Does patient-physiotherapist agreement influence the outcome of low back pain? A prospective cohort study

BACKGROUND: Recent research suggests that agreement between patients' and health professionals' perceptions may influence the outcome of various painful conditions. This issue has received little attention in the context of low back pain and physiotherapy interventions. The current study aimed at exploring the relationship between patient-physiotherapist agreement on baseline low back pain intensity and related functional limitations, and changes in patient outcomes four weeks later. METHODS: Seventy-eight patient-physiotherapist dyads were included in the study. At baseline, patients and physiotherapists completed a Numerical Rating Scale and the Roland-Morris Disability Questionnaire. Patients' perceptions were reassessed over the phone at follow-up. RESULTS: Using multiple regression, baseline level of patient-physiotherapist agreement on pain intensity was associated with both outcome measures at follow-up. Agreement on functional limitations had no impact on outcomes. CONCLUSION: The results of this study indicate that patient-physiotherapist agreement has some impacts on the short-term outcomes of low back pain. Further research is needed to confirm these findings

Catestatin, vasostatin, cortisol, temperature, heart rate, respiratory rate, scores of the short form of the Glasgow composite measure pain scale and visual analog scale for stress and pain behavior in dogs before and after ovariohysterectomy

Background: The stress reaction induced by surgery and associated pain may be detrimental for patient recovery and should be minimized. The neuropeptide chromogranin A (CGA) has shown promise as a sensitive biomarker for stress in humans. Little is known about CGA and its derived peptides, catestatin (CST) and vasostatin (VS), in dogs undergoing surgery. The objectives of this study were to investigate and compare concentrations of CGA epitopes CST and VS, cortisol, body temperature, heart rate, respiratory rate, scores of the short form of the Glasgow composite measure pain scale (CMPS-SF) and visual analog scales (VAS) for stress and pain behavior in dogs before and after ovariohysterectomy. Methods: Thirty healthy privately owned female dogs admitted for elective ovariohysterectomy were included. Physical examination, CMPS-SF, pain behavior VAS, and stress behavior VAS were recorded and saliva and blood samples were collected before surgery, 3h after extubation, and once at recall 7–15 days after surgery. Dogs were premedicated with morphine and received carprofen as analgesia for 7 days during the postoperative period. Results: At 3h after extubation, CMPS-SF and pain behavior VAS scores had increased (p<0.0001) and stress behavior VAS scores, temperature, respiratory rate (p<0.0001), plasma CST concentrations (p=0.002) had decreased significantly compared to before surgery. No significant differences were observed in the subjective and physiological parameters between before surgery and at recall, but plasma CST (p=0.04) and serum cortisol (p=0.009) were significantly lower at recall. Plasma VS, saliva CST, and heart rate did not differ significantly at any observed time. Conclusion: Study parameters for evaluating surgery-induced stress and pain changed in dogs subjected to ovariohysterectomy. To further evaluate CST and VS usefulness as pain biomarkers, studies on dogs in acute painful situations are warranted