4 resultados para PAIN PERCEPTION

em Worcester Research and Publications - Worcester Research and Publications - UK


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Evidence suggests stress slows the healing of wounds but pain may also play a part. Regular assessment could improve patients' quality of life and recovery time.

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PURPOSE: To examine risk-taking and risk-perception associations with perceived exertion, pacing and performance in athletes. METHODS: Two experiments were conducted in which risk-perception was assessed using the domain-specific risk-taking (DOSPERT) scale in 20 novice cyclists (Experiment 1) and 32 experienced ultra-marathon runners (Experiment 2). In Experiment 1, participants predicted their pace and then performed a 5 km maximum effort cycling time-trial on a calibrated KingCycle mounted bicycle. Split-times and perceived exertion were recorded every kilometer. In experiment 2, each participant predicted their split times before running a 100 km ultra-marathon. Split-times and perceived exertion were recorded at 7 check-points. In both experiments, higher and lower risk-perception groups were created using median split of DOSPERT scores. RESULTS: In experiment 1, pace during the first km was faster among lower compared to higher risk-perceivers, t(18)=2.0 P=0.03, and faster among higher compared lower risk-takers, t(18)=2.2 P=0.02. Actual pace was slower than predicted pace during the first km in both the higher risk perceivers, t(9)=-4.2 P=0.001, and lower risk-perceivers, t(9)=-1.8 P=0.049. In experiment 2, pace during the first 36 km was faster among lower compared to higher risk-perceivers, t(16)=2.0 P=0.03. Irrespective of risk-perception group, actual pace was slower than predicted pace during the first 18 km, t(16)=8.9 P<0.001, and from 18 to 36 km, t(16)=4.0 P<0.001. In both experiments there was no difference in performance between higher and lower risk-perception groups. CONCLUSIONS: Initial pace is associated with an individual's perception of risk, with low perceptions of risk being associated with a faster starting pace. Large differences between predicted and actual pace suggests the performance template lacks accuracy, perhaps indicating greater reliance on momentary pacing decisions rather than pre-planned strategy.

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Background: Providing an effective exercise prescription process for patients with non-specific chronic low back pain (NSCLBP) is a challenging task. Emerging research has indicated that partnership in care and shared decision making are important for people with NSCLBP and calls for further investigation into the approaches used to prescribe exercise. Objective: To explore how shared decision making and patient partnership are addressed by physiotherapists in the process of exercise prescription for patients with NSCLBP. Design: A qualitative study using a philosophical hermeneutic approach. Methods: Eight physiotherapists were each observed on three occasions undertaking their usual clinical activities (total n=24 observations). They conducted brief interviews after each observation and a later in depth semi-structured interview. Iterative hermeneutic strategies were used to interpret the texts and identify the characteristics and processes of exercise prescription for patients with NSCLBP. Findings: The findings revealed how physiotherapy practice often resulted in unequal possibilities for patient participation which were in turn linked to the physiotherapists? assumptions about the patients, clinical orientation, cognitive and decision making processes. Three linked themes emerged: (1) I want them to exercise, (2) Which exercise? - the tension between evidence and everyday practice and (3) Compliance-orientated more than concordance based. Conclusions: This research, by focusing on a patient-centred approach, makes an important contribution to the body of evidence relating to the management of NSCLBP. It challenges physiotherapists to critically appraise their approaches to the prescription of exercise therapy in order to improve outcomes for these patients.

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Thought speed and variability are purportedly common features of specific psychological states, such as mania and anxiety. The present study explored the independent and combinational influence of these variables upon condition-specific symptoms and affective state, as proposed by Pronin and Jacobs’ (Perspect Psychol Sci, 3:461–485, 2008) theory of mental motion. A general population sample was recruited online (N = 263). Participants completed a thought speed and variability manipulation task, inducing a combination of fast/slow and varied/repetitive thought. Change in mania and anxiety symptoms was assessed through direct self-reported symptom levels and indirect, processing bias assessment (threat interpretation). Results indicated that fast and varied thought independently increased self-reported mania symptoms. Affect was significantly less positive and more negative during slow thought. No change in anxiety symptoms or threat interpretation was found between manipulation conditions. No evidence for the proposed combinational influence of speed and variability was found. Implications and avenues for therapeutic intervention are discussed.