Scandinavian journal of rheumatology
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Scand. J. Rheumatol. · Jan 1995
Randomized Controlled Trial Clinical TrialPain analysis in patients with fibromyalgia. Effects of intravenous morphine, lidocaine, and ketamine.
Pain intensity, muscle strength, static muscle endurance, pressure pain threshold, and pain tolerance at tender points and control points were assessed in 31 patients with fibromyalgia (FM), before and after intravenous administration of morphine (9 patients), lidocaine (11 patients), and ketamine (11 patients). The three different studies were double-blind and placebo-controlled. The patients were classified as placebo-responders, responders (decrease in pain intensity by > 50%) and non-responders. ⋯ Tenderness at tender points decreased and endurance increased significantly, while muscle strength remained unchanged. The present results support the hypothesis that the NMDA receptors are involved in pain mechanisms in fibromyalgia. These findings also suggest that central sensitization is present in FM and that tender points represent secondary hyperalgesia.
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Scand. J. Rheumatol. · Jan 1995
The relative value of spinal and thoracic mobility measurements in ankylosing spondylitis.
The relative value of nine spinal and thoracic mobility measurements was investigated in 73 male patients with ankylosing spondylitis (AS). The value of a test was obtained by the relative ranks of validity, reliability and sensitivity to change. Validity was determined as age-adjusted correlation of the test result with AS-specific radiological changes in the lumbar spine. ⋯ Of these, FFD had high reliability and sensitivity ranks, but poor correlation with AS-specific spinal changes. TR had high validity and sensitivity ranks, and improvement of the measurement technology would probably result in a superior test for the follow-up of AS. Chest expansion and vital capacity had low ranks in all comparisons.
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Scand. J. Rheumatol. · Jan 1995
The reliability and validity of pain threshold measurements in osteoarthritis of the knee.
The purpose of this study was to examine the reliability and validity of measuring pain threshold (PT) of persons with osteoarthritis (OA) of the knee. The PTs of women with and without OA of the knee were measured on 3 occasions at 6 sites at the knee with a pressure dolorimeter. Subjects with OA also recorded their pain on a visual analogue scale (VAS) and on the McGill Pain Questionnaire (MPQ). ⋯ The correlations between PT and measures of pain intensity were poor. It is concluded that the measurement of PT at the knee distinguishes OA from healthy controls, and that it has moderate reliability. However, it cannot substitute for a measure of pain intensity.
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Scand. J. Rheumatol. · Jan 1995
Are tender point scores assessed by manual palpation in fibromyalgia reliable? An investigation into the variance of tender point scores.
To determine the reliability of tender point assessment by manual palpation in patients with fibromyalgia, and to investigate the sources of variance, tender point scores by manual palpation were obtained in 30 fibromyalgia patients by 2 investigators; the assessments were repeated after 1 week. Test-retest stability and inter-observer agreement of tender point scores was moderate to high. ⋯ It seems to be not less than reliability of assessment by pressure algometer. Tender point scores in fibromyalgia reflect individual differences in mean pain thresholds as well as individual tender point profiles.
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Mobility measurements of spine, chest, hips, and shoulder in 73 adult males with ankylosing spondylitis (AS) were correlated with the duration of disease. Several mobility tests showed a significant correlation with the duration of AS, but after adjustment for age, only rotation of the thoracolumbar spine maintained a highly significant correlation. It is concluded that age has a strong effect on the mobility tests. Rotation of the thoracolumbar spine seems to be a valid measure for AS-specific changes.