European journal of pain : EJP
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The COMFORT scale is a measurement tool to assess distress, sedation and pain in nonverbal paediatric patients. Several studies have described the COMFORT scale, but no formal assessment of the methodological quality has been undertaken. Therefore, we performed a systematic review to study the clinimetric properties of the (modified) COMFORT scale in children up to 18 years. ⋯ WHAT DOES THIS REVIEW ADD?: An in-depth assessment of the clinimetric properties of the COMFORT scale. The COMFORT scale shows overall an adequate reliability in providing information on distress, sedation and pain. Construct validity varies from good to excellent for distress, from moderate to excellent for sedation, and from poor to excellent for pain.
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Randomized Controlled Trial
The effects of total knee replacement and non-surgical treatment on pain sensitization and clinical pain.
The objective was to compare the effect of total knee replacement (TKR) followed by a 3-month non-surgical treatment with the non-surgical treatment alone in reducing pain sensitization and other pain-related measures in patients with knee osteoarthritis. ⋯ At 3 months, TKR followed by non-surgical treatment is more effective in reducing localized and spreading pain sensitization than non-surgical treatment alone. Both treatments are equally efficacious in reducing the pain-related measures of this study. WHAT DOES THIS STUDY ADD?: Knee replacement followed by non-surgical treatment is more effective in reducing pain sensitization, but not other pain-related measures, as compared to non-surgical treatment alone at 3 months.
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Randomized Controlled Trial
Effects of the carrier frequency of interferential current on pain modulation and central hypersensitivity in people with chronic nonspecific low back pain: A randomized placebo-controlled trial.
Interferential current (IFC) is commonly used for pain relief, but the effects of carrier frequency of the current and its action on pain mechanisms remain unclear. This randomized placebo-controlled trial tested the effects of IFC in people with chronic nonspecific low back pain. ⋯ These results suggest that although the IFC has changed some physiological mechanisms of pain and showed decrease frequency use of pain medication, there was no change in the primary aim, pain intensity. WHAT DOES THIS STUDY ADD?: The interferential current (IFC) presented advantages in the physiological measures of pain and showed decrease frequency use of pain medication. Future studies should investigate analgesic intake with IFC treatment.
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There is evidence that sensitivity to noxious stimuli differs between the sexes and across the body, but few studies have investigated differences in the perception and experience of acute pain stimuli across the body in healthy individuals. ⋯ Moreover, these insights are helpful for the design of studies investigating pain experience in healthy persons in experimental or clinical settings. WHAT DOES THIS STUDY ADD?: We tested sensitivity to acute suprathreshold thermal stimulations across a range of body sites to investigate for potential variability. We found significant differences in the perceived intensity and unpleasantness of noxious and innocuous thermal stimuli at the wrist and lower back, compared with the shoulder and leg. These results suggest that pain experience is driven by receptor density or the relative functional importance of these sites.
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Habituation refers to the brain's inhibitory mechanism against sensory overload and its brain correlate has been investigated in the form of a well-defined event-related potential, N100 (N1). Fibromyalgia is an extensively described chronic pain syndrome with concurrent manifestations of reduced tolerance and enhanced sensation of painful and non-painful stimulation, suggesting an association with central amplification of all sensory domains. Among diverse sensory modalities, we utilized repetitive auditory stimulation to explore the anomalous sensory information processing in fibromyalgia as evidenced by N1 habituation. ⋯ Fibromyalgia patients failed to demonstrate auditory N1 habituation to repetitively presenting stimuli, which indicates their compromised early auditory information processing. Our findings provide neurophysiological evidence of inhibitory failure and cortical augmentation in fibromyalgia. WHAT'S ALREADY KNOWN ABOUT THIS TOPIC?: Fibromyalgia has been associated with altered filtering of irrelevant somatosensory input. However, whether this abnormality can extend to the auditory sensory system remains controversial. N!00, an event-related potential, has been widely utilized to assess the brain's habituation capacity against sensory overload. WHAT DOES THIS STUDY ADD?: Fibromyalgia patients showed defect in N100 habituation to repetitive auditory stimuli, indicating compromised early auditory functioning. This study identified deficient inhibitory control over irrelevant auditory stimuli in fibromyalgia.