrer, that describe and interpret local practices of magic through phenomenological and ethnographic lenses. Several themes follow through these chapters and help to unify the content of the book, even as they treat disparate regions and situations. One of the most prominent is that of embodiment, in the sense that each writer seeks to emphasize the bodily, performative, ritualized nature of magic. This perspective falls in direct contrast to the textual bias that many prior anthropologists brought to the study of magic, as they often assumed the core to consist in esoteric scrolls and powerful words (though these, of course, often play important parts). Margaret Chan's essay focuses on tangki war magic in Singapore as ritual theater, performances that channel the powers of warrior gods through spiritpossession by affixing weapons or other objects through the performer's [End Page 128] body. What results are often grotesque displays of superhuman pain endurance, such as the image of a woman with a bicycle frame impaled through her cheeks on the cover of the book. Likewise, Jean-Marc de Grave writes about kanuragan, secret initiation rituals in Java where people of different backgrounds hope to attain invulnerability from weapons and other means of bodily harm. Through learning to harness one's "spirit siblings," initiates could become stronger and eventually progress towards more spiritual knowledge. In his chapter on Yanomami shamans in Venezuela, Željko Jokić highlights the morally ambiguous role of the shapori, who use their powers both to heal members of their villages, but also to launch long-range attacks on other villages that are said to result in horrifying deaths. In describing the death of a child interpreted to be the victim of such an attack, Jokić does not hide the terrifying role of war magic in this society. The way various traditions adapt to changing contexts is another commonality, bringing attention to their basis in history and sociopolitical situations. In his essay on Buddhist war magic, Iain Sinclair relies on tantric sources to explicate the development of a just war theory across several centuries in India. Still, even as they developed criteria for warfare and deployed magical tactics to inflict harm or scatter armies, practitioners did not resort to using the language of "holy war." Similarly, Michael Roberts focuses on the Liberation Tigers of Tamil Eelam, a group that also adopts tantric tactics. Since the 1980s, members have carried a kuppi on their persons, a talisman that provides a sense of reassurance that they are part of a whole, and which happens to be a cyanide pill that they promise to bite if captured. Each chapter spends some time historicizing the practices it highlights, explicitly pushing against stereotypes of magical traditions being primitive or timeless. Closely related to the theme of adaptation, and especially emphasized by Farrer in the introduction and the article he co-writes, is the cycle of disenchantment and re-enchantment. D. S. Farrer and James D...

Avoidance-endurance fast screening (AE-FS) : Content and predictive validity of a9-item screening instrument for patients with unspecific subacute low back pain.

Background Among screening measures to assess psychosocial risk factors (yellow flags) for chronic low back pain (LBP) economic tools which address dysfunctional endurance pain responses besides emotional distress and fear-avoidance pain processing are rare. Targeting contrasting types of pain processing might improve stratified patient counselling. Objective The aim of the study was to develop a short screening method, based on the avoidance-endurance model of pain and to investigate the prognostic validity for pain intensity, disability and physical function. Material and methods A prospective observational study was carried out on 144 patients with subacute LBP ( Results The classification of subgroups as high and low risk by both measures had considerable agreement with a value of 0.71 (Cohen's Kappa). The sensitivity to predict pain intensity >2 was high (82%) as was the positive predictive value (80%) but the negative predictive value was moderate (61%). The ROC (AUC) characteristics (95% confidence interval CI) were 0.70 (0.60-0.80) for pain intensity and for limitations in the pain disability index (PDI) 0.70 (0.55-0.87). Discussion The 9‑item AE-FS displayed sufficient prognostic validity for all three outcomes in a sample of primary care patients with subacute LBP. The differentiation of the high-risk patients into fear-avoidance and endurance-related pain processing enables the physician to provide an individualized counselling with the aim of a healthy balance between stress and relaxation.

The roles of gender and profession on gender role expectations of pain in health care professionals.

IntroductionGender-related stereotypes of pain may account for some assessment and treatment disparities among patients. Among health care providers, demographic factors including gender and profession may influence the use of gender cues in pain management decision-making. The Gender Role Expectations of Pain Questionnaire was developed to assess gender-related stereotypic attributions of pain regarding sensitivity, endurance, and willingness to report pain, and has not yet been used in a sample of health care providers. The purpose of this study was to examine the presence of gender role expectation of pain among health care providers. It was hypothesized that health care providers of both genders would endorse gender stereotypic views of pain and physicians would be more likely than dentists to endorse these views.MethodsOne-hundred and sixty-nine providers (89 dentists, 80 physicians; 40% women) were recruited as part of a larger study examining providers’ use of demographic cues in making pain management decisions. Participants completed the Gender Role Expectations of Pain Questionnaire to assess the participant’s views of gender differences in pain sensitivity, pain endurance, and willingness to report pain.ResultsResults of repeated measures analysis of variance revealed that health care providers of both genders endorsed stereotypic views of pain regarding willingness to report pain (F(1,165)=34.241, P<0.001; d=0.479). Furthermore, female dentists rated men as having less endurance than women (F(1,165)=4.654, P=0.032; d=0.333).ConclusionThese findings affirm the presence of some gender-related stereotypic views among health care providers and suggest the presence of a view among health care providers that men are underreporting their pain in comparison to women. Future work can refine the effects of social learning history and other psychosocial factors that contribute to gender and provider differences in pain management decisions.

Cancer pain management needs and perspectives of patients from Chinese backgrounds: a systematic review of the Chinese and English literature.

More than half of all cancer patients experience unrelieved pain. Culture can significantly affect patients' cancer pain-related beliefs and behaviors. Little is known about cultural impact on Chinese cancer patients' pain management. The objective of this review was to describe pain management experiences of cancer patients from Chinese backgrounds and to identify barriers affecting their pain management. A systematic review was conducted adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were included if they reported pain management experiences of adult cancer patients from Chinese backgrounds. Five databases were searched for peer-reviewed articles published in English or Chinese journals between1990 and 2015. The quality of included studies was assessed using Joanna Briggs Institution's appraisal tools. Of 3,904 identified records, 23 articles met criteria and provided primary data from 6,110 patients. Suboptimal analgesic use, delays in receiving treatment, reluctance to report pain, and/or poor adherence to prescribed analgesics contributed to the patients' inadequate pain control. Patient-related barriers included fatalism, desire to be good, low pain control belief, pain endurance beliefs, and negative effect beliefs. Patients and family shared barriers about fear of addiction and concerns on analgesic side effects and disease progression. Health professional-related barriers were poor communication, ineffective management of pain, and analgesic side effects. Healthcare system-related barriers included limited access to analgesics and/or after hour pain services and lack of health insurance.Significance of resultsChinese cancer patients' misconceptions regarding pain and analgesics may present as the main barriers to optimal pain relief. Findings of this review may inform health interventions to improve cancer pain management outcomes for patients from Chinese backgrounds. Future studies on patients' nonpharmacology intervention-related experiences are required to inform multidisciplinary and biopsychosocial approaches for culturally appropriate pain management.

爱情和金钱对疼痛忍耐力的影响研究

为探讨爱情和金钱对疼痛忍耐力的影响，我们招募61名健康的大学生进行冷压痛实验。在实验正式开始之前，先测量被试的疼痛阈限和疼痛忍耐力。正式实验中，采用2(单身、恋爱)*2(爱情、金钱)被试间实验设计，分别测量不同情感状态的个体在不同奖赏条件下的疼痛忍耐时间。结果发现，单身组和恋爱组被试在疼痛阈限和疼痛忍耐力上并无差异。方差分析结果并无主效应或交互效应出现，但恋爱组被试为爱情忍耐的时间要长于为金钱忍耐的时间，单身组为金钱忍耐的时间要长于为爱情忍耐的时间。这种趋势暗示我们，爱情和金钱对不同情感状态的个体在冷压痛任务中的奖赏效果可能有所不同。 To explore the effects of love and money on pain tolerance, we recruited 61 healthy college students to do the cold pressure pain test. Before the experiment was formally started, the pain threshold and pain endurance were measured first. In the formal experiment, a 2 (single, love) * 2 (love and money) between-subject experimental paradigm was designed to measure pain tolerance time of different emotional states under different reward conditions. The results showed that there was neither difference in pain threshold nor pain endurance between the single group and the love group. The results of variance analysis showed no main effect or interaction effect, but the love group's pain tolerance time under love task was longer than that of money, and the tolerance time for money of the single group was longer than that of for love . The results showed that love and money may have different effects on individuals with different emotional states in the cold pressure pain task.

키네시오 테이핑요법이 여성 고령자의 주관절 통증과 유연성 및 근지구력에 미치는 영향

키네시오 테이핑요법이 여성 고령자의 주관절 통증과 유연성 및 근지구력에 미치는 영향

Locally advanced pancreatic cancer: treatment with Nanoknife percutaneously under guidance of ultrasound and effectiveness evaluated by contrast enhanced ultrasonography

Objective To explore the treatment of locally advanced pancreatic cancer(LAPC) by Nanoknife, and the demonstrations on contrast enhanced ultrasonography (CEUS) after the procedures. Methods Four patients were enrolled. Each of them was percutaneously inserted 3-5 Nanoknife electrodes to ablate the lesions with 2-3 sessions under the guidance of ultrasound. After the procedures, CEUS, contrast enhanced CT, contrast enhanced MRI or computed tomography angiography (CTA) were performed to assess the efficacy. Results All patients uneventfully were able to tolerate the high-voltage Nanoknife procedures.However, the endurable pain or discomfort in abdomen was complained. For one patient with obstructive jaundice and mild liver dysfunction, pancreatic amylase in serum increased slightly at the first day after treatment. Furthermore, C response protein in serum elevated, and biliary tract infection happened at the third day. Moreover, thromboses in portal and splenic vein were found at the seventh day. The survival time for all cases were 3-8 months. According to the findings of CEUS, a well-defined no contrast enhancement was detected at ablative zone for all the patients within one week. Yet, contrast enhancement was sporadically detected at the periphery in 3 patients 1-2 months late. Meanwhile, on contrast enhanced CT or MRI, an area of absent enhancement was also depicted at the ablation zone with heterogeneously decreased enhancement at periphery of the lesion. Base on CTA findings, local stenosis of splenic vein and superior mesenteric vein with varices of collateral vascularity were found in one patient at the fiftieth day, and superior mesenteric vein obstruction accompanied by varices of collateral vascularity was also found in another patient at the seventieth day. Conclusions For patients with LAPC, Nanoknife treatment is a safe and convenient procedure that can be percutaneously completed under the guidance of ultrasound. Along with enhanced CT, MRI or CTA, CEUS is a promising way to evaluate the efficacy of this procedure. Key words: Ultrasonography, interventional; Contrast enhanced ultrasonography; Pancreatic neoplasms; Nanoknife; Electroporation

Effects of an intervention based on the Transtheoretical Model on back muscle endurance, physical function and pain in rice farmers with chronic low back pain.

Chronic low back pain (LBP) can be managed by exercises which should be tailored to an individual's readiness to behavioral change. To evaluate the effects of an intervention program based on the Transtheoretical Model of behavioral change (TTM) on back muscle endurance, physical function and pain in rice farmers with chronic LBP. In a 32-week study, 126 rice farmers were allocated to the TTM (n= 62) and non-TTM (n= 64) groups. Modified Biering-Sorensen test, Oswestry Disability Questionnaire and visual analogue scale were used for evaluating back muscle endurance, physical function and severity of pain, respectively. The evaluations were performed at baseline and at weeks 8, 20 and 32 of the study. Data were analyzed using repeated measure ANOVA. The back muscle endurance was significantly greater in the TTM group than in the non-TTM group at week 32 (p= 0.025). Physical function and severity of pain were significantly improved in the TTM group when compared with the non-TTM group at weeks 20 and 32 (p< 0.01). A TTM-based intervention could improve back muscle endurance and physical function, and reduce the pain in rice farmers with LBP. Further studies should be considered to explore the long-term effects of this intervention.

Somato stimulation and acupuncture therapy.

Acupuncture is an oldest somato stimulus medical technique. As the most representative peripheral nerve stimulation therapy, it has a complete system of theory and application and is applicable to a large population. This paper expounds the bionic origins of acupuncture and analyzes the physiological mechanism by which acupuncture works. For living creatures, functionally sound viscera and effective endurance of pain are essential for survival. This paper discusses the way in which acupuncture increases the pain threshold of living creatures and the underlying mechanism from the perspective of bionics. Acupuncture can also help to adjust visceral functions and works most effectively in facilitating the process of digestion and restraining visceral pain. This paper makes an in-depth overview of peripheral nerve stimulation therapy represented by acupuncture. We look forward to the revival of acupuncture, a long-standing somato stimulus medicine, in the modern medical systems.

Patients’ experiences and actions when describing pain after surgery – A critical incident technique analysis

BackgroundPostoperative pain assessment remains a significant problem in clinical care despite patients wanting to describe their pain and be treated as unique individuals. Deeper knowledge about variations in patients’ experiences and actions could help healthcare professionals to improve pain management and could increase patients’ participation in pain assessments. ObjectiveThe aim of this study was, through an examination of critical incidents, to describe patients’ experiences and actions when needing to describe pain after surgery. MethodsAn explorative design involving the critical incident technique was used. Patients from one university and three county hospitals in both urban and rural areas were included. To ensure variation of patients a strategic sampling was made according to age, gender, education and surgery. A total of 25 patients who had undergone orthopaedic or general surgery was asked to participate in an interview, of whom three declined. FindingsPain experiences were described according to two main areas: “Patients’ resources when in need of pain assessment” and “Ward resources for performing pain assessments”. Patients were affected by their expectations and tolerance for pain. Ability to describe pain could be limited by a fear of coming into conflict with healthcare professionals or being perceived as whining. Furthermore, attitudes from healthcare professionals and their lack of adherence to procedures affected patients’ ability to describe pain. Two main areas regarding actions emerged: “Patients used active strategies when needing to describe pain” and “Patients used passive strategies when needing to describe pain”.Patients informed healthcare professionals about their pain and asked questions in order to make decisions about their pain situation. Selfcare was performed by distraction and avoiding pain or treating pain by themselves, while others were passive and endured pain or refrained from contact with healthcare professionals due to healthcare professionals’ large work load.

Acute effects of Maitland’s central posteroanterior mobilization on youth with low back pain.

Introduction: The low back pain is the most prevalent between the musculoskeletal disorders, and it is the most common reasons ofabsence from work. The flexibility, mobility, strength and endurance of the low back stability influence and the disharmony betweenthese factors may result in low back pain. One of Maitland’s technique, which alter these factors, is posteroanterior (PA) mobilization.Objective: To analyze the posterior chain’s flexibility, low back’s mobility, trunk extensor’s endurance and low back extensors’ musclestrength after performed one treatment session using the Maitland method on youth with low back pain. Method: For this research,sixteen women (22 ± 3.03 years) with chronic low back pain participated. All volunteers were evaluated according to their perceptionof pain, flexibility, mobility, muscular strength and muscular endurance. The treatment protocol was the application of PA mobilizationon the five lumbar vertebrae, from caudal direction to cranial, of three series of one minute in each vertebra. The same proceduresof the initial evaluation were performed after the immediate application of PA mobilization technique (revaluation 1) and 7 days afterthe protocol (revaluation 2). The data were analyzed by the Shapiro-Wilk’s normality test; analysis of variance (ANOVA) repeatedmeasures one-way with pos-hoc Bonferroni and Friedman’s ANOVA with pos-hoc Wilcoxon, with the level of significance of 5% (p&lt; 0,05).Results: After PA mobilization application, there were significant improvements in muscular strength (immediate post-treatment andpast seven days) and muscular endurance (immediate post-treatment). There were no significant improvements in the other variables,such as, level of pain, and lumbar flexibility and mobility. Conclusion: The lumbar PA mobilization was effective for increasing muscularstrength and endurance, with stabilization of the level of pain, flexibility and mobility.

EEG-Based Tonic Cold Pain Characterization Using Wavelet Higher Order Spectral Features.

A novel approach in tonic cold pain characterization, based on electroencephalograph (EEG) data analysis using wavelet higher order spectral (WHOS) features, is presented here. The proposed WHOS-based feature space extends the relative power spectrum-based (phase blind) approaches reported so far a step forward; this is realized via dynamic monitoring of the nonlinerities of the EEG brain response to tonic cold pain stimuli by capturing the change in the underlying quadratic phase coupling at the bifrequency wavelet bispectrum/bicoherence domain due to the change of the pain level. Three pain characterization scenarios were formed and experimentally tested involving WHOS-based analysis of EEG data, acquired from 17 healthy volunteers that were subjected to trials of tonic cold pain stimuli. The experimental and classification analysis results, based on four well-known classifiers, have shown that the WHOS-based features successfully discriminate relax from pain status, provide efficient identification of the transition from relax to mild and/or severe pain status, and translate the subjective perception of pain to an objective measure of pain endurance. These findings seem quite promising and pave the way for adopting WHOS-based approaches to pain characterization under other types of pain, e.g., chronic pain and various clinical scenarios.

How do pregnant women manage lumbopelvic pain? Pain management and their perceived effectiveness.

This study aims to (1) investigate the pain management treatments used by pregnant women with lumbopelvic pain and their perceived effectiveness and (2) identify the predictors of pain treatment use. A variety of treatments have been shown to be effective for reducing pregnancy-related lumbopelvic pain. However, the frequency of use of pain treatments and their perceived efficacy in pregnant women is still unknown. Knowledge regarding the use and perceived efficacy of these treatments would help guide clinical practice and inform future research. A cross-sectional design with consecutive sampling. Participants were pregnant women in the 35th to 40th gestational week who reported lumbopelvic pain in an antenatal clinic of a medical centre in Taiwan. Questionnaires were administered assessing pain treatment use, pain relief associated with each treatment (e.g. perceived effectiveness), pain intensity, pain interference, pain endurance beliefs and demographic variables. Among 295 participants with lumbopelvic pain, only 34 (12%) sought pain treatment. The pain management treatments used included mechanical treatments (80% = 27/34), herbal medicine (9% = 3/34), exercise (6% = 2/34) and medications (6% = 2/34). Average perceived effectiveness associated with the treatments was 55%. Use of pain management strategies was negatively associated with pain endurance beliefs, but not with pain intensity or pain interference. Pregnant women with lumbopelvic pain are unlikely to seek or use pain management treatments for pain, suggesting a greater need for adopting effective pain treatment in clinical settings. The study contributes new knowledge regarding how pregnant women cope with lumbopelvic pain and reveals very low rates in the use of pain treatments. Health professionals should assess pregnant women's pain beliefs about pain endurance and emphasise the safety and effectiveness of interventions that have empirical support, to help minimise unnecessary pain during pregnancy.

Perspectives of Asians living in Texas on pain management in the last days of life.

The recognition that someone's ethnic identity does not necessarily predict their health-care beliefs and preferences, and lack of scientific evidence on this topic provide the fundamental justification for this study. The aim of this descriptive qualitative study was to determine the attitudes about and preferences for pain management in the last days of life for persons born in Japan, China and Vietnam living in Texas. Personal interviews were conducted to elicit people's perspectives on pain management, such as open or indirect acknowledgement of pain and endurance of pain for clarity of consciousness. Thematic analysis revealed three overarching themes for the Japanese group and five themes each for the Chinese and Vietnamese groups. Avoidance of stereotyping based on cultural background was a major finding of this study. Promoting quality of life in the last days of life is a priority for health professionals, and effective, individualised management of pain is of the utmost importance.