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 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patterns of walking and concomitant pain behavior were compared in a group of chronic low back patients (n = 18) and normal controls (n = 18). Subjects were asked to walk a 5 m course. A transducer placed in the subjects' shoes produced a force proportional signal that permitted measurement of walking parameters. Subjects were videotaped in order to record the occurrence of 5 specific pain behaviors: guarding, bracing, rubbing the painful area, grimacing, and sighing. Data analysis revealed significant differences in walking patterns of the patients and controls. Patients walked more slowly, took shorter steps and did not show the symmetrical gait patterns evident in normal controls. Patients also exhibited much higher levels of pain behavior. The gait of patients receiving disability payments or taking narcotics differed significantly from those who were not. Patients receiving disability payments had significantly longer stride lengths and swing time than patients not receiving disability/financial compensation payments. Patients taking narcotics showed longer single limb support time for the left leg than those who were not. By combining objective measures of gait and motor pain behaviors, clinicians and researchers may be able to more objectively evaluate factors that may affect patient behavior and measure the effects of interventions designed to modify behavior.
Pain 1985 Feb
PMID:An objective approach to quantifying pain behavior and gait patterns in low back pain patients. 315 94

The present article examines the relations among self-reported and physician-estimated chest pain variables to angiographically determined coronary stenosis (CAD) and neuroticism scores. Six of the 48 chest pain variables were significantly related to coronary stenosis, but only one variable, chest pain elicited by walking, was positively related to stenosis. Chest pain during sleep, sighing and dizziness accompanying chest pain, right lower chest pain radiation, and infrequent rest to cope with the chest pain were significantly negatively related to stenosis. Neuroticism scores (N) were not significantly related to CAD but were significantly correlated with 13 of the 48 chest pain variables. In addition to correlating positively with the chest pain variables that were negatively correlated with CAD, N scores were significantly related to higher pain severity ratings, being angry, annoyed, tense, afraid, worried, and upset before the chest pain, breathlessness during the pain episode, and pain sensations described as stabbing. The six chest pain variables significantly correlated with CAD yielded a multiple correlation of 0.58, accounting for 34% of the variance, whereas N scores accounted for only 5% of the variance; however, N contributed less than 1% unique variation to stenosis in combination with the six chest-pain variables. That N influences chest pain reports more than actual stenosis is further confirmed by the results of physicians' ratings of their patients' typical chest pain episodes. Recognition of patients' characteristic levels of distress or neuroticism may aid physicians in evaluating symptoms more accurately and in treating their chest pains more appropriately.
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PMID:The relation of chest pain symptoms to angiographic findings of coronary artery stenosis and neuroticism. 400 Dec 86

Several involuntary movements were observed in patients who were totally immobile except for vertical gaze due to bilateral pyramidal transverse lesion at the pontine or midbrain level. In those conscious locked-in patients extensor spasms and flexor spasms could be elicited by nonspecific stimulation. Mimic pain reactions, pathological crying, and primordial screaming ("cat crying') were also noted. Other motor patterns were whining, moaning, groaning, sighing, and yawning. The pathophysiological implications of these observations are discussed.
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PMID:Involuntary motor phenomena in the locked-in syndrome. 615 12

Trained observers measured the occurrence of 5 behaviors (guarding, bracing, rubbing, grimacing, and sighing) in a group of 80 low back pain patients undergoing physical examination. Bracing was frequently displayed, rubbing, guarding, and grimacing were moderately frequent and sighing was infrequent. Pain behaviors were much more likely to occur when patients were moving than when they were in a static position. The rate of guarding, bracing, and total pain behavior was predicted by physical examination findings and/or number of prior operations. Patients having longer pain histories were also more likely to show guarded movement. Topics for future research in this area are identified, and the utility of behavioral observation for clinicians is discussed.
Pain 1984 Sep
PMID:Direct observation of pain behavior in low back pain patients during physical examination. 623 69

In a 71-year-old woman suffering from recurrent fever, dry cough, pain during sighing, hoarseness and later severe inflammation of the cartilage of both auricles 'relapsing polychondritis' was diagnosed. This is a rare disease of cartilage and connective tissue. Most frequent symptoms are inflammation of the auricles and nasal septum, joint disorders and inflammation of eye structures, larynx and trachea. The aetiology may be autoimmunity. The clinical diagnosis can be confirmed by a cartilage biopsy. The disease is recurrent and causes substantial morbidity and mortality. Therapy consists of NSAIDs, steroids, and sometimes immunosuppressive agents.
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PMID:[Chronic recurrent polychondritis]. 793 47

Pain evaluation typically relies upon the use of self-report instruments. The validity of these tools is questionable in many older adults, however, particularly those with cognitive impairment. Rating of pain behavior (e.g. grimacing, sighing) by an objective observer represents an alternative pain assessment strategy which has been validated in subjects of heterogeneous ages. The purpose of this study was to examine, in a group of community-dwelling elderly with low back pain and lumbosacral osteoarthritis, the concurrent validity of observational pain behavior rating techniques as compared with self-report instruments and the degree to which pain and pain behavior relate to disability. Thirty-nine cognitively intact subjects, age > 65 years, without depression, other sources of pain, or other known spinal pathology underwent the following measures: (1) pain self-report using the verbal 0-10 scale, vertical verbal descriptor scale, Arthritis Impact Measurement Scales and McGill Pain Questionnaire; (2) pain behavior was sampled during two protocols, one, identical to that used by Keefe and Block (Behav. Ther., 13 (1982) 363-375), that required subjects to sit, stand, walk, and recline for 1-2 minute periods (which we have labelled the traditional protocol), and a second, more demanding protocol that was designed to simulate activities of daily living that place a premium on axial movement (the 'ADL' protocol); (3) disability was assessed using the Roland questionnaire, a 6 month global disability question and the Jette Functional Status Index; and (4) radiographic evaluation of the lumbosacral spine; osteoarthritis was quantitated using a previously validated scoring system. Interrelationships among pain, pain behavior and disability measures were tested using canonical correlations. Self-reported pain was associated with pain behavior frequency; the association was stronger when the ADL protocol was used, as compared with the traditional protocol. The association between pain and disability was modestly strong with both self-report instruments and pain behavior observation when the ADL protocol was used, but not when the traditional protocol was used. Our findings suggest that pain behavior observation is a valid assessment tool in the elderly. In addition, it seems that observation of elders during performance of activities of daily living may be a more sensitive and valid way of assessing pain behavior than observing pain behavior during sitting, walking, standing, or reclining.
Pain 1996 Oct
PMID:Pain measurement in elders with chronic low back pain: traditional and alternative approaches. 895 42

The diagnosis of a functional respiratory disorder is sometimes difficult and time-consuming, because the symptoms often resemble those of organic diseases. The most common entities are hyperventilation syndrome, psychogenic cough, sighing dyspnea, and vocal cord dysfunction. Typical signs are heavy breathing or dyspnea, cough or sneezing, various breathing sounds, tightness of the throat or chest, pain, and fear. Criteria for differentiation include the lack of nocturnal symptoms, the sudden occurrence, no typical trigger factors, the variable duration, a quick regression, and that symptoms do not respond to adequate pharmacotherapy and finally normal results of diagnostic work-up. Therapeutic options comprise psychological intervention (by reassurance, relaxation techniques, and behaviour therapy) and physiotherapy (e.g. breathing therapy, voice training). Intensive efforts should be made to diagnose functional symptoms at an early stage because this will prevent stigmatization and fixation of symptoms and disease, and also prevent children from undergoing unnecessary and potentially harmful therapies.
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PMID:Functional symptoms confused with allergic disorders in children and adolescents. 1243 Nov 89

This study used Ward's minimum variance hierarchical cluster analysis to identify homogeneous subgroups of rheumatoid arthritis patients suffering from chronic pain who exhibited similar pain behavior patterns during a videotaped behavior sample. Ninety-two rheumatoid arthritis patients were divided into two samples. Six motor pain behaviors were examined: guarding, bracing, active rubbing, rigidity, grimacing, and sighing. The cluster analysis procedure identified four similar subgroups in Samples 1 and 2. The first subgroup exhibited low levels of all pain behaviors. The second subgroup exhibited a high level of guarding and low levels of other pain behaviors. The third subgroup exhibited high levels of guarding and rigidity and low levels of other pain behaviors. The fourth subgroup exhibited high levels of guarding and active rubbing and low levels of other pain behaviors. Sample 1 contained a fifth subgroup that exhibited a high level of active rubbing and low levels of other pain measures. The results of this study suggest that there are homogeneous subgroups within rheumatoid arthritis patient populations who differ in the motor pain behaviors they exhibit.
J Pain Symptom Manage 2008 Jul
PMID:Pain behavior in rheumatoid arthritis patients: identification of pain behavior subgroups. 1835 82

This case study report utilized the grief counseling principles proposed by Worden to elucidate the grief responses of a woman whose husband died of AIDS. It also described the nursing care provided by staff nurses to assist the woman to get through the period of grief by achieving "the four goals of grief". Fifteen in-depth interviews were performed and field notes were collected. As the study reports, the grief responses of the wife were: affective expressions, including grief, anger, guilt, self blame, anxiety, loneliness, fatigue, helplessness, and shock; physical expressions, including insomnia, palpitations, and chest tightness; cognitive expressions, including disbelief, confusion, a sense that the loved one is still alive; and behavioral expressions, including insomnia, poor appetite, social withdrawal, avoidance of mentioning the deceased, searching, sighing and sobbing. After her husband had been deceased for six months, the wife completed the phases of 1) acceptance of loss, 2) experiencing grief and pain, 3) adapting to a new environment without the deceased, and 4) redirecting the positive feelings towards the deceased in building a brighter future. This case report will help clinical nurses to understand how to assist families with HIV/AIDS through proper grief counseling, and thus how to guide them through grief.
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PMID:[Utilizing grief counseling principles to assist a woman whose husband died of AIDS]. 1854 92

Whereas sighing appears to function as a physiological resetter, the psychological function of sighing is largely unknown. Sighing has been suggested to occur both during stress and negative emotions, such as panic and pain, and during positive emotions, such as relaxation and relief. In three experiments, sigh rate was investigated during short imposed states of stress and relief. Stress was induced by exposure to a loud noise stressor or by anticipation of it. Relief was induced by the end of the stressor or the anticipation that no stressor would follow. Breathing parameters were recorded continuously by means of the LifeShirt System. Results consistently showed that more sighing occurred during conditions of relief compared to conditions of stress.
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PMID:Why do you sigh? Sigh rate during induced stress and relief. 1949 9


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