Exercise Increases Pressure Pain Tolerance but Not Pressure and Heat Pain Thresholds in Healthy Young Men

Background: Exercise causes an acute decrease in the pain sensitivity known as exercise-induced hypoalgesia (EIH), but the specificity to certain pain modalities remains unknown. This study aimed to compare the effect of isometric exercise on the heat and pressure pain sensitivity. Methods: On three different days, 20 healthy young men performed two submaximal isometric knee extensions (30% maximal voluntary contraction in 3 min) and a control condition (quiet rest). Before and immediately after exercise and rest, the sensitivity to heat pain and pressure pain was assessed in randomized and counterbalanced order. Cuff pressure pain threshold (cPPT) and pain tolerance (cPTT) were assessed on the ipsilateral lower leg by computer-controlled cuff algometry. Heat pain threshold (HPT) was recorded on the ipsilateral foot by a computer-controlled thermal stimulator. Results: Cuff pressure pain tolerance was significantly increased after exercise compared with baseline and rest (p \u3c 0.05). Compared with rest, cPPT and HPT were not significantly increased by exercise. No significant correlation between exercise-induced changes in HPT and cPPT was found. Test–retest reliability before and after the rest condition was better for cPPT and CPTT (intraclass correlation \u3e 0.77) compared with HPT (intraclass correlation = 0.54). Conclusions: The results indicate that hypoalgesia after submaximal isometric exercise is primarily affecting tolerance of pressure pain compared with the pain threshold. These data contribute to the understanding of how isometric exercise influences pain perception, which is necessary to optimize the clinical utility of exercise in management of chronic pain. Significance: The effect of isometric exercise on pain tolerance may be relevant for patients in chronic musculoskeletal pain as a pain-coping strategy. What does this study add? The results indicate that hypoalgesia after submaximal isometric exercise is primarily affecting tolerance of pressure pain compared with the heat and pressure pain threshold. These data contribute to the understanding of how isometric exercise influences pain perception, which is necessary to optimize the clinical utility of exercise in management of chronic pain

Disrupted Brain Circuitry for Pain‐Related Reward/Punishment in Fibromyalgia

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/102040/1/art38191.pd

Pain modulatory phenotypes differentiate subgroups with different clinical and experimental pain sensitivity

Pain biomarkers are warranted for individualized pain management. Based on different pain modulatory phenotypes, the objectives of this study were to explore the existence of subgroups within patients with nonmalignant chronic pain and to investigate differences in clinical pain and pain hypersensitivity between subgroups. Cuff algometry was performed on lower legs in 400 patients with chronic pain to assess pressure pain threshold, pressure pain tolerance, temporal summation of pain (TSP: increase in pain scores to 10 repeated stimulations), and conditioned pain modulation (CPM: increase in cuff pressure pain threshold during cuff pain conditioning on the contralateral leg). Heat detection and heat pain thresholds at clinical painful and nonpainful body areas were assessed. Based on TSP and CPM, 4 distinct groups were formed: group 1 (n 85) had impaired CPM and facilitated TSP; group 2 (n 148) had impaired CPM and normal TSP; group 3 (n 45) had normal CPM and facilitated TSP; and group 4 (n 122) had normal CPM and normal TSP. Group 1 showed more pain regions than the other 3 groups (P &lt; 0.001), indicating that impaired CPM and facilitated TSP play an important role in widespread pain. Groups 1 and 2 compared with group 4 had lower heat pain threshold at nonpainful areas and lower cuff pressure pain tolerance (P &lt; 0.02), indicating that CPM plays a role for widespread hyperalgesia. Moreover, group 1 demonstrated higher clinical pain scores than group 4 (P &lt; 0.05). Although not different between subgroups, patients were profiled on demographics, disability, pain catastrophizing, and fear of movement. Future research should investigate interventions tailored towards these subgroups.</p

Occupational therapy lifestyle intervention added to multidisciplinary treatment for adults living with chronic pain: A feasibility study

OBJECTIVES: To evaluate the feasibility and outcomes of an occupational therapy lifestyle intervention for adults living with chronic pain. DESIGN: This one-group pre-post interventional study investigated the feasibility and outcomes of the Redesign Your Everyday Activities and Lifestyle with Occupational Therapy (REVEAL(OT)) intervention targeting meaningful activities and lifestyle. SETTINGS: The occupational therapist-led intervention was added to standard multidisciplinary chronic pain treatment at a Danish pain centre. PARTICIPANTS: Of the 40 adult participants aged 18-64 (mean 46.6±10.9 years old, 85% females, chronic pain duration ≥3 months), there were 31 completers. INTERVENTION: Three feasibility rounds were carried out in 2019-2021. The intervention focused on meaningful activities, healthy eating habits and daily physical activity. Methods of didactical presentations, group discussions, personal reflection and experiential learning were used in the intervention composed both of individual and group sessions. OUTCOMES: Primary outcomes were predefined research progression criteria evaluated by the red-amber-green method. Secondary outcomes measured pre-post changes in health-related quality of life and occupational performance and satisfaction. RESULTS: The study demonstrated satisfactory programme adherence (77.5%), patients' self-perceived relevance (97%), timing and mode of delivery (97%) and assessment procedure acceptance (95%). No adverse events causing discontinuation occurred. Recruitment rate (n=5.7 monthly), retention (77.5%) and the fidelity of delivery (83.3%) needed improvement. We observed no improvement in health-related quality of life (mean=0.04, 95% CI -0.03 to 0.12) but positive change in occupational performance (mean=1.80, 95% CI 1.25 to 2.35) and satisfaction (mean=1.95, 95% CI 1.06 to 2.84). The participants reached the minimal clinically important difference for occupational performance (≥3.0 points in 13.8%) and satisfaction (≥3.2 points in 24.0%). CONCLUSIONS: The REVEAL(OT) intervention was feasible to deliver and beneficial for the participants' occupational performance and satisfaction. The interventions' recruitment, retention and delivery strategies need optimisation in a future definitive trial. TRIAL REGISTRATION NUMBER: NCT03903900.</p

Internet-delivered cognitive behavioral therapy for tinnitus compared to Internet-delivered mindfulness for tinnitus: a study protocol of a randomized controlled trial

Background: Tinnitus affects around 15% of the population and can be a debilitating condition for a sizeable part of them. However, effective evidence-based treatments are scarce. One recommended treatment for tinnitus is cognitive behavioral therapy which has been found to be effective when delivered online. However, more treatments including mindfulness-based interventions have been studied recently in an attempt to facilitate the availability of effective treatments. There are promising findings showing great effects in reducing tinnitus-induced distress and some evidence about the efficacy of such intervention delivered online. However, there is a lack of evidence on how these two treatments compare against one another. Therefore, the aim of this study will be to compare Internet-delivered cognitive behavioral therapy for tinnitus against an Internet-delivered mindfulness-based tinnitus stress reduction intervention in a three-armed randomized controlled trial with a waiting list control condition. Methods: This study will be a randomized controlled trial seeking to recruit Lithuanian-speaking individuals suffering from chronic tinnitus. The self-report measure Tinnitus Handicap Inventory will be used. Self-referred participants will be randomized into one of three study arms: Internet-delivered cognitive behavioral therapy, Internet-delivered mindfulness-based tinnitus stress reduction intervention, or a waiting-list control group. Post-treatment measures will be taken at the end of the 8-week-long intervention (or waiting). Long-term efficacy will be measured 3 and 12 months post-treatment. Discussion: Internet-delivered interventions offer a range of benefits for delivering evidence-based treatments. This is the first randomized controlled trial to directly compare Internet-delivered CBT and MBTSR for tinnitus in a non-inferiority trial

Students' professional commitment and involvement in the study field of music

Darbe sprendžiama įsipareigojimo profesijai ir studentų įsitraukimo į studijas problema. Keliami šie Tyrimo klausimai: Kaip studentų įsitraukimas į studijas siejasi su įsipareigojimu profesijai? Kiek muzikos studentai yra aktyvūs studijų procese? Kiek giliai muzikos studentai yra įsipareigoję savo pasirinktai profesijai? Tyrimo objektas: studentų įsipareigojimo profesijai ir įsitraukimo į studijas sąsajos Tyrimo tikslas: atskleisti studentų įsipareigojimo profesijai ir įsitraukimo į studijas sąsajas. Tyrimo metodai: mokslinės literatūros analizė, anketinė apklausa. Įsipareigojimas profesijai yra daugiasluoksnė asmens būsena ir nuostata, tvirtai susieta su suvoktu pasižadėjimu tobulinti save pasirinktoje profesijoje, skirti jai laiko ir energijos, puoselėti ryšius, siejančius su ja ir kitais esančiais joje. Galimas emocinis (jausmų), kognityvinis (asociacijų, įsitikinimų) ir elgesio (veiksmų) ar šių komponentų derinių įsipareigojimas. Įsipareigojimas profesijai vertinamas elgesio (suvokiamos naudos) ir psichologiniu (vertybių ir tikslų tapatumo) požiūriais. Įsipareigojimas profesijai, siekiant sulaukti atlygio ateityje, galimas planuoti iš anksto, akcentuotina ne tik asmeninė nauda, bet ir praradimo kaina. Pastangos, pareiga, prieraišumas, lojalumas, vertybinis atitikimas, parama, išskirtinos įsipareigojimo profesijai dedamosios. Įsitraukimas į studijas yra susijęs su įsipareigojimu profesijai ir reiškiasi per: Studento požiūrį į studijas ir į savo būsimas karjeros galimybes. Paviršutiniškas požiūris lemia menką įsitraukimą ir menką įsipareigojimą, giluminis požiūris suponuoja aktyvų įsitraukimą ir įsipareigojimą profesijai, Studijų vertės gilumą, Studento savęs identifikacija su aukštąja mokykla, kurioje studijuoja. Kuo giliau studentas save identifikuoja aukštosios mokyklos dalimi, tuo jo studijos labiau išsiplečia iš tradicinio užduoties atlikimo į papildomos vertės kūrimą- dalyvavimą tobulinant studijų procesą, Studento dalyvavimą darbo rinkoje, lemiantį arba tikslingesnį studijavimą aukštojoje mokykloje, arba paviršutinę nuostatą į studijas, Studijų krypties nekeitimą, tik ypatingai retais atvejais muziką studijuojantis studentas keičia studijų kryptį studijų proceso metu, Apibrėžtą laimės jausmą ir aukštą pasitenkinimo lygį, Lojalumą pasirinktai profesijai ir neketinimą jos keisti.The paper deals with the problem of commitment to the profession and students’ involvement in studying. The study raises the following questions: How does students’ involvement in studies relate to the commitment to the profession? How active music students are in the educational process? How deep the music students are committed to their chosen profession? The object of the research: the link between students' commitment to the profession and involvement in studies. The aim of the research: to reveal the link between students' commitment to the profession and involvement in studies. Research methods: analysis of scientific literature and questionnaire survey. Commitment to the profession is a multi-characteristic state and provision, strongly associated with the perceived pledge to improve yourself in the chosen profession, dedicate time and energy to it, nurture relationships related to it and others in it. Commitment can be emotional (feelings), cognitive (associations, beliefs) and behavior (actions), or combinations of these components. Commitment to the profession is valued by behavior (perceived benefits) and psychological (values and goals) aspects. To get rewards in the future, commitment to the profession should be planned in advance, emphasized not only personal benefits, but also the price of loss. Efforts, duty, affection, loyalty, values compliance, support, are exceptional components of the commitment to the profession. Involvement in studying is related to the commitment to the profession and is expressed through: - Students’ approach to their studies and in their future careers opportunities. A superficial approach leads to little involvement and commitment where as a deep approach presupposes the active involvement and commitment to the profession. - The depth of the value of the study - Student’s participation in the labor market, either leading to a more targeted study in higher educational institution, or a superficial attitude towards their studies. - No changes in the direction of the study, only in extremely rare cases music student changes the direction of the study during a studying process. - A defined sense of happiness and a high level of satisfaction - A loyalty to a chosen profession and no intention to change it

Cochlear dimensions and cochlear implant electrode insertion resistance

Introduction: Size variations of cochlea are common in patient populations. One of the goals of cochlear implantation could be full-length insertion, which may benefit patient hearing outcomes. Our objective is to measure cochlear size and evaluate its effect on full-length electrode insertion resistance.Methods: Multiplanar reconstructions of high resolution CT defined by specific criteria were used to perform measurements: cochlear basal length and width, basal turn lumen diameter. All patients implanted with 31,5mm FlexSoft (MedEl) electrode array were included. Implantations were performed in a single tertiary referral center by single surgeon between 2011 and 2016. Electrode insertion resistance was measured using determined criteria.Results: 111 cochlear implantations were performed (27 bilateral). Cochlear basal length average was 8,9 (7,9-10,2)mm, basal width - 6,2 (5,1-7,1) mm. Basal turn diameter - 1,6 (0,8-2,8) mm. Cochlear duct length was 37,5 (33,1-42,6) mm. Correlations between cochlear dimensions were determined. No resistance was encountered during insertion of electrode array in 52,7% implantations, in 19,1% - strong resistance was observed. Data analysis showed smaller than 8,99 mm cochlear basal length was associated with encountering resistance points during cochlear electrode insertion (p=0,02).Conclusions: Though cochlea size might vary, cochlear structures retain similar ratio, which could leave small cochleae unnoticed during preoperative examination. In patients with smaller cochlear basal length, cochlear electrode insertion was associated with encountering resistance points. Measuring cochlear basal length before cochlear implantation might alert surgeon about possible difficulties inserting electrode array.Der Erstautor gibt keinen Interessenkonflikt an