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Query: UMLS:C0030193 (pain)
261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The objectives were: (i) to present a method for assessing muscle pain during exercise, (ii) to provide reliability and validity data in support of the measurement tool, (iii) to test whether leg muscle pain threshold during exercise was related to a commonly used measure of pain threshold pain during test, (iv) to examine the relationship between pain and exertion ratings, (v) to test whether leg muscle pain is related to performance, and (vi) to test whether a large dose of aspirin would delay leg muscle pain threshold and/or reduce pain ratings during exercise. In study 1, seven females and seven males completed three 1-min cycling bouts at three different randomly ordered power outputs. Pain was assessed using a 10-point pain scale. High intraclass correlations (R from 0.88 to 0.98) indicated that pain intensity could be rated reliably using the scale. In study 2, 11 college-aged males (age 21.3 +/- 1.3 yr) performed a ramped (24 W.min-1) maximal cycle ergometry test. A button was depressed when leg muscle pain threshold was reached. Pain threshold occurred near 50% of maximal capacity: 50.3 (+/- 12.9% Wmax), 48.6 (+/- 14.8% VO2max), and 55.8 (+/- 12.9% RPEmax). Pain intensity ratings obtained following pain threshold were positively accelerating function of the relative exercise intensity. Volitional exhaustion was associated with pain ratings of 8.2 (+/- 2.5), a value most closely associated with the verbal anchor "very strong pain." In study 3, participants completed the same maximal exercise test as in study 2 as well as leg cycling at 60 rpm for 8 s at four randomly ordered power outputs (100, 150, 200, and 250 W) on a separate day. Pain and RPE ratings were significantly lower during the 8-s bouts compared to those obtained at the same power outputs during the maximal cycle test. The results suggest that noxious metabolites of muscle contraction play a role in leg muscle pain during exercise. In study 4, moderately active male subjects (N = 19) completed two ramped maximal cycle ergometry tests. Subjects drank a water and Kool-Aid mixture, that either was or was not (placebo) combined with a 20 mg.kg-1 dose of powdered aspirin 60 min before exercise. Paired t-tests revealed no differences between conditions for the measures of exercise intensity at pain threshold [aspirin vs placebo mean (+/- SD)]: power output: 150 (+/- 60.3 W) versus 153.5 (+/- 64.8 W); VO2: 21.3 (+/- 8.6 mL.kg-1.min-1) versus 22.1 (+/- 10.0 mL.kg-1.min-1); and RPE: 10.9 (+/- 3.1) versus 11.4 (+/- 2.9). Repeated measures ANOVA revealed no significant condition main effect or condition by trial interaction for pain responses during recovery or during exercise at 60, 70, 80, 90, and 100% of each condition's peak power output. It is concluded that the perception of leg muscle pain intensity during cycle ergometry: (i) is reliably and validly measured using the developed 10-point pain scale, (ii) covaries as a function of objective exercise stimuli such as power output, (iii) is distinct from RPE, (iv) is unrelated to performance of the type employed here, and (v) is not altered by the ingestion of 20 mg.kg-1 acetylsalicylic acid 1 h prior to the exercise bout.
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PMID:Naturally occurring muscle pain during exercise: assessment and experimental evidence. 926 56

About 10 percent of all patients in general practice suffer from a depression. In about one half of these cases depressive syndromes remain undetected by the physician. Common leading symptoms in these undiagnosed patients are: pain, rapid exhaustion, irritability and sexual problems. Depressive episodes in women are twice as frequent as in men. Furthermore, chronic diseases, chronic pain symptoms, addiction problems as well as recent, psychologically burdening events increase the risk for a depression. If anamnesis or clinical investigation are suggestive for a depression, the patient should be explored systematically with respect to his symptoms. Main symptoms of a depression are depressed mood, loss of enthusiasm and joyfulness as well as depressed motivation and increased fatigability. Further common symptoms are reduced self-confidence, unfounded self-accusations, suicidal thoughts, reduced ability to concentrate, hyperagitation or psychomotor restriction, sleeping disorders as well as loss of appetite. Since depression can be positively influenced by antidepressive drugs or suitable psychotherapeutic methods, early diagnosis by the physician is of decisive importance.
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PMID:[Diagnosis of depression in general practice]. 938 Oct 18

A double-blind, placebo-controlled study using male subjects (n = 60), was conducted to investigate the efficacy of three different frequencies of combined phototherapy/low-intensity laser therapy (CLILT) in alleviating the signs and symptoms of delayed-onset muscle soreness (DOMS). The study was approved by the University's ethical committee. After screening for relevant pathologies, recent analgesic or steroid drug usage, current pain, diabetes, or current involvement in regular weight-training activities, subjects were randomly allocated to one of five experimental groups: Control, Placebo, or 2.5-Hz, 5-Hz, or 20-Hz CLILT groups (660-950 nm; 31.7 J/cm2; pulsed at the given frequencies for a duration of 12 min; n = 12 all groups). Once baseline measurements were obtained, DOMS was induced in the nondominant arm, which was exercised in a standardized fashion until exhaustion, using repeated eccentric contractions of the elbow flexors. The procedure was repeated twice more to ensure exhaustion was achieved, after which subjects were treated according to group allocation. In the CLILT/placebo groups, the treatment head was applied directly to the affected arm at the level of the musculotendinous junction. Subjects returned on two consecutive days for further treatment and assessment. The range of variables used to assess DOMS included range of movement (universal goniometer), mechanical pain threshold/tenderness (algometer) and pain (visual analogue scale and McGill Pain Questionnaire). Measurements were taken before and after treatment on each day, except for the McGill Pain questionnaire, which was completed at the end of the study. Analysis of results using repeated measures and one-factor analysis of variance with relevant post hoc tests showed significant changes in ranges of movement accompanied by increases in subjective pain and tenderness for all groups over time (p = 0.0001); however, such analysis failed to show any significant differences between groups on any of the days. These results thus provide no convincing evidence for any putative hypoalgesic effect of CLILT upon DOMS at the parameters used here.
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PMID:Delayed-onset muscle soreness: lack of effect of combined phototherapy/low-intensity laser therapy at low pulse repetition rates. 946 28

The impact of stressful life events on the development and onset of chronicity of low-back pain is not yet fully understood. Sixty-four consecutive patients with chronic low-back pain treated at the orthopedic out-patient unit of the Innsbruck University Hospital were investigated with regard to stressful life events. Patients were classified into two groups: one group consisting of patients whose pain had an organic etiology (n= 16), and another group consisting of those with pain of uncertain origin (idiopathic group, n=48). A method combining a semistructured interview with a self-assessment of the severity of stress caused by life events was employed for assessing the impact of such events on chronic low-back pain. In comparison to the patient group having organic causes of pain, the idiopathic group showed significantly more patients having at least one highly stressful event preceding the last substantial aggravation of pain (p=0.028). The latter group experienced significantly more exhaustion (p=0.016) and significantly more difficulties in active coping (p=0.011) when confronted with stressful life events. Stressful life events that arouse feelings of helplessness may contribute to the development of chronic idiopathic low-back pain. Our results emphasize the importance of investigating the subjective meaning and appraisal of stressful life events, taking into consideration both individual predisposition and psychosocial resources available to the patient. Finally, it is also important that the attending physician be aware of any life event that is particularly stressful for the patient so that psychosocial help be made available at the appropriate time.
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PMID:The impact of stressful life events on exacerbation of chronic low-back pain. 962 76

Physiological alterations following unaccustomed eccentric exercise in an isokinetic dynamometer of the right m. quadriceps until exhaustion were studied, in order to create a model in which the physiological responses to physiotherapy could be measured. In experiment I (exp. I), seven selected parameters were measured bilaterally in 7 healthy subjects at day 0 as a control value. Then after a standardized bout of eccentric exercise the same parameters were measured daily for the following 7 d (test values). The measured parameters were: the ratio of phosphocreatine to inorganic phosphate (PCr/Pi), the ratio of inorganic phosphate to adenosintriphosphate (Pi/ATP), the ratio of phosphocreatine to adenosintriphosphate (PCr/ATP) (all three ratios measured with 31P-nuclear magnetic resonance spectroscopy), dynamic muscle strength, plasma creatine kinase (CK), degree of pain and "muscle" blood flow rate (133Xenon washout technique). This was repeated in experiment II (exp. II) 6-12 months later in order to study reproducibility. In experiment III (exp. III), the normal fluctuations over 8 d of the seven parameters were measured, without intervention with eccentric exercise in 6 other subjects. All subjects experienced pain, reaching a maximum 48 h after eccentric exercise in both exp. I and II. A systematic effect over time for CK (increasing 278% resp. 308%), muscle strength (decreasing more than 10%), PCr/Pi (decreasing 31% resp. 43%) and Pi/ATP (increasing 55% resp. 99%) was found in both exp. I and II (P < 0.05), but not in exp. III. No significant difference was observed between exp. I and II for CK, blood-flow rate, concentric muscle strength, PCr/Pi, Pi/ATP and PCr/ATP. It is concluded that pathophysiological alterations in m. quadriceps following eccentric exercise can be induced and can be reproduced after an interval of 6 months. Thus, this model can be used to study the effects of physiotherapy.
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PMID:Isokinetic eccentric exercise as a model to induce and reproduce pathophysiological alterations related to delayed onset muscle soreness. 976 42

The aim of this study was to measure if passive stretching would influence delayed onset muscle soreness (DOMS), dynamic muscle strength, plasma creatine kinase concentration (CK) and the ratio of phosphocreatine to inorganic phosphate (PCr/P(i)) following eccentric exercise. Seven healthy untrained women, 28-46 years old, performed eccentric exercise with the right m. quadriceps in an isokinetic dynamometer (Biodex, angle velocity: 60 degrees.s-1) until exhaustion, in two different experiments, with an interval of 13-23 months. In both experiments the PCr/P(i) ratio, dynamic muscle strength, CK and muscle pain were measured before the eccentric exercise (day 0) and the following 7 d. In the second experiment daily passive stretching (3 times of 30 s duration, with a pause of 30 s in between) of m. quadriceps was included in the protocol. The stretching was performed before and immediately after the eccentric exercise at day 0, and before measurements of the dependent variables daily for the following 7 d. The eccentric exercise alone led to significant decreases in PCr/P(i) ratio (P < 0.001) and muscle strength (P < 0.001), and an increase in CK concentration (P < 0.01). All subjects reported pain in the right m. quadriceps with a peak 48 h after exercise. There was no difference in the reported variables between experiments one and two. It is concluded that passive stretching did not have any significant influence on increased plasma-CK, muscle pain, muscle strength and the PCr/P(i) ratio, indicating that passive stretching after eccentric exercise cannot prevent secondary pathological alterations.
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PMID:The effect of passive stretching on delayed onset muscle soreness, and other detrimental effects following eccentric exercise. 976 43

Intravenous injection of stearoyl vanillylamide (C18-VA), a nonpungent capsaicin (CAP) analog, enhances adrenaline secretion significantly and as effectively as CAP in rats. Because swimming capacity was enhanced by CAP in mice due to CAP-induced adrenal catecholamine secretion, we investigated the effects of oral administration of C18-VA on swimming capacity using an adjustable-current water pool. Male Std ddY 6-wk-old mice were fed a commercial diet for this study and one group was orally administered C18-VA via a stomach tube. Treated mice were able to swim longer before exhaustion than the control mice (62.9 +/- 5.6 vs. 49.6 +/- 7. 0 min, P < 0.05). The swimming capacity of two groups administered C18-VA (0.02 and 0.033 mmol/kg) was significantly greater than that of those administered vehicle alone, (P < 0.05). Substance P concentration in cerebrospinal fluid, which is involved in pain transmission and is the first direct measure of pungency, was not affected by C18-VA administration. In an experiment examining the effects of C18-VA on serum adrenaline concentration, adrenaline was significantly greater in C18-VA treated mice than in controls at 2-h post-dose (C18-VA group, 26.09 +/- 2.82; control group 13.29 +/- 0. 96 microg/L, P < 0.01). In a separate study free fatty acids in serum were elevated in treated mice at 2-h post-dose (P < 0.01). While serum glucose concentration was not affected. These results suggest that C18-VA increased swimming capacity of mice via adrenaline release, independent of pungency. In addition, the present study suggests the usefulness of its application to humans.
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PMID:Swimming capacity of mice is increased by oral administration of a nonpungent capsaicin analog, stearoyl vanillylamide. 980 52

In developed countries, postpartum care begins in the hospitals where most women give birth. In the UK, midwives continue postpartum care with home visits up to the 10th day, which can be extended to the 28th day if necessary. Then care is transferred to the health visitor who performs child health surveillance to age 5 years. Family physicians usually perform the 6-week postpartum maternal check-up. This routine, which was more appropriate in days when serious postpartum maternal infection was prevalent, seeks to promote and monitor maternal and infant health but its ability to meet these goals is questionable (this includes the value of a 6-week vaginal exam). Common and persistent maternal problems such as backache, perineal pain, urinary or bowel incontinence, sexual problems, hemorrhoids, depression, or exhaustion are not addressed by this routine. Research in Australia suggests that the timing as well as the content of maternal care should be reexamined. In this case/control study, no differences were found in health outcomes at 3- and 6-month follow-up among women who received their postpartum exam at 1 week from those who were examined at 6 weeks. It may be beneficial to base postpartum care on women's individual needs rather than on routine, but this must be investigated in order to devise proper guidelines and distinguish the roles of various health professionals. Reorganization of the delivery of postpartum care to improve its impact on women's health is a priority in the UK, and several research trials are in progress.
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PMID:What does postnatal care do for women's health? 1023 54

Fatigue is a subjective state of overwhelming, sustained exhaustion and decreased capacity for physical and mental work that is not relieved by rest. Cancer-related fatigue has many causes. Included in the causes are the illness itself, the side effects of virtually every treatment, depression, and other biopsychosocial factors. As a result, fatigue is the most common symptom reported by cancer patients in most descriptive studies. In addition to arising from multiple etiologies, fatigue is also multidimensional in its manifestation and impact. Its effect on the quality of life of the patient is comparable to that of pain. Experienced by most patients as an extremely frustrating state of chronic energy depletion, it leads to loss of productivity which can reduce self-esteem. As a subtle and chronic symptom, it also places people at risk for being questioned about the veracity of their complaints, particularly during the post-treatment, disease-free survival period. Patients themselves are reluctant to complain of fatigue, perhaps because they believe little can be done about it, or they wish to avoid drawing attention away from treating their cancer.
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PMID:Progress toward guidelines for the management of fatigue. 1002 20

Living with daily pain during a long period of time is a considerable strain which affects many aspects of life. The aim of this study was to explore the experiences and coping strategies of patients with chronic low back pain. A strategic sample of 22 patients with chronic low back pain were interviewed according to a semistructured qualitative method: 14 women and eight men, with a mean age of 46 and a mean duration of illness of 15 years. 18 had been treated with low back surgery. All patients had pain every day. 19 were never without pain. They reported disturbed sleep, irritable mood and depression; 15 had thought of suicide. They felt constantly worn out. The pain influenced their everyday life and their total situation. The lives of patients with intermittent daily pain were less affected. The patients were asked what advice they would give to others in a similar situation. Their main point was not to give up, to focus less on the pain and the limitations and more on everything that could bring dedication and joy to everyday life.
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PMID:[The pain takes hold of life. A qualitative study of how patients with chronic back pain experience and cope with their life situation]. 1038 6


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