Musculoskeletal pain is common. Because pain is subjective, objectively describing it is crucial. However, pain assessment may cause distress in patients;therefore, physical therapists (PTs) should conduct these tests...Musculoskeletal pain is common. Because pain is subjective, objectively describing it is crucial. However, pain assessment may cause distress in patients;therefore, physical therapists (PTs) should conduct these tests quickly and accurately. Simple and clear instructions are recommended for pain assessment. However, few studies have provided evidence to support this hypothesis. Correspondingly, this study aimed to confirm the effectiveness of specific verbal instructions for pain location during five consecutive Passive Straight Leg Raise (PSLR) tests. The 28 asymptomatic participants (age 27.4 ± 9.6 years) who provided informed consent received five consecutive PSLR tests: three without and two with specific verbal instructions to ascertain pain intensity, quality, and location. The participants drew pain locations on a body chart and described the pain intensity and quality after each test. All participants were interviewed regarding the differences they noted in the presence and absence of specific verbal instructions. Each pain location was classified into one of ten areas for statistical analysis. The proportion of participants who changed the pain location was compared between the tests using McNemar’s test, and the kappa coefficient was confirmed for consistency of pain location. There was a significant difference in the proportion of participants who changed their pain location between the second and third tests and from the third to the fourth test (McNemar’s test: p = 0.003). Kappa coefficients had low consistency (κ = 0.28) just after receiving the specific verbal instructions in the fourth test compared to the third test. Consistency improved in the fifth test (κ = 0.57);93% of the participants answered that the pain location had become clearer. This study revealed the effects of specific verbal instructions in identifying pain locations. This detailed information may help PTs provide appropriate treatment and contribute to reducing pain in clinical settings.展开更多
The most prevalent issue in physical therapy is pain. Due to the subjective nature of pain, assessment tools are essential in understanding it as objective data. However, assessment of pain may result in distress for ...The most prevalent issue in physical therapy is pain. Due to the subjective nature of pain, assessment tools are essential in understanding it as objective data. However, assessment of pain may result in distress for the patient. A physical therapist (PT) should conduct these tests as quickly and accurately as possible. Straightforward instructions are vital in such cases. This study aimed to clarify the effect of verbal instructions for pain assessment during a passive straight leg raise (PSLR) test for participants with chronic low back pain (CLBP). This study included 22 participants who provided informed consent and received three consecutive PSLR tests with measurement of the hip flexion range of motion (HFROM) and were instructed to cease the test at submaximal pain before the first test. Following the second and third tests, participants were given specific verbal instructions to remember pain intensity, quality, and location. After each test, participants were to circle the pain location on the body chart and rate their pain intensity on a numeric rating scale (NRS) and pain quality. All participants were then interviewed about the differences between having and not having specific verbal instructions. The results of HFROM, NRS, and pain extent were not significantly different between the first and second tests or between the second and third tests using a paired t-test. Eleven changes in pain location were found in the second test compared to those in the first test. In the third test, only three participants circled a different area than in the second test. Ten participants showed similar changes with pain location in pain quality in the three PSLR tests. This study revealed the effect of specific verbal instructions prior to PSLR tests. Particularly, participants could notice exact pain location. Our findings may help PT to understand pain cause and reduce patients’ stress during pain assessment in clinical settings.展开更多
Purpose: Anxiety disorders are frequently associated with chronic stress with possible cognitive consequences. The aim of this study was to determine the verbal fluency performance in a cohort of patients with anxiety...Purpose: Anxiety disorders are frequently associated with chronic stress with possible cognitive consequences. The aim of this study was to determine the verbal fluency performance in a cohort of patients with anxiety disorders and allostatic load, treated with alprazolam during 12 weeks. Methods: Patients with GAD (general anxiety disorders, DSM IV), with >6 in Hamilton Anxiety Rating Scale (HAM-A), neuroticism > 18 (NEO-FFI inventory), and normal Mini-Mental State Examination were included. Clinical and Psychiatric examination, Allostatic Load Index and cognitive assessment were analyzed before and after 12 weeks of treatment. The phonemic and semantic verbal fluency tests were determined in all patients. The scoring for each fluency task was determined by counting the number of correct words. The total score from each semantic and phonemic verbal task was analyzed comparing the individual score with normal data controlled by age and sex. Patients with scores > ?2 standard deviation (SD) from normative data were considered impaired. Results: Fifty-four patients completed the semantic verbal fluency test before treatment and fifty patients completed after treatment. According to the z-scores before treatment 7 patients of 54 (12.9%) had verbal fluency impairments. After treatment none patients showed semantic verbal fluency deficits but 3 patients of 50 (6%) showed phonemic impairments. Impaired group was significantly associated with an older age before treatment (p = 0.033) and with a similar tendency but not significant (p = 0.09) after treatment (Student t test). Conclusion: In this study older age factor was associated with verbal fluency impairment in GAD patients. Stratified treatments analyzing age and sex factors, including allostatic load measurements and cognitive assessments may be useful tools to determine the effectiveness and the safety of psychopharmacological treatments.展开更多
文摘Musculoskeletal pain is common. Because pain is subjective, objectively describing it is crucial. However, pain assessment may cause distress in patients;therefore, physical therapists (PTs) should conduct these tests quickly and accurately. Simple and clear instructions are recommended for pain assessment. However, few studies have provided evidence to support this hypothesis. Correspondingly, this study aimed to confirm the effectiveness of specific verbal instructions for pain location during five consecutive Passive Straight Leg Raise (PSLR) tests. The 28 asymptomatic participants (age 27.4 ± 9.6 years) who provided informed consent received five consecutive PSLR tests: three without and two with specific verbal instructions to ascertain pain intensity, quality, and location. The participants drew pain locations on a body chart and described the pain intensity and quality after each test. All participants were interviewed regarding the differences they noted in the presence and absence of specific verbal instructions. Each pain location was classified into one of ten areas for statistical analysis. The proportion of participants who changed the pain location was compared between the tests using McNemar’s test, and the kappa coefficient was confirmed for consistency of pain location. There was a significant difference in the proportion of participants who changed their pain location between the second and third tests and from the third to the fourth test (McNemar’s test: p = 0.003). Kappa coefficients had low consistency (κ = 0.28) just after receiving the specific verbal instructions in the fourth test compared to the third test. Consistency improved in the fifth test (κ = 0.57);93% of the participants answered that the pain location had become clearer. This study revealed the effects of specific verbal instructions in identifying pain locations. This detailed information may help PTs provide appropriate treatment and contribute to reducing pain in clinical settings.
文摘The most prevalent issue in physical therapy is pain. Due to the subjective nature of pain, assessment tools are essential in understanding it as objective data. However, assessment of pain may result in distress for the patient. A physical therapist (PT) should conduct these tests as quickly and accurately as possible. Straightforward instructions are vital in such cases. This study aimed to clarify the effect of verbal instructions for pain assessment during a passive straight leg raise (PSLR) test for participants with chronic low back pain (CLBP). This study included 22 participants who provided informed consent and received three consecutive PSLR tests with measurement of the hip flexion range of motion (HFROM) and were instructed to cease the test at submaximal pain before the first test. Following the second and third tests, participants were given specific verbal instructions to remember pain intensity, quality, and location. After each test, participants were to circle the pain location on the body chart and rate their pain intensity on a numeric rating scale (NRS) and pain quality. All participants were then interviewed about the differences between having and not having specific verbal instructions. The results of HFROM, NRS, and pain extent were not significantly different between the first and second tests or between the second and third tests using a paired t-test. Eleven changes in pain location were found in the second test compared to those in the first test. In the third test, only three participants circled a different area than in the second test. Ten participants showed similar changes with pain location in pain quality in the three PSLR tests. This study revealed the effect of specific verbal instructions prior to PSLR tests. Particularly, participants could notice exact pain location. Our findings may help PT to understand pain cause and reduce patients’ stress during pain assessment in clinical settings.
文摘Purpose: Anxiety disorders are frequently associated with chronic stress with possible cognitive consequences. The aim of this study was to determine the verbal fluency performance in a cohort of patients with anxiety disorders and allostatic load, treated with alprazolam during 12 weeks. Methods: Patients with GAD (general anxiety disorders, DSM IV), with >6 in Hamilton Anxiety Rating Scale (HAM-A), neuroticism > 18 (NEO-FFI inventory), and normal Mini-Mental State Examination were included. Clinical and Psychiatric examination, Allostatic Load Index and cognitive assessment were analyzed before and after 12 weeks of treatment. The phonemic and semantic verbal fluency tests were determined in all patients. The scoring for each fluency task was determined by counting the number of correct words. The total score from each semantic and phonemic verbal task was analyzed comparing the individual score with normal data controlled by age and sex. Patients with scores > ?2 standard deviation (SD) from normative data were considered impaired. Results: Fifty-four patients completed the semantic verbal fluency test before treatment and fifty patients completed after treatment. According to the z-scores before treatment 7 patients of 54 (12.9%) had verbal fluency impairments. After treatment none patients showed semantic verbal fluency deficits but 3 patients of 50 (6%) showed phonemic impairments. Impaired group was significantly associated with an older age before treatment (p = 0.033) and with a similar tendency but not significant (p = 0.09) after treatment (Student t test). Conclusion: In this study older age factor was associated with verbal fluency impairment in GAD patients. Stratified treatments analyzing age and sex factors, including allostatic load measurements and cognitive assessments may be useful tools to determine the effectiveness and the safety of psychopharmacological treatments.
