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The science of respiratory characteristics in individuals with chronic low back pain: Interpreting through statistical perspective

Mohan V, Paungmali A, Sitilertpisan P

J Bodyw Mov Ther, 2018 01;22(1):11-12.
PMID: 29332732 DOI: 10.1016/j.jbmt.2017.03.017
Matched MeSH terms: Pain Measurement*
Fulltext Development of a stepping force analgesic meter for a rat arthritic model

Yam MF, Por LY, Peh KK, Ahmad M, Asmawi MZ, Ang LF, et al.

Sensors (Basel), 2011;11(5):5058-70.
PMID: 22163890 DOI: 10.3390/s110505058

Behavioural assessment of experimental pain is an essential method for analysing and measuring pain levels. Rodent models, which are widely used in behavioural tests, are often subject to external forces and stressful manipulations that cause variability of the parameters measured during the experiment. Therefore, these parameters may be inappropriate as indicators of pain. In this article, a stepping-force analgesimeter was designed to investigate the variations in the stepping force of rats in response to pain induction. The proposed apparatus incorporates new features, namely an infrared charge-coupled device (CCD) camera and a data acquisition system. The camera was able to capture the locomotion of the rats and synchronise the stepping force concurrently so that each step could be identified. Inter-day and intra-day precision and accuracy of each channel (there were a total of eight channels in the analgesimeter and each channel was connected to one load cell and one amplifier) were studied using different standard load weights. The validation studies for each channel also showed convincing results whereby intra-day and inter-day precision were less than 1% and accuracy was 99.36-100.36%. Consequently, an in vivo test was carried out using 16 rats (eight females and eight males). The rats were allowed to randomly walk across the sensor tunnel (the area that contained eight channels) and the stepping force and locomotion were recorded. A non-expert, but from a related research domain, was asked to differentiate the peaks of the front and hind paw, respectively. The results showed that of the total movement generated by the rats, 50.27 ± 3.90% in the case of the male rats and 62.20 ± 6.12% in that of the female rats had more than two peaks, a finding which does not substantiate the assumptions made in previous studies. This study also showed that there was a need to use the video display frame to distinguish between the front and hind paws in the case of 48.80 ± 4.01% of the male rats and 66.76 ± 5.35% of the female rats. Evidently the assumption held by current researchers regarding stepping force measurement is not realistic in terms of application, and as this study has shown, the use of a video display frame is essential for the identification of the front and hind paws through the peak signals.

Matched MeSH terms: Pain Measurement/instrumentation*; Pain Measurement/methods
Assessment of post-operative pain in cats: a case study on veterinary students of Universiti Putra Malaysia

Lim MY, Chen HC, Omar MA

J Vet Med Educ, 2014;41(2):197-203.
PMID: 24589865 DOI: 10.3138/jvme.0713-099R1

The ability to assess and control pain is listed as one of the desired Day One competencies among veterinary graduates. As such, a study was conducted to examine the current status and effectiveness of a video-based training module on the attitude toward and knowledge of pain assessment in cats among fourth- and final-year veterinary students of Universiti Putra Malaysia (UPM) in January of 2013. A total of 92 students participated in this study, resulting in a response rate of 60.1%. Upon completion of a pre-training survey, the respondents undertook an interactive video-based presentation, followed by a post-training survey. The majority of the students (96.7%) agreed on the importance of pain management. Before the training, many (76.1%) disagreed that they had received adequate training, while 53.3% were not confident in their pain-recognition skills. After training, their knowledge and confidence in pain assessment increased. Responses to the survey were not associated with differences in gender, level of study, or field of interest. Students were found to have mistaken some physiologic parameters as good pain indicators after ovariohysterectomy. Their assessment of three standardized video cases revealed that they could recognize prominent signs of pain but failed to identify changes in behavior that were more subtle. Refinement to the training module is required to address the above deficiencies.

Matched MeSH terms: Pain Measurement/methods*; Pain Measurement/veterinary
Fulltext Antinociceptive activity of Melicope ptelefolia ethanolic extract in experimental animals

Sulaiman MR, Mohd Padzil A, Shaari K, Khalid S, Shaik Mossadeq WM, Mohamad AS, et al.

J. Biomed. Biotechnol., 2010;2010:937642.
PMID: 21274262 DOI: 10.1155/2010/937642

Melicope ptelefolia is a medicinal herb commonly used in Malaysia to treat fever, pain, wounds, and itches. The present study was conducted to evaluate the antinociceptive activity of the Melicope ptelefolia ethanolic extract (MPEE) using animal models of nociception. The antinociceptive activity of the extract was assessed using acetic acid-induced abdominal writhing, hot-plate, and formalin-induced paw licking tests. Oral administration of MPEE produced significant dose-dependent antinociceptive effects when tested in mice and rats using acetic acid-induced abdominal constriction test and on the second phase of the formalin-induced paw licking test, respectively. It was also demonstrated that MPEE had no effect on the response latency time to the heat stimulus in the thermal model of the hot-plate test. In addition, the antinociception produced by MPEE was not blocked by naloxone. Furthermore, oral administration of MPEE did not produce any effect in motor performance of the rota-rod test and in acute toxicity study no abnormal behaviors as well as mortality were observed up to a dose level of the extract of 5 g/kg. These results indicated that MPEE at all doses investigated which did not produce any sedative and toxic effects exerted pronounce antinociceptive activity that acts peripherally in experimental animals.

Matched MeSH terms: Pain Measurement/drug effects*; Pain Measurement/methods
The application of a feasible exercise training program in the office setting

Shariat A, Lam ET, Kargarfard M, Tamrin SB, Danaee M

Work, 2017;56(3):421-428.
PMID: 28269804 DOI: 10.3233/WOR-172508

BACKGROUND: Previous research support the claim that people who work in offices and sit for a long time are particularly prone to musculoskeletal disorders.
OBJECTIVE: The main objective of this paper is to introduce an exercise training program designed to decrease muscle stiffness and pain that can be performed in the office setting.
METHODS: Forty healthy office workers (age: 28±5.3 years old; body mass: 87.2±10.2 kg; height: 1.79±0.15 m) apart from suffering from any sub-clinical symptoms of muscle and joint stiffness, and who had at least two years of experience in office work were chosen and randomly assigned to either an experimental group (n = 20) or a control group (n = 20). The experimental group performed the exercise training program three times a week for 11 weeks. The Cornell Musculoskeletal Discomfort Questionnaire was used to measure the pain levels in the neck, shoulders, and lower back areas. The Borg CR-10 Scale was used to measure their perceived exertion when doing the exercises, and a goniometer was used to measure the changes in range of motion (ROM) of the neck, hips, knees, and shoulders.
RESULTS: The overall results indicated that the exercise program could significantly (p pains of the participants in the exercise group while those in the control group showed no improvement in those pains. There were significant (p pains, but also can improve the ROM or flexibility of the office workers.

Matched MeSH terms: Pain Measurement/instrumentation; Pain Measurement/methods
Fulltext Pain management: trends and challenges

Cardosa MS

Med. J. Malaysia, 2006 Jun;61(2):139-41.
PMID: 16898301

Pain remains as one of the most common reasons for visits to a doctor. The paper by Zalinawati et all published in this issue of the Journal confirmed this in two primary care settings, showing that a complaint of pain was recorded in almost a third of patients, similar to the prevalence reported in European studies.

Matched MeSH terms: Pain Measurement
Fulltext Non-Verbal Pain Assessment: A Literature Review

Che Badariah, A.A., Shamsul Kamalrujan, H.

International Medical Journal Malaysia, 2010;9(1):67-71.
MyJurnal

Pain is infl uenced by multiple factors including personal experience, psychological, sociocultural and situational factors. Failure to recognise pain will lead to poor patient management and deleterious effect on the patients wellbeing. Assessing pain in paediatric and cognitively compromised patients remains a challenge. Pain assessment in these groups of patients depends on the observers assessment and studies have shown the discrepancy between the observers assessment and patients verbal report. A specifi c and accurate tool is required to assist in the pain assessment. Although there are assessment tools available using behaviour scoring system and physiological indicators, none of the tool demonstrates its superiority than the others. Biochemical indicators such as stress hormones are frequently measured and used in con-junction with verbal reports; however they are non specifi c to pain and are increased in infl ammation, haemodynamic and emotional changes. The association between immunological indicators e.g. IL-1 , IL-6, IL- 8 and clinical pain has been shown, however; the defi nite correlation of the changes in the indicators and the level of pain is still unclear and may require further investigation.

Matched MeSH terms: Pain Measurement
Fulltext Percutaneous Endoscopic Transforaminal Lumbar Discectomy - An Early Experience

Wong, C.C., Loke, W.P.

Malays Orthop J, 2007;1(1):1-4.
MyJurnal

Percutaneous endoscopic spinal surgery performed in the awake state offers a new paradigm for treatment of symptomatic lumbar disc prolapse. We report the outcome of 23 patients who underwent this procedure. Visual analogue scale for pain improved from 7.3 to 2.1; 19 of the 23 patients achieved good to excellent results according to the MacNab criteria. Patient acceptance of the procedure was 91.3%. All but one patient were discharged from hospital within 24 hours. One patient developed foot drop post-operatively. There was no incidence of dural tear, post-operative infection or worsening of symptoms. We conclude that this is a safe, effective, and well-tolerated procedure.

Matched MeSH terms: Pain Measurement
Fulltext Outpatient pre-operative assessment in joint replacement surgery

Chan CY, Nam HY, Raveenthiran R, Choon SK, Tai CC

Med. J. Malaysia, 2008 Jun;63(2):100-3.
PMID: 18942292 MyJurnal

An anaesthetist-led outpatient pre-operative assessment (OPA) clinic was introduced in our unit in an effort to improve patient care and cost-effectiveness. To assess the efficiency of the clinic, 112 patients who attended the OPA clinic (attendance rate 98%) during the first year were assessed prospectively and compared with 118 patients who did not undergo OPA the year before. There were fewer cancellations among those who attended the OPA clinic (13.6% compared to 3.6%), and the hospital stay was shortened from an average of 10.7 days to 7.0 days. This has resulted in more efficient utilization of operating theatre, reduced hospital costs and improved patient satisfaction. More extensive use of the pre-admission clinic is recommended and should be explored in other clinical settings.

Matched MeSH terms: Pain Measurement
Fulltext Analgesic efficacy of transversus abdominis plane block in neonates and early infants for colostomy and reversal of colostomy

Chen CK, Teo SC, Phui VE, Saman MA

Agri, 2015;27(4):210-4.
PMID: 26860495 DOI: 10.5505/agri.2015.66487

The application of ultrasound-guided transversus abdominis plane (TAP) block in paediatric population is gaining popularity among anaesthetists. We present a case series of ultrasound-guided TAP block in ten neonate and infants undergoing colostomy and reversal of stoma. Classical TAP as described by Hebbard was carried out and a maximum dosage of 1ml/kg of 0.25% levobupivacaine was injected. Pain score was assessed using Neonatal Infant Pain Scale for 24 hours. In all patients, the block was successful with minimal hemodynamic changes intraoperatively and no additional systemic analgesia was needed intraoperative and immediate postoperatively. Ultrasound-guided TAP block has an important role in providing safe and effective analgesia for colostomy creation and reversal of stoma surgeries in paediatric population.

Matched MeSH terms: Pain Measurement/methods
The Assessment of Acute Pain in Pre-Hospital Care Using Verbal Numerical Rating and Visual Analogue Scales

Ismail AK, Abdul Ghafar MA, Shamsuddin NS, Roslan NA, Kaharuddin H, Nik Muhamad NA

J Emerg Med, 2015 Sep;49(3):287-93.
PMID: 26022936 DOI: 10.1016/j.jemermed.2015.02.043

Prehospital care (PHC) pain evaluation is an essential patient assessment to be performed by paramedics. Pain intensity is frequently assessed using Verbal Numerical Rating Scale (VNRS) or Visual Analog Scale (VAS).

Matched MeSH terms: Pain Measurement/methods*
Validation of electrical impedance tomography qualitative and quantitative values and comparison of the numeric pain distress score against mammography

Juliana N, Shahar S, Chelliah KK, Ghazali AR, Osman F, Sahar MA

Asian Pac. J. Cancer Prev., 2014;15(14):5759-65.
PMID: 25081698

Electrical impedance tomography (EIT) is a potential supplement for mammogram screening. This study aimed to evaluate and feasibility of EIT as opposed to mammography and to determine pain perception with both imaging methods. Women undergoing screening mammography at the Radiology Department of National University of Malaysia Medical Centre were randomly selected for EIT imaging. All women were requested to give a pain score after each imaging session. Two independent raters were chosen to define the image findings of EIT. A total of 164 women in the age range from 40 to 65-year-old participated and were divided into two groups; normal and abnormal. EIT sensitivity and specificity for rater 1 were 69.4% and 63.3, whereas for rater 2 they were 55.3% and 57.0% respectively. The reliability for each rater ranged between good to very good (p<0.05). Quantitative values of EIT showed there were significant differences in all values between groups (ANCOVA, p<0.05). Interestingly, EIT scored a median pain score of 1.51±0.75 whereas mammography scored 4.15±0.87 (Mann Whitney U test, p<0.05). From these quantitative values, EIT has the potential as a health discriminating index. Its ability to replace image findings from mammography needs further investigation.

Matched MeSH terms: Pain Measurement*
Validation of the Malay Brief Pain Inventory questionnaire to measure cancer pain

Aisyaturridha A, Naing L, Nizar AJ

J Pain Symptom Manage, 2006 Jan;31(1):13-21.
PMID: 16442478

The original version of the Brief Pain Inventory (BPI) was translated into a Malay version by the standard procedure and was then evaluated for its psychometric properties. Of 119 eligible patients, a total of 113 (95%) agreed to participate in this study. Ages ranged from 18 to 76 years and interviews were conducted between August, 2004 and November, 2004. The pain intensity items demonstrated high loading with one factor, whereas the pain interference items were loaded on another factor. Two factors explained 62% of the variance. Compared to the Karnofsky Performance Scale, the pain intensity scales had a moderate negative (Pearson's) correlation (-0.520, P < 0.001) and the pain interference scales had a high negative correlation (-0.732, P < 0.001), showing good concurrent validity. The coefficient alpha of both subscales demonstrated good internal consistency of the items. The intraclass correlation coefficient for the test-retest stability was 0.61 for the pain intensity scale and 0.88 for the pain interference scale. The Malay version of the BPI is a reliable and valid instrument for cancer pain assessment and is comparable with the original version of the BPI in terms of structure and psychometric properties.

Matched MeSH terms: Pain Measurement/methods*
Documenting pain as the fifth vital sign: a feasibility study in an oncology ward in Sarawak, Malaysia

Devi BCR, Tang TS

Oncology, 2008;74 Suppl 1:35-9.
PMID: 18758195 DOI: 10.1159/000143216

BACKGROUND: Monitoring acute postoperative pain as the fifth vital sign is currently practiced in many developed countries. In Sarawak, pain is an important symptom as 70% of cancer patients present with advanced disease. As the existing validated pain assessment tools were found to be difficult to use, we studied the feasibility of modifying the use of a pain assessment tool, consisting of the short form of the Brief Pain Inventory and the Wong-Baker Faces Scale.
METHOD: This tool was used to document pain in all 169 patients who were admitted for pain control to the oncology ward between July 2000 and June 2001. Nurses were trained in the use of the modified scale before the start of the study.
RESULTS: The method was easy to use, and the mean number of days to reduce pain was found to be 3.1 days (SD: 2.9; median: 2 days; range: 1-31 days). At discharge, none in the group with initially mild pain had pain, and the severity of pain for 98% of patients with moderate pain and 61% with severe pain was downgraded to mild pain.
CONCLUSION: The staff found that the tool allowed continuous pain assessment in an objective manner.

Matched MeSH terms: Pain Measurement/methods*
Fulltext Subcutaneous administration of tramadol after elective surgery is as effective as intravenous administration in relieving acute pain and inflammation in dogs

Buhari S, Hashim K, Yong Meng G, Mustapha NM, Gan SH

ScientificWorldJournal, 2012;2012:564939.
PMID: 22778699 DOI: 10.1100/2012/564939

Subcutaneous (SC) administration of tramadol was compared with intravenous (IV) administration to evaluate analgesia following canine ovariohysterectomy (OHE). Healthy female dogs (n = 12) between 1 and 3 years of age (1.95 ± 0.65 years), weighing between 10.5 and 17.1 kg (13.12 ± 1.95 kg), were used. Pain was assessed at baseline before surgery and then hourly for 8 hr after surgery. Tramadol was administered both SC and IV at a dose of 3 mg/kg and provided significant postoperative analgesia, as indicated by analgesiometry, β-endorphin levels, and interleukin 6 (IL-6) levels. The respiratory rates and rectal temperatures remained normal and were not significantly different between or within the groups. A significant increase in heart rate was observed at 4 hr for dogs in both groups relative to the baseline, but there was no significant difference in heart rates between the groups at any time point. A significant decrease in mechanical pain threshold was observed within each group after surgery, but both groups responded similarly, suggesting that SC administration of tramadol is as effective as IV administration. Increased serum levels of both IL-6 and β-endorphin 3 hr postoperatively further indicate that both routes of administration achieve similar pain control. Thus, the relative analgesic efficacy of SC tramadol is comparable to that of IV administration and can be used to achieve similar effects for postsurgical pain management in dogs undergoing OHE.

Matched MeSH terms: Pain Measurement/drug effects; Pain Measurement/veterinary
The effects of L-arginine, D-arginine, L-name and methylene blue on channa striatus-induced peripheral antinociception in mice

Zakaria ZA, Sulaiman MR, Somchit MN, Jais AM, Ali DI

J Pharm Pharm Sci, 2005;8(2):199-206.
PMID: 16124931

To determine the involvement of nitric oxide/cyclic guanosine monophosphate (NO/cGMP) pathway in aqueous supernatant of haruan (Channa striatus) fillet (ASH) antinociception using the acetic acid-induced abdominal constriction test.

Matched MeSH terms: Pain Measurement/drug effects*; Pain Measurement/methods
Chronic pain, impact of pain and pain severity with physical disability in older people--is there a gender difference?

Hairi NN, Cumming RG, Blyth FM, Naganathan V

Maturitas, 2013 Jan;74(1):68-73.
PMID: 23103063 DOI: 10.1016/j.maturitas.2012.10.001

To establish if there is any gender difference in associations between chronic pain, impact of pain and pain severity with physical disability.

Matched MeSH terms: Pain Measurement
Fulltext Periprostatic lidocaine infiltration versus transrectal lidocaine gel for local anaesthesia in transrectal ultrasound guided prostate biopsy

Goh, E.H., Christopher, C.K.H., Praveen, S., Zulkifli, M.Z.

Journal of Surgical Academia, 2011;1(1):35-38.
MyJurnal

Management of pain plays an important role during prostate biopsy. Various types of management of pain plays an important role during prostate biopsy. Various types of anaesthetic methods have been used. The present study aimed to compare the efficacy and complication rate between periprostatic lidocaine infiltration and transrectal lidocaine gel in transrectal ultrasound guided prostate biopsy. All prostate biopsy patients were included except those with lidocaine, allergy, haemorrhagic diathesis, anticoagulation therapy, the inability to rate a visual analogue scale and inability to obtain consent. They were randomized into two groups. Group 1 received 20ml 2% transrectal lidocaine gel. Group 2 received 5ml 1% lidocaine infiltration for each periprostatic nerve block with 23-gauge spinal needle. After three minutes, prostate biopsy was performed with an 18 gauge 7-inch spring-loaded biopsy gun. Six biopsies were taken for each lobe. Pain during probe insertion, biopsy and immediately after the procedure was assessed using the Visual Analogue Scale. Any complication immediately after procedure, one day or after one week, was recorded. Mean pain score was lower after periprostatic lidocaine infiltration compared to transrectal lidocaine gel (3.1 + 1.9 versus 4.9 + 2.4, p = 0.027). There was no statistically significant difference in the complication rate. Transrectal ultrasound prostate biopsy using periprostatic lidocaine infiltration provides better anaesthesia as compared to the transrectal lidocaine gel application with no significant difference in complication. Thus, the use of periprostatic lidocaine infiltration in TRUS guided prostate biopsy is recommended.

Matched MeSH terms: Pain Measurement
Fulltext Superior somatic pain relief and improved visceral pain control is achieved using pre-emptive analgesia for laparoscopic cholecystectomy: a randomized controlled trial

Koh, P.S., Cha, K.H., Lucy, C., Rampal, S., Yoong, B.K.

JUMMEC, 2012;15(2):1-7.
MyJurnal

BACKGROUND:
Laparoscopic cholecystectomy, although is less invasive than open surgery, is not completely pain free. The use of local anaesthesia to relieve pain following this procedure is a common practice. However, it remains debatable whether a pre- or post-operative drug administration is more effective. Here, we investigated the role of preemptive local anaesthetic infiltration given pre- or post-incisional, in relieving the pain during laparoscopic surgery.

METHODOLOGY:
A randomized controlled trial was conducted with 96 patients receiving 0.5% Bupivacaine 100mg. Group A (n=48) received post-incisional skin infiltration whilst Group B (n=48) received pre-incisional infiltration. Incisional (somatic) and intra-abdominal (visceral) pain was assessed using Visual Analog Scale (VAS) at day 0, day 1 and day 7 post-operative days.

RESULT:
Baseline characteristics between the two groups were similar. Incisional pain was lower in Group B as compared to Group A at day 0 (P=0.03) and day 1 (P0.05).

CONCLUSION:
Administration of pre-incisional local anaesthesia offers better pre-emptive pain relief measure than post-incisional administration by reducing somatic and visceral pain in laparoscopic gall bladder surgery.

Matched MeSH terms: Pain Measurement
Fulltext The impact of dry needling on patients with neck pain in a tertiary hospital

Ho, S.E., Loong, S., Fatin Nur Laily R., Wan Nur Aizzati M., Muhammad Firdaus I.Z., Ho, Christopher C.K., et al.

Journal of Surgical Academia, 2015;5(1):44-50.
MyJurnal

Neck pain presents as a symptom of dull pain or discomfort mainly along the trapezius muscle. Dry needling is an invasive procedure which uses acupuncture needle directed at myofascial trigger points. The aim of the study was to evaluate the effectiveness of dry needling in managing patients with neck pain. A pre-test-post-test interventional study design was used. Patient education package was provided to 32 respondents who fulfilled the inclusion criteria. A 13-item Pain Catastrophizing Scale (PCS) questionnaire was used to assess Rumination, Magnification and Helplessness. Subjective pain intensity was measured by Visual Analogue Scale (VAS). These questionnaires were given before and after the dry needling intervention. The findings reported that respondents scored high in pre-test total PCS score (27.41±13.652). Post-test result revealed a significant improvement in total PCS score (23.06±13.938) (p = 0.000). Post-test VAS score (4.78±1.237) was also significantly better than pre-test (6.47±1.414) (p = 0.000). There was no significant difference in pre-test PCS in terms of marital status (p > 0.05) whereas there was significant difference between marital status and rumination in post-test (Z = -2.303, p = 0.021). There was significant difference between pre-test magnification in terms of respondents’ occupation (p = 0.008) and race (p = 0.035) but no significant difference in post-test. Respondents’ age group showed no significant differences between pre-test and post-test PCS and VAS (p > 0.05). In conclusion, patients who received dry needling showed improvement in pain intensity and catastrophizing towards neck pain.

Matched MeSH terms: Pain Measurement

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