Variance In Pain Intensity Research Articles

Validation of the Keele STarT MSK Tool for Patients With Musculoskeletal Pain in United States-based Outpatient Physical Therapy Settings

The STarT MSK tool was developed to enable risk stratification of patients with common musculoskeletal (MSK) pain conditions and help identify individuals who may require more targeted interventions or closer monitoring in primary care settings, however, its validity in U.S.-based outpatient physical therapy settings has not been investigated. The 10-item Keele STarT MSK risk stratification tool was tested for construct (convergent and discriminant) and predictive validity using a multicenter, prospective cohort study design. Participants (n = 141) receiving physical therapy for MSK pain of the back, neck, shoulder, hip, knee, or multisite regions completed intake questionnaires including the Keele STarT MSK tool, Functional Comorbidity Index (FCI), Optimal Screening for Prediction of Referral and Outcome Review-of-Systems and Optimal Screening for Prediction of Referral and Outcome Yellow Flag tools. Pain intensity, pain interference, and health-related quality of life (Medical Outcomes Study 8-item Short-Form Health Survey (SF-8) physical [PCS] and mental [MCS] component summary scores) were measured at 2- and 6-month follow-up. Participants were classified as STarT MSK tool low (44%), medium (39%), and high (17%) risk. Follow-up rates were 70.2% (2 months) and 49.6% (6 months). For convergent validity, fair relationships were observed between the STarT MSK tool and FCI and SF-8 MCS (r = .35–.37) while moderate-to-good relationships (r = .51–.72) were observed for 7 other clinical measures. For discriminant validity, STarT MSK tool risk-dependent relationships were observed for Optimal Screening for Prediction of Referral and Outcome Review-of-Systems, Optimal Screening for Prediction of Referral and Outcome Yellow Flag, pain interference, and SF-8 PCS (low < medium < high; P < .01) and FCI, pain intensity, and SF-8 MCS (low < medium-or-high; P < .01). For predictive validity, intake STarT MSK tool scores explained additional variability in pain intensity (11.2%, 20.0%), pain interference (7.5%, 14.1%), and SF-8 PCS (8.2%, 12.8%) scores at 2 and 6 months, respectively. This study contributes to the existing literature by providing additional evidence of STarT MSK tool cross-sectional construct validity and longitudinal predictive validity. PerspectiveThis study presents STarT MSK risk stratification tool validity findings from a U.S. outpatient physical therapy sample. The STarT MSK tool has the potential to help physical therapists identify individuals presenting with the most common MSK pain conditions who may require more targeted interventions or closer monitoring.

Choice over placebo administration enhances open-label placebo hypoalgesia.

Many studies indicate that deceptively administered placebos can improve pain outcomes. However, the deception involved presents an ethical barrier to translation because it violates informed consent and patient autonomy. Open-label placebos (OLPs), inert treatments that are openly administered as placebos, have been proposed as an ethically acceptable alternative. Early studies have suggested that OLP can improve pain outcomes, but important questions remain as to how to maximise OLP hypoalgesia to improve treatment outcomes in pain patients. This study investigated whether providing choice over when to administer an OLP treatment has the capacity to enhance OLP hypoalgesia using an electrocutaneous pain paradigm. One hundred thirty-two healthy volunteers were randomised to 3 types of treatment: OLP with choice, OLP without choice, and no treatment (natural history). The OLP groups were further randomised such that half were tested with a consistent pain intensity and the other half were tested with variable pain intensity to mimic day-to-day variability in pain intensity in health settings. The results indicated that treatment provided with choice exhibited greater OLP hypoalgesia than that provided without choice and that greater expectancy mediated this effect. Of interest, there was no evidence for OLP hypoalgesia without choice relative to natural history. Furthermore, variability in pain intensity did not affect OLP hypoalgesia. The current findings present novel evidence that choice over treatment administration may be a cheap and effective strategy for boosting the efficacy of OLPs in the clinical care of pain.

The effectiveness of non-surgical interventions in athletes with groin pain: a systematic review and meta-analysis

BackgroundGroin pain is a common pathology among athletes, presenting pain and a reduced range of motion (ROM) as clinical characteristics. Passive physical therapy (PPT) and exercise therapy (ET) interventions are chosen firstly before surgery. The aim of this systematic review and meta-analysis was: (i) to qualitative review the effects of each non-surgical intervention; (ii) to quantitative compare the effects of PPTs plus ET intervention to ET in isolation in pain intensity, and hip ROM in athletes with groin pain.MethodsA systematic review and meta-analysis was conducted. Pubmed, PEDro, Web of science, Scopus and Cochrane library were searched. Randomized controlled trials comparing PPT plus ET to ET interventions were included. The methodological quality and risk of bias of the included studies, were assessed with the PEDro scale and the Cochrane risk-of-bias tool. To assess the certainty of evidence the GRADEpro GDT was used. Meta-analyses were conducted using RevMan 5.4 using mean difference analysis to assess the variables pain intensity and hip ROM.ResultsA total of 175 studies was identified from the consulted databases. Five studies were included for systematic- review, from which three studies were meta-analyzed. The methodological quality of the included studies ranged from poor to high. ET compared to PPT plus ET provided statistically significant improvements in pain intensity in the short-term (MD = 2.45; 95% CI 1.11, 3.79; I2 :65%). No statistically significant differences between interventions were obtained for hip ROM in the short-term.ConclusionsThe qualitative review showed that PPTs plus ET and ET seem to have positive effects on pain intensity and hip ROM. The quantitative analysis found very low certainty of evidence proposing a positive effect in pain intensity for ET interventions based on hip muscles stretching, compared to PPT combined with ET, in the short-term.

Corneal confocal microscopy identifies corneal nerve fiber loss in patients with migraine.

Migraine affects >1 billion people but its pathophysiology remains poorly understood. Alterations in the trigeminovascular system play an important role. We have compared corneal nerve morphology in patients with migraine to healthy controls. Sixty patients with episodic (n = 32) or chronic (n = 28) migraine and 20 age-matched healthy control subjects were studied cross-sectionally. Their migraine characteristics and signs and symptoms of dry eyes were assessed. Manual and automated quantification of corneal nerves was undertaken by corneal confocal microscopy. In patients with migraine compared to controls, manual corneal nerve fiber density (P < 0.001), branch density (P = 0.015) and length (P < 0.001); and automated corneal nerve fiber density (P < 0.001), branch density (P < 0.001), length (P < 0.001), total branch density (P < 0.001), nerve fiber area (P < 0.001), nerve fiber width (P = 0.045) and fractal dimension (P < 0.001) were lower. Automated corneal nerve fiber density was higher in patients with episodic migraine and aura (P = 0.010); and fractal dimension (P = 0.029) was lower in patients with more headache days in the last three months. Automated corneal nerve fiber density predicted a significant amount of the observed variance in pain intensity (adjusted r2 = 0.14, partial r = -0.37, P = 0.004) in patients with migraine. Corneal confocal microscopy reveals corneal nerve loss in patients with migraine. It may serve as an objective imaging biomarker of neurodegeneration in migraine.

Pain intensity and psychological distress show different associations with interference and lack of life control: A clinical registry-based cohort study of >40,000 chronic pain patients from SQRP.

Both chronic pain and depressive and/or anxiety symptoms are associated with negative impacts on daily living, including interference and lack of life control. However, little is known about how pain and psychological distress affect these impacts. The first aim was to assess how pain intensity, psychological distress, and social support interact with interference and lack of life control. A second aim was to investigate whether the strength of these relationships is moderated by the presence or absence of depression and/or anxiety. Patient-Reported Outcome Measures (PROMs), which are available in the Swedish Quality Registry for Pain Rehabilitation (SQRP), were retrieved for patients with chronic pain (N = 40,184). A theoretical model with the constructs/latent variables pain intensity, psychological distress, interference, lack of life control, and social support was proposed and analyzed using Partial Least Squares Structural Equation Modelling (PLS-SEM). Indicators for these constructs were identified from the PROMs of the SQRP. Two models of the total cohort, which differed with respect to the causal relationship between pain intensity and psychological distress, were investigated. The moderating effects of anxiety and/or depression were also analyzed. Relatively low correlation and explanatory power (R 2 = 0.16) were found for the pain intensity-psychological distress relationship. Pain intensity had a stronger effect on interference than on lack of life control. The reverse was found for psychological distress - i.e., psychological distress seemed to have a higher negative influence on function than on interference. The underlying assumption of the causal relationship between pain intensity and psychological distress determined how strong pain intensity and psychological distress influenced interference and lack of life control. Social support showed very similar absolute significant correlations with interference and lack of life control. Interference and lack of life control showed relatively weak associations. The psychological distress level was a moderating factor for several of the paths investigated. A clinical treatment consequence of the low correlation between pain intensity and psychological distress may be that clinically treating one may not reduce the effect of the other. The relative importance of pain intensity and psychological distress on interference and lack of life control depends on the underlying assumption concerning the pain intensity-psychological distress relationship. Interference and lack of life control showed relatively weak associations, underscoring the need to clinically assess them separately. Social support influenced both impact constructs investigated. The cohort display heterogeneity and thus presence of definite signs of anxiety and/or depression or not was a moderating factor for several of the associations (paths) investigated. The results are important both for the assessments and the design of treatments for patients with chronic pain.

The effect of psychological factors in pain intensity of patients with chronic pain conditions

IntroductionChronic pain can lead to depression, weariness, sleep problems, decreased physical and cognitive function, personality changes/shifts, and social interactions, all of which can lead to social marginalization and financial loss.ObjectivesThe aim of the present study was to investigate how psychological variables affects pain intensity.Methods193 patients diagnosed with chronic pain conditions, men 67 (34.8%) and women 126 (65.2%), participated in the study. This study used a quantitative between-subjects design to investigate the effect of psychological factors on pain intensity using the VAS scale. Analysis was performed with the use of SPSS23.ResultsThe analysis produces a coefficient of determination R2 = 0.448 – suggesting that a total 44.8% variability in pain intensity in the previous month can be explained by Age, Fear-avoidance belief about physical activity, Commitment to activity, fear avoidance beliefs about work and Pain catastrophizing magnification. A repeated measure analysis of variance shows that the regression model is statistically significant F (1, 187) = 30.381, p = 0.000. The predictors variables (Age, fear-avoidance belief about physical activity, commitment in activity, fear avoidance beliefs about work and pain catastrophizing magnification) are found to statistically significant t (187) = 9.627, p = 0.001, t (187) = 4.616, p = 0.001, t (187) = 2.982, p = 0.003, t (187) = -2.599, p = 0.010, t (187) = 2.253, p = 0.025 respectively.ConclusionsThe findings of this study are in agreement with previous literature and also provide insight into the major psychological factors correlates with pain intensityDisclosure of InterestNone Declared

Can high pain intensity and catastrophizing interfere with the cognitive performance of women with chronic pain related TMD? A cross-sectional study

Interventions based on pain education and self-management are dependent on factors such as attention, memory, concentration, and executive function. To explore the relationship between cognitive performance and the variables pain intensity, central sensitization, catastrophizing, and hypervigilance in women diagnosed with chronic pain-related TMD. This is a cross-sectional study. A total of 33 women (mean age: 38±4.6 years; range: 18 to 66 years) with chronic pain-related TMD (myalgia and/or arthralgia) diagnosed according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Specific questionnaires were used to evaluate cognitive performance, overall pain intensity, central sensitization, hypervigilance, and pain catastrophizing. The data were analyzed using Pearson's correlation coefficient and backward stepwise multiple linear regression (statistical significance at 5% alpha). Approximately 53% of the study sample showed decreased cognitive performance. High central sensitization, hypervigilance, and pain catastrophizing were observed. A significant negative correlation was observed between cognitive performance and hypervigilance (p=.003, r=-.49), cognitive performance and catastrophizing (p<.001, r=-.58), and cognitive performance and pain intensity (p<.001, r=-.58). Regarding the partial regression coefficients, only catastrophizing and pain intensity showed statistical significance (t=-2.12, p=.043; t=-2.64, p=.014, respectively), indicating a significant role in explaining cognitive performance at the sample. High pain intensity and the presence of catastrophic thoughts regarding pain can predict impaired cognitive performance in women with chronic pain-related TMD. Management strategies addressing psychosocial dimensions such as reducing catastrophizing and ensuring complete understanding of the condition are important.

Premenstrual syndrome and dysmenorrhea status before and after practicing yoga among selected women of reproductive age group living in Kathmandu valley: a mixed method study

Introduction: Premenstrual syndrome and dysmenorrhea are most common gynecological disorders associated with reduced quality of life among women of reproductive age. This study aims to compare the premenstrual syndrome and dysmenorrhea before and after practice of yoga among women of reproductive age living in Kathmandu, Nepal. Surya Namaskar, Surya Kriya and Shambhavi Mahamudra were common yoga types practiced by participants.&#x0D; &#x0D; Method: A retrospective pre-post study with concurrent mixed method design was used. Study respondents were 41 women of reproductive age. Numeric pain rating scale and Premenstrual syndrome scale were used for quantitative data collection. Interview guide was used for the qualitative data collection. Google form was used for quantitative data whereas telephone was used for an in-depth interview. R-4.2.1 software was used for the quantitative data analysis. Qualitative data was analyzed using Braun and Clarke’s 6-steps thematic analysis in RQDA 0.3.8.1 package of R software. Qualitative findings were triangulated with quantitative findings to determine convergent, divergent and expansive findings.&#x0D; &#x0D; Result: All outcome variables pain intensity score (Baseline: 6.46±2.31, Endline: 3.71±2.24, p&lt;0.0001), pain duration in hour (Baseline: 6, Endline 2.5, p&lt;0.0001) and premenstrual syndrome score (Baseline: 104.73±33.28, Endline: 74.24±22.08, p&lt;0.0001) were significantly different after practice of yoga as compared to before yoga practice. Qualitative findings supported the quantitative result and presented expansive finding as yoga may be beneficial for management of irregular menstrual cycles and polycystic ovarian syndrome as well.&#x0D; &#x0D; Conclusion: The study suggests yoga may help in alleviating premenstrual syndrome and dysmenorrhea.&#x0D;

Exploring pain experience and anxiety sensitivity among Latinx adults in a federally qualified health center.

The Latinx population is the largest minority group in the United States (U.S.) and is expected to continue to grow through at least 2050. Although there is growing recognition of the importance of pain among Latinx individuals, few studies have examined individualized psychological processes governing pain severity and disability in Latinx populations. One psychological factor that has shown promise in relation to pain experience specifically and clinical conditions more generally is anxiety sensitivity. The present investigation sought to (1) characterize the severity of pain among an unselected sample of adult Latinx individuals attending a Federally Qualified Health Center (FQHC); (2) evaluate the severity of anxiety sensitivity as a function of pain severity; and (3) test the potential explanatory relevance of anxiety sensitivity as an individual difference factor for pain intensity, pain disability, psychological inflexibility for emotional distress, and global life impairment. Participants included 406 adult Spanish-speaking Latinx persons (87.2% female; Mage = 40.26years, SD = 11.20, and 98.3% used Spanish as their first language) who attended an FQHC in Houston, Texas. Analyses revealed that 62.6% of the sample had at least some pain, and 21.9% of the same had high intensity, moderate interference, or severe interference chronic pain. Further, results provided evidence for anxiety sensitivity as a function of pain grade, such that individuals with grade 2 (high-intensity pain), grade 3 (moderate pain interference), and grade 4 (severe pain interference) chronic pain reported significantly higher levels of anxiety sensitivity than those with grade 0 pain (no chronic pain). Additionally, after controlling for age, gender, marital status, years of education, years living in the U.S., and generalized anxiety, anxiety sensitivity significantly accounted for significant variance in pain intensity, inflexibility in relation to emotional distress, and life impairment. Overall, the current study builds upon what is currently understood about anxiety sensitivity among the Latinx population and uniquely extends past work by linking individual differences in this construct to clinically relevant aspects of pain experience and life impairment among adults attending FQHC's. Additional clinical attention should be focused on anxiety sensitivity to offset pain disparities among this established health disparities group.

Evaluation of effective factors on pain in patients undergoing sleep apnea surgery

Objectives: The aim of this study was to investigate the factors affecting postoperative pain. Methods: This descriptive cross-sectional study was performed on patients referred to the hospital to determine the factors affecting postoperative pain for patients with obstructive sleep apnea (OSA). Patients' information was recorded: age, sex, weight, height, body mass index, duration of surgery, possible complications, and anesthesia. Patients were evaluated for pain according to VAS criteria. The first time a patient requested a drug was recorded in 24 hours after surgery and data was then analyzed. Results: A total of 40 patients were enrolled in the study, including 14 women (35%) and 26 men (65%). The mean age of patients was 41.55 ± 7.43 years. Examination of the relationships between other variables with patients' pain intensity showed a statistically significant difference between patients' pain intensity with other variables such as history of stroke (P = 0.005), history of cardiovascular disease (P = 0.048), history of drug abuse (P = 0.046) and type of analgesia received after surgery (P = 0.032). In multivariate analysis of the studied data, no statistically significant relationship was found between any of the variables with the intensity of patients' postoperative pain. The variances of height, weight, body mass index, duration of surgery and the first time of application of analgesic after surgery did not differ in different groups of pain intensity variables. But a significant difference was found between the two variables of age and pain intensity of patients (P &lt;0.05). Conclusion: The results of this study showed a statistically significant difference in pain intensity with a history of stroke, cardiovascular disease, history of drug abuse and also the type of analgesia received after surgery. The serious complications caused by tolerating acute postoperative pain, especially the long-term effects of experiencing severe pain, necessitates more attention to pain control.

Intolerance of Uncertainty Moderates the Relationship between Catastrophizing, Anxiety, and Perceived Pain in People with Chronic Nononcological Pain.

Substantial empirical evidence has shown that intolerance of uncertainty is a central transdiagnostic feature in psychopathology and it has been suggested to be a pain-related psychological factor contributing to the experience of chronic pain. However, research in this area is virtually nonexistent. The objective of this study was to investigate associations between pain severity, catastrophizing, and anxiety in people with chronic nononcological pain, while assuming that intolerance of uncertainty moderates these relationships. A convenience sample of 188 individuals with nononcological chronic pain (157 women and 32 men) participated in the study. We investigated the moderated mediation of intolerance of uncertainty between anxiety and catastrophizing and between catastrophizing and pain intensity. The full moderated mediation model accounted for significant variance in pain intensity (R2 = 0.148, P< .001). Intolerance of uncertainty significantly moderated the interaction between anxiety and catastrophizing (B = 0.039, SE = 0.012, 95% CI [0.015, 0.063]) and between catastrophizing and pain intensity (B = -0.034, SE = 0.010, 95% CI [-0.054, -0.014]). Anxiety and intolerance of uncertainty did not interact in predicting catastrophizing, although an interaction effect was found between intolerance of uncertainty and catastrophizing in predicting pain intensity. This study is the first to address the interrelationship of intolerance of uncertainty, catastrophizing, and anxiety in relation to perceived pain intensity. The current findings support intolerance of uncertainty as a relevant psychological variable that is distinct from other relevant constructs in the setting of pain research and treatment.

Anxiety sensitivity and opioid use motives among adults with chronic low back pain.

The opioid epidemic is a significant public health crisis in the United States, and chronic pain is a leading precipitating and maintaining factor for opioid misuse. To better understand substance misuse generally, research has examined motivational models of why people use substances, and pain management and affect-driven coping are cited as primary reasons for opioid misuse. Further, research examining psychosocial predictors of opioid misuse has identified anxiety sensitivity (AS; fear of anxiety-related physical sensations) as a unique predictor of opioid misuse severity, and it is possible that AS is uniquely related to opioid pain management and coping motives, which in turn, are related to opioid misuse. Therefore, the current study examined AS as a predictor of opioid pain management and coping motives, as well as the indirect effect of AS, through opioid motives, on opioid misuse status, among 292 adults (Mage = 45.76, SD = 11.20, 68.9% female) with chronic low back pain. Results for the current study support hypotheses that AS is significantly associated with pain management and coping motives (over and above variance of pain intensity) and indirectly associated with opioid misuse status through both motives. These results highlight the importance of better understanding opioid use motives in the context of chronic pain and provide potential treatment targets to add to a growing body of literature targeting psychosocial factors for opioid misuse. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Tolérance à la détresse et expérience de la douleur chronique

IntroductionChronic pain is a highly prevalent condition that is associated with distressing somatic and emotional experiences. Consequently, an individual's distress tolerance, the perceived capacity to tolerate negative psychological and physical states, may influence their pain experience. This effect could be explained in part by a reduction in the catastrophic interpretation of pain which is associated with increased pain intensity and interference in everyday activities. AimsThe first aim of this study was to explore the association between the components of the 5-factor model of distress tolerance and (1) pain intensity and (2) pain interference in everyday activities. The secondary aim was to assess the potential mediating effect of pain catastrophizing in the eventual association between components of distress tolerance and (1) pain intensity or (2) pain interference in everyday activities. MethodThis is a cross-sectional study of adult (18 years or older) university students and staff with chronic pain (3 months). They were invited to complete the online questionnaire through an email invitation. Pain intensity and interference in everyday functioning were assessed with the corresponding subscales of the Brief Pain Inventory. The following instruments were used to assess the components of the 5-factor model of distress tolerance: Ambiguity Tolerance Scale (tolerance to ambiguity), Intolerance to Uncertainty Scale (reversed score: tolerance to uncertainty), Discomfort Intolerance Scale (reversed score: discomfort tolerance), Distress Tolerance Scale (tolerance to negative emotions), Frustration Discomfort Scale (tolerance to frustration). Participants also completed the Pain Catastrophizing Scale. ResultsEighty participants were recruited (57 % women, mean age=33.09; standard deviation=12,87). Tolerance to negative emotions was the only component of distress tolerance that was associated with pain (ß=−0.04; 95% CI): −0.07–−0.01; t (78)=−3.06, p<0.01) or pain interference in everyday functioning (ß=−0.07; 95% CI: −0.10–−0.03; t (78)=−3.97, p<0.01), independently of the others. Combined with age, these factors explained 16.2 % of the variance in pain intensity and 19.4 % of the variance in pain interference. Pain catastrophizing partially mediated the association between tolerance to negative emotions and pain interference in everyday functioning, but it was not involved in the association between tolerance to negative emotions and pain intensity. ConclusionTolerance to negative emotions appears to be the most relevant aspect of distress tolerance in the context of chronic pain and is a potential clinical target that is independent and complementary from pain catastrophizing.

Reliabilities of Intra-Individual Mean and Intra-Individual Variability of Self-Reported Pain Derived From Ecological Momentary Assessments: Results From the Einstein Aging Study

An individual's pain experiences vary substantially over time. Though variability in pain may be an important metric which usually predicts health consequences, research on the measurement of pain variability estimates is lacking among older adults. We aimed to examine the reliabilities of both intra-individual mean (IIM) and intra-individual variability (IIV) of pain assessed using ecological momentary assessments (EMA) among racially diverse, systematically recruited community dwelling cohort of older adults. Participants (N = 311, age = 70–91) completed a 14-day EMA protocol which included self-reports of pain intensity, pain interference with activities, and pain interference with concentration multiple times a day. Over a 2-week period, we found excellent reliabilities for both pain IIM (.99), and pain IIV (≥.90). We also found that we need 5 to 6 days to achieve good reliability (.8) for pain IIV, suggesting that a shorter protocol may be used to reduce participants’ burden among the current sample, although caution is required when using this result to determine EMA study designs among different samples. Future studies are required to examine the associations of various EMA pain metrics with different health outcomes among older adults to facilitate the detection of underlying mechanisms linking pain to health as a prelude to interventions. PerspectiveMean levels and variability in pain intensity, pain interference with activities, and pain interference with concentration can be reliably measured to be linked with various health outcomes in older adults. Future studies including these pain metrics will assess the natural history, the consequences, and effects of intervention of pain.

Methodology and applicability of the human contact burn injury model: A systematic review.

The contact burn injury model is an experimental contact thermode-based physiological pain model primarily applied in research of drug efficacy in humans. The employment of the contact burn injury model across studies has been inconsistent regarding essential methodological variables, challenging the validity of the model. This systematic review analyzes methodologies, outcomes, and research applications of the contact burn injury model. Based on these results, we propose an improved contact burn injury testing paradigm. A literature search was conducted (15-JUL-2020) using PubMed, EMBASE, Web of Science, and Google Scholar. Sixty-four studies were included. The contact burn injury model induced consistent levels of primary and secondary hyperalgesia. However, the analyses revealed variations in the methodology of the contact burn injury heating paradigm and the post-burn application of test stimuli. The contact burn injury model had limited testing sensitivity in demonstrating analgesic efficacy. There was a weak correlation between experimental and clinical pain intensity variables. The data analysis was limited by the methodological heterogenicity of the different studies and a high risk of bias across the studies. In conclusion, although the contact burn injury model provides robust hyperalgesia, it has limited efficacy in testing analgesic drug response. Recommendations for future use of the model are being provided, but further research is needed to improve the sensitivity of the contact burn injury method. The protocol for this review has been published in PROSPERO (ID: CRD42019133734).

Determinants of Pain Intensity in Physical Education Teachers Focusing on Dance Teachers: A Cross-Sectional Study.

(1) Background: Dance teachers (DT) are dependent on their functional body. Pain can hardly be avoided during the professional practice of dance. Pain can become so intense that it impairs, or even prevents, the professional practice. The aim of this study was to identify the determinants of pain intensity of the most severely affected body regions of DT in pain during the three-month period prior to the survey. (2) Methods: This cross-sectional study was conducted by an online survey. A total of 166 DT participated in the study; 143 of the DT were in pain during the three-month period and were included in the analysis. Using multiple linear regression, the determinants of pain intensity were identified from population parameters, occupational data, pain localisation, and temporal pain course. (3) Results: Regions of the lower extremity and head/trunk regions were most frequently indicated as the body regions with the most severe pain. The multiple regression model generated with the factors “functional impairment”, “biomechanical exposure”, and “pain at rest” explains a statistically significant, moderate proportion of the variance in pain intensity (R2 = 0.22, F (3, 106) = 10.04, p < 0.001). (4) Conclusions: Intensity of pain in DT seems to be related to the physical demands of professional practice.

The Problem of Pain in Systemic Lupus Erythematosus: An Explication of the Role of Biopsychosocial Mechanisms.

To define biopsychosocial mechanisms of pain that go above and beyond disease activity and organ damage in systemic lupus erythematosus (SLE). We conducted a cross-sectional analysis of patient-reported data in a population-based registry of 766 people with SLE. Predictors of pain intensity and interference were examined using hierarchical linear regression. We built 2 main hierarchical regression models with pain intensity and interference as outcomes, both regressed on disease activity and organ damage. For each model, we sought to establish the relationship between pain outcomes and the primary exposures using sequential steps comprising the inclusion of each construct in 6 stages: demographic, socioeconomic, physical, psychological, behavioral, and social factors. We also conducted sensitivity analyses eliminating all overt aspects of pain in the disease activity measure and reestimated the models. Disease activity and organ damage explained 32-33% of the variance in pain intensity and interference. Sociodemographic factors accounted for an additional 4-9% of variance in pain outcomes, whereas psychosocial/behavioral factors accounted for the final 4% of variance. In the sensitivity analyses, we found that disease activity and organ damage explained 25% of the variance in pain outcomes. Disease activity only explained 33% of the variance in pain outcomes. However, there was an attenuation in these associations after accounting for psychosocial/behavioral factors, highlighting their roles in modifying the relationship between disease activity and pain. These findings suggest that multilevel interventions may be needed to tackle the negative effect of pain in SLE.

Os efeitos do Functional Fascial Taping (FFT) associado a fisioterapia convencional na funcionalidade do joelho: um estudo quase-experimental

INTRODUÇÃO: O Functional Fascial Taping (FFT) é uma técnica de aplicação de bandagem rígida objetivando estimular o alinhamento estrutural das fibras de colágeno da fáscia muscular, desobstruindo a passagem dos fluidos assegurando assim sua função. OBJETIVO: Avaliar os efeitos do FFT associado a Fisioterapia convencional nas disfunções crônicas no joelho baseado nas variáveis intensidade da dor, amplitude de movimento, força e flexibilidade muscular. METODOLOGIA: Tratou-se de um estudo quase-experimental realizado com 10 pacientes de ambos os gêneros e sintomatologia de dor e limitação funcional, estando em tratamento fisioterapêutico. Todos os pacientes foram submetidos a avaliação cinético-funcional, incluindo dados de dor, amplitude de movimento, força e flexibilidade muscular. A aplicação do FFT foi padronizada, onde primeiro identificou-se os vetores, seguido da aplicação do tape hipoalergênico. Depois aplicou-se três tiras de bandagem rígida, então, recobriu-se com o tape hipoalergênico novamente. A aplicação da bandagem ocorreu três vezes por semana, totalizando 10 sessões. RESULTADOS: Houve redução nos níveis de dor de mediana 10,0 cm para 2,0 cm ao final das 10 sessões (Z=2,6; p=0,007). Aumentou a força muscular para extensão do joelho com mediana inicial de 4,0 para final de 4,0 (Z=2,0; p=0,04). A amplitude de movimento para flexão (Mediana: de 102,5° para 110,0°, Z=2,3, p=0,01) e flexibilidade muscular (Mediana: de 5,0 cm para 0,0 cm, Z=2,0, p=0,04) também melhorou significavamente. CONCLUSÃO: O FFT pode ser utilizado como coadjuvante no tratamento de desordens no joelho, tanto ortopédicas quanto reumáticas, auxiliando a manutenção de uma mecânica funcional equilibrada, o que favorece a redução no quadro álgico, aumento no arco de movimento e melhora na força e flexibilidade muscular.

Significant correlation between plasma proteome profile and pain intensity, sensitivity, and psychological distress in women with fibromyalgia

Fibromyalgia (FM) is a complex pain condition where the pathophysiological and molecular mechanisms are not fully elucidated. The primary aim of this study was to investigate the plasma proteome profile in women with FM compared to controls. The secondary aim was to investigate if plasma protein patterns correlate with the clinical variables pain intensity, sensitivity, and psychological distress. Clinical variables/background data were retrieved through questionnaires. Pressure pain thresholds (PPT) were assessed using an algometer. The plasma proteome profile of FM (n = 30) and controls (n = 32) was analyzed using two-dimensional gel electrophoresis and mass spectrometry. Quantified proteins were analyzed regarding group differences, and correlations to clinical parameters in FM, using multivariate statistics. Clear significant differences between FM and controls were found in proteins involved in inflammatory, metabolic, and immunity processes. Pain intensity, PPT, and psychological distress in FM had associations with specific plasma proteins involved in blood coagulation, metabolic, inflammation and immunity processes. This study further confirms that systemic differences in protein expression exist in women with FM compared to controls and that altered levels of specific plasma proteins are associated with different clinical parameters.

Behavioural activation and inhibition systems in relation to pain intensity and duration in a sample of people experiencing chronic musculoskeletal pain

BackgroundThere is potential clinical utility in tailoring patients’ pain management based on behavioural tendencies. Previous work demonstrates a link between behavioural approach/inhibition and pain experience. ObjectivesTo investigate the relationship of pain intensity and duration with behavioural activation and inhibition tendencies and fear-avoidance beliefs, kinesiophobia, and disability, in a sample group (n = 709) reporting chronic musculoskeletal pain. MethodsRegression analyses assessed the predictive value of these variables on pain intensity and on pain duration. Differences in behavioural tendencies between groups reporting high and low pain intensities were examined. ResultsNeither pain intensity nor pain duration were correlated with behavioural activation (BAS) and inhibition (BIS). Both pain intensity and duration were correlated with fear-avoidance beliefs (intensity p < .001, duration p = .005), kinesiophobia (intensity and duration both p < .001, and disability (intensity and duration both p < .001). There were significant positive relationships between pain intensity and fear-avoidance beliefs (p < .001), kinesiophobia (p = .021), and disability (p < .001), as well as positive relationships between pain duration and fear-avoidance (p = .543), kinesiophobia (p = .084) and disability (p = .002). Fear-avoidance beliefs, kinesiophobia and disability accounted for 31% of the variance in pain intensity. ConclusionsNeither BIS nor BAS significantly related to, or predicted pain intensity or duration. No differences in activation and inhibition tendencies were evident between high and low pain intensity groups. This study provides further support for the inter-relationships between fear-avoidance beliefs, kinesiophobia, disability and pain duration and intensity. No explicit support for behavioural links to pain were shown, however, this may be due to the measurement instrument rather than an invalid theory.