Relationship between Body Mass Index and the Sub-Dimensions of the Brief Pain Inventory in Chronic Pain Patients

Individuals with chronic pain find it hard to exercise which often results in an elevated Body Mass Index (BMI). Often these individuals only have mild to moderate structural or biomechanical reasons to explain their pain yet their fear of pain seems to influence their functional capacity before any biomechanical mechanism actually prevents them doing so.A retrospective analysis of 25 individuals with a diagnosis of chronic pain (>3 months duration) to establish anthropometric measures, pain severity and Brief Pain Inventory (BPI) questionnaire including the affective sub-dimension score (REM: relations with others, enjoyment of life, and mood) and the activity subdimension score (WAW: walking, general activity, and work) were assessed.BMI was shown to have a significant effect on the overall daily functional BPI score as assessed using ANOVA, F (4,110) = 29.4, p<0.05, with an effect size w = 0.5. Turkey HSD tests to compare all groups identified a significant relationship between BMI and (i) pain (p<0.05), (ii) REM (p<0.05), and (iii) sleep (p<0.05).These results would suggest that individuals who are overweight and who show higher REM scores on the BPI assessment may benefit from early psychological counselling rather than physical therapy

The striated muscles in pulmonary arterial hypertension: adaptations beyond the right ventricle

Pulmonary arterial hypertension (PAH) is a fatal lung disease characterised by progressive remodelling of the small pulmonary vessels. The daily-life activities of patients with PAH are severely limited by exertional fatigue and dyspnoea. Typically, these symptoms have been explained by right heart failure. However, an increasing number of studies reveal that the impact of the PAH reaches further than the pulmonary circulation. Striated muscles other than the right ventricle are affected in PAH, such as the left ventricle, the diaphragm and peripheral skeletal muscles. Alterations in these striated muscles are associated with exercise intolerance and reduced quality of life. In this Back to Basics article on striated muscle function in PAH, we provide insight into the pathophysiological mechanisms causing muscle dysfunction in PAH and discuss potential new therapeutic strategies to restore muscle dysfunction