Orthostatic-induced Hypotension Attenuates Cold Pressor Pain Perception

In recent years, numerous studies have established a connection between blood pressure and nocioception. While this connection is well documented in the literature, its underlying physiological mechanisms have yet to be elucidated. Much attention has focused on the relationship between cardiovascular regulatory centers and nocioception, yet the intricacies of this relationship have not been fully explored. Therefore, the purpose of this investigation was to examine the role of the baroreflex system as a modulator of pain perception. Twenty normotensive males participated in two laboratory sessions. Time to cold pain threshold and pain tolerance was measured at rest during the first visit. On visit two, blood pressure was orthostatically manipulated via tilt table at postures 90o, 120o, and 180o. Orthostatic manipulation significantly lowered systolic blood pressure (SBP), pain threshold, and pain tolerance from seated baseline at 120o and 180o. The regression models for baroreceptor reflex sensitivity (BRS) assessed during seated baseline and at 120o and 180o revealed a significant negative beta weight for the effect of SBP. A significant negative beta weight for the effects of BRS, SBP, and their interaction was observed at 90o. In conclusion, orthostatic baroreceptor activation appears to exert an inhibitory effect on the brain that decreases pain sensitivity

Exercise Intensity as a Determinant of Exercise Induced Hypoalgesia

The purpose of this study was to examine pain perception during and following two separate 30-min bouts of exercise above and below the Lactate Threshold (LT). Pain Threshold (PT) and Pain Intensity (PI) were monitored during (15 and 30 min) and after exercise (15 and 30 min into recovery) using a Cold Pressor Test (CPT) and Visual Analog Scale (VAS) for pain of the non-dominant hand. Significant differences in PT scores were found both during and after exercise conditions. Post hoc analysis revealed significant differences in PT scores at 30 min of exercise (P=0.024, P=0.02) and 15 min of recovery (P=0.03, P=0.01) for exercise conditions above and below LT, respectively. No differences (P=0.05) in PT scores were found at any time point between exercise conditions. No differences were found in PI scores at any time point within each trial (P=0.05) as well as between exercise conditions (p=0.05). Based upon these data, the effects of moderate exercise on PT appear to be similar at exercise intensities just above and below LT. This may indicate that the requisite intensity needed to ellicit Exercise-Induced Hypoalgesia may be lower than previously reported. Because a hypoalgesic effect was not observed in either condition until 30 min of exercise had been completed, total exercise time may be an important factor in the augmentation of pain perception under these conditions

Current Exercise Behaviors of Breast Cancer Patients Diagnosed with Chemotherapy-Induced Peripheral Neuropathy

Introduction: Chemotherapy-induced peripheral neuropathy (CIPN) is a common, dose-limiting effect of cancer therapy. The neuropathic pain associated with CIPN often has negative implications on an individual’s quality of life (QOL) and has long been recognized as one of the more difficult types of pain to treat. Treatment of neuropathic pain due to CIPN often requires a multidisciplinary approach, with much attention focused on the use of pharmacological therapies. However, in most instances, these agents have been shown to have additional negative side effects for cancer patients. Thus, other interventions that address the symptoms of CIPN should be considered. One such possible intervention is exercise rehabilitation, which has previously been reported effective in attenuating numerous cancer treatment-related toxicities and enhancing the QOL of patients. However, to our knowledge, there have been no published clinical trials examining the role of exercise in preserving neurological function following chemotherapy. As such, the purpose of this investigation was to examine the current exercise habits of breast cancer patients who are diagnosed with CIPN and the impact on pain and QOL. Methods: 300 women listed in the Breast Cancer Registry of Greater Cincinnati database were recruited by mail and asked to complete three questionnaires (McGill QOL, Leeds Assessment of Neuropathic Symptoms and Signs, and Current Exercise Behaviors). Data was analyzed at the 0.05 level of significance using a student’s t-test and a Pearson’s product moment correlation. Results: 134 completed surveys were returned and analyzed (44.6% response rate). Overall, QOL and exercise behaviors were moderately correlated (r = 0.56). Patients reported exercising an average of 2.3 d/wk and an overall QOL of 4.7. Of the patients completing the recommended amount of physical activity (EX, n = 21), QOL was 6.3, which was significantly higher than patients who did not meet these recommendations (SED, n = 113, p\u3c0.001). Likewise, only 15% of EX patients reported experiencing pain compared to 72% of SED patients (p\u3c0.001). Conclusions: Based on these data, it seems likely that an exercise intervention would be successful in attenuating symptoms of CIPN and improving the overall QOL of breast cancer patients

The Physiological Consequences of Bed Rest

Bed rest often is used to treat a wide variety of medical conditions. However, bed rest results in profound deconditioning of the body. Bed rest reduces the hydrostatic pressure gradient within the cardiovascular system, reduces muscle force production, virtually eliminates compression on the bones, and lowers total energy expenditure. This review focuses on the deconditioning that occurs in the cardiovascular, muscular, and skeletal systems following bed rest. Reduction in plasma volume reduces cardiac preload, stroke volume, cardiac output, and ultimately, maximal oxygen consumption. Skeletal muscle volume, muscle cross sectional area, and fiber cross sectional area decrease, which results in diminished muscular strength. These changes are most pronounced in the antigravity muscles. Increased bone resorption leads to a negative calcium balance and eventually decreased bone mass, particularly in the lower limbs. Diminished bone mass coupled with decreased muscular strength increases the risk of bone fractures, even with minor falls. It is important for clinicians to recognize these negative consequences of bed rest, which can be explained independent of disease or disorder. With this in mind, bed rest can be minimized as much as possible and early ambulation and physical activity may be prescribed to limit the deconditioning effects of bed rest

Unmasking Pain: A Look at the Latest Research

Recent research into the physical and psychological mechanisms of pain in revealing new ways to help ease the hurt without the use of medication

Public experiences of mass casualty decontamination

In this article, we analyze feedback from simulated casualties who took part in field exercises involving mass decontamination, to gain an understanding of how responder communication can affect people’s experiences of and compliance with decontamination. We analyzed questionnaire data gathered from 402 volunteers using the framework approach, to provide an insight into the public’s experiences of decontamination and how these experiences are shaped by the actions of emergency responders. Factors that affected casualties’ experiences of the econtamination process included the need for greater practical information and better communication from responders, and the need for privacy. Results support previous findings from small-scale incidents that involved decontamination in showing that participants wanted better communication from responders during the process of decontamination, including more practical information, and that the failure of responders to communicate effectively with members of the public led to anxiety about the decontamination process. The similarity between the findings from the exercises described in this article and previous research into real incidents involving decontamination suggests that field exercises provide a useful way to examine the effect of responder communication strategies on the public’s experiences of decontamination. Future exercises should examine in more detail the effect of various communication strategies on the public’s experiences of decontamination. This will facilitate the development of evidence-based communication strategies intended to reduce anxiety about decontamination and increase compliance among members of the public during real-life incidents that involve mass decontamination

Design and Fabrication of Soft 3D Printed Actuators: Expanding Soft Robotics Applications

Soft pneumatic actuators are ideal for soft robotic applications due to their innate compliance and high power-weight ratios. Presently, the majority of soft pneumatic actuators are used to create bending motions, with very few able to produce significant linear movements. Fewer can actively produce strains in multiple directions. The further development of these actuators is limited by their fabrication methods, specifically the lack of suitable stretchable materials for 3D printing. In this thesis, a new highly elastic resin for digital light projection 3D printers, designated ElastAMBER, is developed and evaluated, which shows improvements over previously synthesised elastic resins. It is prepared from a di-functional polyether urethane acrylate oligomer and a blend of two different diluent monomers. ElastAMBER exhibits a viscosity of 1000 mPa.s at 40 °C, allowing easy printing at near room temperatures. The 3D-printed components present an elastomeric behaviour with a maximum extension ratio of 4.02 ± 0.06, an ultimate tensile strength of (1.23 ± 0.09) MPa, low hysteresis, and negligible viscoelastic relaxation

Changes in Pain Perception in Women During and Following an Exhaustive Incremental Cycling Exercise

Exercise has been found to alter pain sensitivity with a hypoalgesic response (i.e., diminished sensitivity to pain) typically reported during and/or following high intensity exercise. Most of this research, however, has involved the testing of men. Thus, the purpose of the following investigation was to examine changes in pain perception in women during and following exercise. Seventeen healthy female subjects (age 20.47±.87; VO2 peak 36.77± 4.95) volunteered to undergo pain assessment prior to, during, and after a graded exhaustive VO2 peak cycling challenge. Heart Rate (HR) and Oxygen Uptake (VO2) were monitored along with electro-diagnostic assessments of Pain Threshold (PT) and Pain Tolerance (PTOL) at: 1) baseline (B), 2) during exercise (i.e., 120 Watts), 3) at exhaustive intensity (VO2 peak), and 4) 10 minutes into recovery (R). Data were analyzed using repeated measures ANOVA to determine differences across trials. Significant differences in PT and PTOL were found across trials (PT, p = 0.0043; PTOL p = 0.0001). Post hoc analyses revealed that PT were significantly elevated at VO2 peak in comparison to B (p = 0.007), 120 Watts (p = 0.0178) and R (p = 0.0072). PTOL were found to be significantly elevated at 120 Watts (p = 0.0247), VO2 peak (p \u3c 0.001), and R (p = 0.0001) in comparison to B. In addition, PTOL were found to be significantly elevated at VO2 peak in comparison to 120 Watts (p = 0.0045). It is concluded that exercise-induced hypoalgesia occurs in women during and following exercise, with the hypoalgesic response being most pronounced following exhaustive exercise