Medicine and Health Sciences Commons^™

A Literature Review Of Pain Control In Osteoarthritis Patients Using Blood Flow Restriction Training, John Gericke, Dakota Pastore, Tyler Pigott

Rowan-Virtua Research Day

Background: Osteoarthritis (OA) is a degenerative disease that mainly affects articular cartilage of joints. OA most commonly affects the knees and causes pain and reduces quality of life in older adults. Blood flow restriction (BFR) occludes arterial and venous flow during exercise using a blood pressure cuff placed on the proximal lower limb. This creates an intramuscular hypoxic environment which promotes muscle hypertrophy. High load training can cause pain and inflammation in knee OA patients due to increased stress. BFR can allow patients with knee OA to use lower loads to achieve beneficial effects of rehabilitation.

Methods: Data was ascertained …

Development And Validation Of The Pain Resilience And Optimism Scale (Pros), Wonjin Seo

Electronic Thesis and Dissertation Repository

Numerous self-report questionnaires have been used in pain research to explore patients' experiences. However, these questionnaires often employ negatively worded items that can potentially worsen patients' distress. In response to the emergence of positive psychology, this thesis aimed to develop a new questionnaire that adopts a positive and strengths-focused approach, incorporating resilience, to replace the negative items found in existing tools such as the Pain Catastrophizing Scale (PCS). First, the effectiveness of the Connor-Davidson Resilience Scale (CD-RISC) in measuring resilience following trauma was assessed through a systematic review using the COnsensus-based Standards for the selection of health status Measurement INstruments …

Is There A Relationship Between Lived Discrimination And Chronic Pain? - A Pilot Study, Jordan Taylor Kasube Spt, Erin P. O'Neill Spt, Sean White Spt, Karin Steere Dpt, Phd

Physical Therapy Research Symposium

Background: The complexity of the human experience of pain involves myriad biological, psychological, and social factors, each contributing uniquely to the overall experience. Recent literature illustrates the impact of social determinants on health outcomes, including an association between chronic pain and lived-discrimination. Heart rate variability (HRV) is used as a measure of systemic health, with diminished HRV often accompanying chronic pain.

Purpose: The primary aim of this study is to provide a pilot feasibility protocol to investigate the relationship between lived discrimination and HRV across the spectrum of pain duration.

Methods: HRV data was collected from 39 participants while seated …

The Multidimensional Symptom Index: User Manual And Questionnaire, David Walton

Physical Therapy Publications

The user manual for the MultiDimensional Symptom Index, including hard copy versions in both English and Canadian French translations.

Click here for a direct link to an online interactive version of the MSI: dwalton5.pythonanywhere.com

Pain Catastrophizing, Pain Intensity And Perceived Injustice Do Not Predict Hrv In Acute Pain, Jacqueline Diulio Spt, Hailey Kettel Spt, Karin Steere Dpt, Phd

Physical Therapy Research Symposium

BACKGROUND: The nature of chronic pain conditions is well documented, with systemic biological, psychological and social factors interacting in an emergent fashion. Autonomic nervous system dysregulation, reflected as decreased heart rate variability (HRV), is suggested to be a biomarker of systemic dysfunction. Previous research has demonstrated correlations between numerous chronic pain disorders and diminished HRV.

PURPOSE: To determine the relationship between pain and HRV in the acute phase of pain, and to examine the predictive value of psychosocial variables on HRV. This study is meant to enhance our sense of how early in the pain experience decreased HRV may occur. …

Pne – Lots Of Talk, Superficial Results, Aidan Keller, Michael Ray, Taylor Baugher

Honors Projects

Objective: A narrative review (NR) of meta-analyses (MA) and systematic reviews (SR) that assess the effectiveness or efficacy of pain neuroscience education (PNE) on various outcome measures in individuals with chronic musculoskeletal (MSK) pain. Methods: This was a mixed methodology review involving systematic searches across 4 databases (PubMed, ScienceDirect, CENTRAL (Cochrane), and Google Scholar). Inclusion criteria stipulated MAs and SRs that assessed the effectiveness or efficacy of PNE on CP population. Quantitative eligibility criteria included randomized controlled trials (RCTs), adults (18+ years of age), English or Spanish speaking individuals, and reporting of chronic pain (persistent or recurrent pain lasting ≥ …

The Use Of Mobility And Medication On Patient’S Perception Of Pain In Hospitalized Patients With Chronic Back Pain Benchmark Study, Katherine E. Zaske Merenda Mrs., Katherine Merenda

MSN Capstone Projects

According to Boss & Huether, twenty-nine percent of Americans have been diagnosed with chronic low back pain (CLBP). This pain can affect every part of their lives leading to lost wages and decreased quality of life. CLBP is an issue experienced by many hospitalized patients. These patients may not be able to mitigate their pain as they normally would due to safety protocols in hospital settings. Exercise or mobility has been shown to decrease a person’s perception of pain. The importance of exercise and mobility in a hospital setting to help decrease a patient’s perception of pain needs further research. …

The Genetics Of Pain: An Exploration Of Gene-By-Environment Interactions And Their Effects On Pain, Mohamad F. Fakhereddin

Electronic Thesis and Dissertation Repository

The findings presented in this dissertation are part of the bigger SYMBIOME project which aims to use the biopsychosocial model of pain to develop a prognostic clinical phenotype for people that experience musculoskeletal (MSK) trauma. Chapter 2 presents an exploratory analysis to assess the relationships between genetic polymorphisms and pain severity and interference. Early childhood trauma was also explored as a moderator between genetic polymorphisms and pain outcomes. For pain severity, major allele carriers (A/A and G/A) of FKBP5 rs9394314 reported significantly higher scores than minor allele carriers (G/G). Further, major allele carriers who had at least one adverse childhood …

Analysis Of Zero Balancing Case Studies Through An Occupational Therapy Lens, Deanna Waggy Otr, Msa, Czb, Csla

Journal of Transformative Touch

Does Zero Balancing positively impact occupational performance? This is a question many Occupational Therapists (OTs) ask when discerning if Zero Balancing (ZB) is an evidence-based treatment modality. Case studies from the book Experiencing the Power of Zero Balancing: Case Studies of Journeys to Health and Wholeness (Quarry & King, 2016) were reviewed and compared to the Occupational Therapy domain of practice to show clear evidence that each case study had a positive impact on occupational performance. A comparison chart shows a direct link between the occupational categories and documented evidence of improved occupational performance through practitioner observation and client feedback …

Does The Application Of Kt Tape Decrease Pain In Chronic Low Back Pain?, Jordan Vitelli

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine “Does the application of KT tape decrease pain in chronic low back pain?”

Study Design: A systematic review of three randomized controlled trials (RCTs) published between 2018 and 2019.

Data Sources: The three RCTs were published in English in peer reviewed journals and obtained from PubMed. The studies were selected based on their relevance to the clinical question.

Outcome Measured: The outcome measured within all three RCTs was pain intensity using the Visual Analog Scale (VAS). The VAS scoring ranges from 0 to 10, defining 0 as no pain …

Does Dance Therapy During Active Labor Reduce Labor Pain?, Sarah E. Naber

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine “Does dance therapy during active labor decrease labor pain?”

STUDY DESIGN: A systematic review of two randomized control trials and a cohort study that were published in English between 2014 and 2020.

DATA SOURCES: Three studies were obtained from PubMed, Alt HealthWatch, and AMED. They were all published in peer-reviewed journals and chosen based on their relevance to the clinical question proposed.

OUTCOMES MEASURED: The main outcome measured in all three studies is pain during active labor. Pain was measured in all studies using the visual analog scale (VAS). …

Is Transcutaneous Electrical Nerve Stimulation (Tens) An Effective Treatment For Pain Caused By Knee Osteoarthritis?, Zuhra Nassery

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not “is TENS an effective treatment for pain caused by knee osteoarthritis?”.

Study Design: A systematic review of three randomized controlled trials (RCTs) published between 2012 and 2019.

Data Sources: All RCTs were discovered utilizing PubMed. The articles were published in English in peer-reviewed journals and selected based on applicability and pertinence to the clinical question as well as the incorporation of patient-oriented outcomes.

Outcome Measured: Knee pain was the outcome measured using the Visual Analog Scale (VAS), which requires participants to draw a mark between the …

The Relationship Of Catastrophization, Pain Intensity, And Heart Rate Variability In Acute Pain - A Pilot Study, Carolyn Barbee Spt, Elizabeth A. Waddell Spt, Karin Steere Dpt

Physical Therapy Research Symposium

Background: Reduction in heart rate variability (HRV) can strongly and independently predict adverse health outcomes.Chronic pain conditions are associated with reduced HRV, and HRV may be a biomarker for predicting chronic pain.

Purpose: While pain intensity and catastrophization are associated with chronic pain,the aim of this study is to investigate their relationship with HRV in individuals with acute pain.

Methods: Fourteen subjects from two facilities participated. Data from two participants was excluded. HRV was collected while seated as participants completed an iPad survey. Raw inter-beat interval (IBI) data was analyzed with Kubios software.

Results: Multiple regression analyses were …

A Transformative Journey: The Lived Experience Of Healthcare Learners Participating In Pain Management Education, Zoe A. Leyland

Electronic Thesis and Dissertation Repository

There is little emphasis on pain management education for healthcare providers. In September 2019, the Master of Clinical Science (MClSc) program in Advanced Healthcare Practice at Western University in London, Ontario introduced a new, “Interprofessional Pain Management” (IPM) field. The program follows a competency-based framework, and the learners are all practicing healthcare providers with a special interest in pain. Part of the purpose of this thesis is to describe the process of development and implementation. The objective is to provide educators and healthcare providers an in-depth look at how the pain education is experienced. This includes exploring the lived experience …

Development Of A Low-Cost Algometer, Thomas D. Naish, Ana Luisa Trejos, Dave M. Walton

Undergraduate Student Research Internships Conference

Many people suffer from chronic pain, the reasons for which are not always well understood. Algometers are instruments that can help clinicians understand the nature of pain by determining the force at which pain becomes noticeable or unbearable. Algometers can also be used to determine the effects that external influences can have on pain tolerance in healthy people.

The goal of this project was to develop an algometer that can measure the normal range of pain thresholds and tolerances of most patients, which ranges up to 35 lbs. Also, the result needed to be accurate to about 1% and made …

Creation Of A Virtual Interface For Stress-Trauma Investigations Through Open World Navigation: An Exploration Of Tolerability And Physiological Reactions, Michael J. Lukacs

Electronic Thesis and Dissertation Repository

It is estimated that as many as 50% of people suffering from Whiplash Associated Disorders (WAD) may experience chronic alterations of their activities of daily living as much as 1-year post injury. Despite their burden, there is little to evidence to suggest why some people may be more likely to acquire WAD or develop chronic symptomology. Additionally, the link between biomechanical forces at the time of impact and symptom development or recovery is poor. As a result, interest in alternative theories such as stress system reactivity have received interest in recent literature, but empirical methods to test them has been …

Do People With Acute Low Back Pain Have An Attentional Bias To Threat-Related Words?, Ian Skinner, Markus Hubscher, Hopin Lee, Adrian C. Traeger, G. Lorimer Moseley, Benedict M. Wand, Sylvia M. Gustin, James H. Mcauley

Physiotherapy Papers and Journal Articles

Objectives: It has been hypothesised that attentional bias to environmental threats can contribute to persistent pain. It is unclear whether people with acute low back pain (LBP) have an attentional bias to environmental threats. We investigated if attentional bias of threat related words is different in people with acute LBP and pain-free controls.

Methods: People with acute LBP and pain-free people completed a free viewing eye tracking task. Participants were simultaneously presented with two words, a threat related word and a neutral control word. Threat related words were general threat, affective pain and sensory pain. We conducted linear mixed models …

Pattern Of Recovery And Outcomes Of Patient Reported Physical Function And Pain Interference After Ankle Fusion: A Retrospective Cohort Study, Jessica M. Kohring, Jeff Houck, Irvin Oh, Adolf S. Flemister, John P. Keptz, Judith F. Baumhauer

Faculty Publications - College of Physical Therapy

Background: Research on outcomes after ankle fusion focuses on basic activities of daily living, fusion rates, and gait parameters. Little has been reported on the patient’s perspective after surgery. The purpose of this study was to determine the change in patient reported physical function and pain interference after ankle fusion surgery to guide patient expectations and improve provider communication.

Methods: This was a retrospective review of prospectively collected patient reported outcome measurement information system (PROMIS) data in 88 ankle arthrodesis procedures performed from May 2015 to March 2018. The PROMIS Physical function (PF) and pain interference (PI) measures were collected …

The Symbiome Project: An Exploratory Investigation Of The Biological, Psychological, And Social Mechanisms That Contribute To The Transition From Acute To Chronic Musculoskeletal Pain, Joshua Y. Lee

Electronic Thesis and Dissertation Repository

This dissertation presents the initial findings of the SYMBIOME project; which attempts to combine the objective and subjective aspects of musculoskeletal pain to develop a prognostic clinical phenotype. Chapter 2 presents a moderator analysis of functional outcomes (pain interference and pain severity). Psychosocial moderators can affect the relationship between biomarkers and pain. For pain severity, TNF-α, TGF-β1, and CRP were moderated by employment status, pre-existing psychopathology, and sex. For pain interference, IL-1β, cortisol, TGF-β1, CRP, and IL-6 were moderated by pre-existing pain, peri-traumatic fear, region of injury, and peri-traumatic stress. Chapter 3 presents a latent growth curve analysis in determining …

Giving Credence To The Experience Of X-Linked Hypophosphatemia In Adulthood: An Interprofessional Mixed-Methods Study, Melissa Hughes, Carolyn Macica, Catherine Meriano, Maya Doyle

Journal of Patient-Centered Research and Reviews

Purpose: X-linked hypophosphatemia (XLH) is a rare X-linked dominant metabolic bone disease, often diagnosed in childhood but causing increasing physical debilitation and pain in adulthood. Physical comorbidities of XLH in adulthood include pervasive and early-onset degenerative arthritis, mineralizing enthesophytes and osteophytes, osteomalacia and pseudofracture, dental abscesses, and hearing loss.

Methods: This mixed-methods analysis included physical findings, diagnostic imaging, occupational and physical therapy assessments, and semi-structured interviews by social work to understand the functional outcomes and lived experience of XLH in adulthood, through connections between qualitative data obtained by social work and occupational therapy with the quantitative findings from other disciplines. …

Treatment Of Phantom Limb Pain And Knee Flexion Contracture Due To Transtibial Amputation: A Case Study, Kristin Smead, Donna Leigel

Miami, Fall 2019

This case study evaluated the effectiveness of a combination of visual mirror therapy for phantom limb pain desensitization in conjunction with a physical therapy regimen of therapeutic exercise, short-wave diathermy, and gait training in a 66-year-old male with left lower extremity amputation.

Through a combination of mirror therapy, short-wave diathermy over the hamstring musculature, and therapeutic exercise, the patient displayed an overall improvement in left lower limb knee flexion contracture and a reduction in perceived phantom limb pain.The patient can now tolerate full weight bearing through this extremity from an improved fit of the prosthesis socket. Throughout the course of …

Latent Effects Of Stress On Delayed Modulation Of Chronic Low Back Pain: Case Series, Roger Allen Phd, Pt, Anna Chang Spt, Catherine Mooney-Myers Spt, Lauren Gallison

Physical Therapy Research Symposium

Purpose: The purpose of the study was to investigate the temporal relationship between psychogenic stress and perceived intensity of chronic low back pain (LBP). LBP was chosen as a pilot condition prefacing a larger research effort to determine which variants of chronic pain may manifest latent psychogenic modulation based on previous studies of neuropathic pain conditions.

Methods: The study consisted of five subjects, one male and four females, ranging from 19-32 years old and chronicity of pain ranging from 5 months to 6+ years since diagnosis. Over 12-15 weeks, participants completed daily visual analog pain, stress, and pain-related function scales. …

Quantifying The Outcomes Of A Virtual Reality (Vr)-Based Gamified Neck Rehabilitation, Shahan Salim

Electronic Thesis and Dissertation Repository

Neck pain is a major global public health concern and adds a significant financial burden to both the healthcare system as well as people suffering from it. Additionally, it presents measurement and evaluation challenges for clinicians as well as adherence challenges and treatment barriers for the patients. We have developed a virtual reality (VR)-based video game that can be used to capture outcomes that may aid in the assessment and treatment of neck pain. We investigated: (i) performance metrics of overall accuracy, accuracy based on movement difficulty, duration, and total envelope of movement; (ii) stability across sessions; (iii) accuracy across …

Caring For Children With Severe Cerebral Palsy: The Lived Experience Of Parents, Jason Eric Cook

Department of Physical Therapy Student Theses, Dissertations and Capstones

The purpose of this study is to explore the lived experience of parents who care for their child withcerebral palsy who function at Gross Motor Function Classification System (GMFCS) Level V. Additionally, the study also explores the parent’s understandings and beliefs about pain and non-pain related emotional distress, and the meaning of caring, providing care, and providing comfort for their child with GMFCS Level V cerebral palsy. The study was conducted using a qualitative, hermeneutic phenomenology approach with semi-structured interviews and participant-initiated journaling. The study included 11 participants who are caregiving parents of their child with GMFCS Level V cerebral …

Promis Pain Interference Is Superior Vs Numeric Pain Rating Scale For Pain Assessment In Foot And Ankle Patients, David N. Bernstein, Meghan Kelly, Jeff Houck, John P. Ketz, Samuel Flemister, Benedict F. Digiovanni, Judith F. Baumhauer, Irvin Oh

Faculty Publications - College of Physical Therapy

Background: The Numeric Pain Rating Scale (NPRS) is a popular method to assess pain. Recently, the Patient-Reported Outcomes Measurement Information System (PROMIS) has been suggested to be more accurate in measuring pain. This study aimed to compare NPRS and PROMIS Pain Interference (PI) scores in a population of foot and ankle patients to determine which method demonstrated a stronger correlation with preoperative and postoperative function, as measured by PROMIS Physical Function (PF).

Methods: Prospective PROMIS PF and PI and NPRS data were obtained for 8 common elective foot and ankle surgical procedures. Data were collected preoperatively and postoperatively at a …

Systemic Exercise-Induced Hypoalgesia Following Isometric Exercise Reduces Conditioned Pain Modulation, Ali Alsouhibani, Henrik Bjarke Vaegter, Marie K. Hoeger Bement

Physical Therapy Faculty Research and Publications

Objective

Physically active individuals show greater conditioned pain modulation (CPM) compared with less active individuals. Understanding the effects of acute exercise on CPM may allow for a more targeted use of exercise in the management of pain. This study investigated the effects of acute isometric exercise on CPM. In addition, the between-session and within-session reliability of CPM was investigated.

Design

Experimental, randomized crossover study.

Setting

Laboratory at Marquette University.

Subjects

Thirty healthy adults (19.3±1.5 years, 15 males).

Methods

Subjects underwent CPM testing before and after isometric exercise (knee extension, 30% maximum voluntary contraction for three minutes) and quiet rest in …

Validation And Generalizability Of Preoperative Promis Scores To Predict Postoperative Success In Foot And Ankle Patients, Michael R. Anderson, Jeff Houck, Charles L. Saltzman, Man Hung, Florian Nickisch, Alexej Barg, Timothy Beals, Judith F. Baumhauer

Faculty Publications - College of Physical Therapy

Background: A recent publication reported preoperative Patient-Reported Outcomes Measurement Instrumentation System (PROMIS) scores to be highly predictive in identifying patients who would and would not benefit from foot and ankle surgery. Their applicability to other patient populations is unknown. The aim of this study was to assess the validation and generalizability of previously published preoperative PROMIS physical function (PF) and pain interference (PI) threshold t scores as predictors of postoperative clinically meaningful improvement in foot and ankle patients from a geographically unique patient population.

Methods: Prospective PROMIS PF and PI scores of consecutive patient visits to a tertiary foot and …

The Effect Of Asymmetry On Pregnancy-Related Pain In The Postpartum Period, Krista G. Meder

Graduate Theses, Dissertations, and Problem Reports

Nearly 50% of women experience back pain and other lower extremity pain during pregnancy, with many reporting lasting pain postpartum. Pregnant women experience changes to their pelvis and lower extremities that do not always return to pre-pregnancy baseline. Not much is known of the lingering effects of pregnancy related asymmetry and its relationship to pain. Therefore, the purpose of this study was to assess asymmetries of the pelvis and lower extremities to determine whether malalignment is related to areas of pain at the low back, hip, thigh, knee, leg, and foot/ankle. Methods: Seventeen postpartum women and seven nulliparous controls were …

Effects Of Lower Extremity Aerobic Exercise And Conditioned Pain Modulation On Evoked Shoulder Pain, Logan Lumpkins, Craig Wassinger

Undergraduate Honors Theses

Background: Emerging evidence suggests that aerobic exercise and conditioned pain modulation may be advocated in treating patients with musculoskeletal pain. The effects of lower extremity aerobic exercise and conditioned pain modulation on evoked shoulder pain are not known.

Purpose: To determine the acute effects of lower extremity aerobic exercise and conditioned pain modulation on outcomes of evoked shoulder pain from pain pressure threshold measurements.

Study Design: Repeated measures.

Methods: Thirty (30) healthy volunteers were tested over the course of two sessions. Session 1 consisted of collecting pain pressure threshold measurements over the infraspinatus before and immediately following a conditioned pain …

The Effect Of High Baseline Pain On Impairment Outcomes One Year After Distal Radius Fracture, Farrukh Riaz

Electronic Thesis and Dissertation Repository

Objective

The purpose of this study is to evaluate whether high baseline pain predicts impairment outcomes in grip strength or wrist range of motion (ROM) at one year after a distal radius fracture (DRF). Impairments occur for less than 15% of patients.

Methods:

In this cohort study patients with a DRF were recruited from a hand clinic in London, Ontario. This data was collected at two evaluation time points: at baseline (within the first 10 days after fracture) and at one year after fracture. Baseline pain was assessed using the pain subscale of the Patient-Rated Wrist Evaluation (PRWE) and classified …