Pain
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Randomized Controlled Trial Comparative Study
Evaluation of analgesic effect of skin-to-skin contact compared to oral glucose in preterm neonates.
Nonpharmacological interventions are important alternatives for pain relief during minor procedures in preterm neonates. Skin-to-skin contact or kangaroo mother care is a human and efficient way of caring for low-weight preterm neonates. The aim of the present study was to assess the analgesic effect of kangaroo care compared to oral glucose on the response of healthy preterm neonates to a low-intensity acute painful stimulus. ⋯ In group 3 (glucose, n=31), the neonate was in the prone position in the isolette and received oral glucose (1 ml, 25%) 2 min before heel lancing. A smaller variation in heart rate (p=0.0001) and oxygen saturation (p=0.0012), a shorter duration of facial activity (brow bulge, eye squeeze and nasolabial furrowing) (p=0.0001), and a lower PIPP (Premature Infant Pain Profile) score (p=0.0001) were observed in group 2. In conclusion, skin-to-skin contact produced an analgesic effect in preterm newborns during heel lancing.
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Comparative Study
Numbness in clinical and experimental pain--a cross-sectional study exploring the mechanisms of reduced tactile function.
Pain patients often report distinct numbness of the painful skin although no structural peripheral or central nerve lesion is obvious. In this cross-sectional study we assessed the reduction of tactile function and studied underlying mechanisms in patients with chronic pain and in healthy participants exposed to phasic and tonic experimental nociceptive stimulation. Mechanical detection (MDT) and pain thresholds (MPT) were assessed in the painful area and the non-painful contralateral side in 10 patients with unilateral musculoskeletal pain. ⋯ Irrespective of the mode of nociceptive stimulation (phasic vs. tonic) tactile hypaesthesia and hyperalgesia developed with a similar time course and disappeared within approximately 1 day. Hypaesthesia (numbness) often encountered in clinical pain can be reproduced by experimental nociceptive stimulation. The time course of effects suggests a mechanism involving central plasticity.
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Comparative Study
Predictors of low back pain hospitalization--a prospective follow-up of 57,408 adolescents.
Low back pain (LBP) is common among adolescents and it has been estimated that one-fifth of adolescents suffer from recurrent severe LBP. However, longitudinal studies describing the risk factors of LBP are scarce. The purpose of this study was to investigate whether health, physical activity and other health behaviors, socio-demographic background and school success predict LBP hospitalization until early middle age. ⋯ The associations between the risk factors and LBP hospitalization persisted into adulthood. Efforts to reduce adolescent smoking may decrease LBP-related morbidity in males. Coaches should pay special attention to the nature of physical training and personal exercises in females, and physiotherapists and sports physicians to the prevention of LBP hospitalization.
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The length of the reporting period specified for items assessing pain and fatigue varies among instruments. How the length of recall impacts the accuracy of symptom reporting is largely unknown. This study investigated the accuracy of ratings for reporting periods ranging from 1 day to 28 days for several items from widely used pain and fatigue measures (SF36v2, Brief Pain Inventory, McGill Pain Questionnaire, Brief Fatigue Inventory). ⋯ An additional 7 day-by-day recall task suggested that patients have increasing difficulty actually remembering symptom levels beyond the past several days. These data were collected while patients were receiving usual care and may not generalize to conditions where new interventions are being introduced and outcomes evaluated. Reporting periods can influence the accuracy of retrospective symptom reports and should be a consideration in study design.
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Comparative Study
Assessing fear in patients with cervical pain: development and validation of the Pictorial Fear of Activity Scale-Cervical (PFActS-C).
The fear avoidance model (FAM) postulates that fear of pain or reinjury is a risk factor for persistent pain and disability, because it leads to the avoidance of physical activity. Research on the FAM has not yielded consistent results, which may be attributed to the model itself, but could also be a product of the way fear of movement is assessed. Studies of the FAM have measured fear using verbal scales consisting of items that are often vague and have only an indirect relationship with fear. ⋯ Internal consistency (alpha=.98), stability over time (n=44, IntraClass Correlation=.72), and construct validity were all good to excellent. The results indicate that the PFActS-C may be a useful tool for assessing fear of movement in patients with cervical pain. Research is needed to confirm the factor structure of the PFActS-C and to assess the generalizability of the results to other samples with neck pain.