Articles: pain-measurement.
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The heat beam dolorimeter (HBD) was developed to evaluate cutaneous pain thresholds in humans. In the present study, the hypothesis that a patient's underlying pain status affects his pain tolerance to an incident HBD stimulus was tested. Twenty-seven chronic pain patients with a variety of clinical problems unresponsive to conventional algological therapy were scheduled for neurosurgical procedures. ⋯ Twenty-four of the 27 patients reported significant pain relief following surgery. Our results show that, in chronic pain patients, endogenous pain significantly affected incident pain perception in the HBD test when compared with the responses of normal pain-free volunteers. Consequently, HBD may be useful in objectively assessing chronic pain and its relief by neurosurgical procedures.
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Arch Phys Med Rehabil · Jul 1987
Comparative StudyThe Pain Disability Index: psychometric and validity data.
The Pain Disability Index (PDI) is a brief instrument that was developed to assess pain-related disability, providing information that complements assessment of physical impairment. This paper presents the results of two studies concerning the psychometric properties and the validity of the PDI. In study I, PDI scores of 108 patients appeared internally consistent (alpha = .86), although a factor analysis revealed two factors. ⋯ Study II found that the PDI scores of 37 former inpatients were significantly higher than 36 former outpatients who responded to a follow-up questionnaire. These findings support the validity of the PDI. Several methodologic issues are discussed, and suggestions are made for future uses of the instrument.
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Clinical Trial Controlled Clinical Trial
Reliability and validity of verbal descriptor scales of painfulness.
Previous studies have provided information about the reliability and validity of verbal descriptor scales of sensory intensity and unpleasantness and have shown that these two dimensions can be differentially affected by pharmacological manipulations. Since the relation between these dimensions and the general term 'pain' is not known, two experiments developed a verbal descriptor scale of painfulness and compared the sensitivity of this scale to pharmacological manipulations used previously with scales of sensory intensity and unpleasantness. In exp. ⋯ Seven electrical stimuli spaced between individually determined pain threshold and tolerance values were delivered in random sequence 6 times before and after double-blind intravenous infusions of placebo, 0.11 mg/kg diazepam, 0.66 microgram/kg fentanyl or a combination of the diazepam and fentanyl doses. Mean responses were reduced significantly after all active drugs but not after placebo. These results suggest that the term pain does not represent a simple combination of sensory intensity and/or unpleasantness and shows that the sensitivity to an inert placebo, an active placebo, and an analgesic can vary with the type of pain assessment procedure.
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The influence of sex and anxiety on experimental pain perception was studied in a homogeneous population of 50 volunteer and healthy dental students. Three threshold (minimum perceptible threshold, pain threshold and pain tolerance threshold) were determined by delivering electrical stimulations, at regular intervals, on the left hand finger pads. ⋯ Statistical analysis of the results showed a lower pain tolerance threshold in females than in males and a significant correlation between the anxiety score and the pain tolerance threshold. The fact that females are more anxious than males could explain these results.
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The McGill Pain Questionnaire (MPQ) and the Minnesota Multiphasic Personality Inventory (MMPI) were administered to 72 subjects with burning mouth syndrome (BMS) who were also requested to match the levels of their clinical pain to line lengths on a visual analogue scale (VAS) and to experimentally induced warm and painful thermal stimuli. The responses of 102 toothache pain subjects and 43 asymptomatic age- and sex-matched control subjects were used to compare the responses of the BMS subjects on the MPQ and MMPI, respectively. The results indicated that BMS pain is quantitatively similar to, but qualitatively different from, toothache pain, that self-reports of BMS pain appear to be valid, that when compared to the asymptomatic control subjects, BMS subjects show elevations in certain personality characteristics which are similar to those seen in other chronic pain patients, and that these personality disturbances tend to increase with increased pain. Therefore, our findings indicate that the pain of BMS is more severe than has previously been suggested and that the severity of this pain may explain some of the personality changes which occur in the BMS subjects.