فصلنامه بیهوشی و درد
سال یازدهم شماره 1 (بهار 1399)

Hemodialysis prolongs the life of patients with chronic renal failure, but hemodialysis complications always cause these patients to suffer. Chronic pain is one of the most common problems for patients undergoing hemodialysis and is a debilitating condition that is associated with some psychological variables. Therefore, the aim of this study was to determine the effectiveness of mindfulness-based cognitive therapy on pain severity in patients undergoing hemodialysis.

The present study was a semi-experimental design with pretest-posttest and follow-up with control group. The study population consisted of hemodialysis patients in Zanjan in 1397. 20 patients were selected by purposeful method and were randomly divided into two groups (n = 10). Patients in the experimental group received mindfulness-based cognitive therapy in 8 sessions within two months and the control group did not receive any treatment. The 11-point Numbered Rating Scale (NRS-11) was used to measure the research variables. Data were analyzed by multivariate analysis of variance using SPSS 24 software.

Results of repeated measure ANOVA showed that after intervention, the severity of pain severity score was significantly decreased compared to the control group (P <0.01) and the stage was not significant in any of the subscales (P <0.01).

In general, the results of the present study showed that Mindfulness-based cognitive therapy is considered as an effective therapeutic approach in reducing the severity of pain in hemodialysis patients. Therefore, it is suggested that therapists and specialists use this type of intervention to improve the health of patients.

With respect to the prevalence of ankle injuries due to the decrease in range of motion of dorsiflexion, and to the lack of proper function in foot and/or lack of balance among basketball players, utilizing exercise plans is of great importance. Therefore, the present study aims to investigate the effect of eight weeks of thera-band exercises on the range of motion on pain, dynamic balance, and function in amateur teenage basketball players suffering from ankle dorsiflexion limitation.

Thirty teenage basketball players aged between 12 and 17 suffering from ankle dorsiflexion limitation participated in this quasi-experimental study, and were assigned to experimental group (n=15) and control group (n=15). Evaluation of ankle dorsiflexion range of motion, dynamic balance, function, and pain were conducted using lunge test with weight bearing, Y test, v-cut test, and VAS test respectively. The participants in experimental group performed thera-band exercises for eight weeks, three thirty-minute sessions each week.

The results of the statistical tests showed that thera-band exercises have positive effects on pain, dorsiflexion range of motion, dynamic balance, and function of teenage basketball players suffering from dorsiflexion limitation, and it significantly increases range of motion, balance, function, and pain reduction in ankle (p≤0.05).

Adding thera-band exercises to the common sets of exercises of teenage basketball players may result in more balance and range of motion of the ankle, and improvement in function, which would prevent ankle injuries.

Chronic pain has many emotional and psychological pressures and is a complex psychological experience. The purpose of the study was to investigate the relationship of pain-related beliefs and pain anxiety with depression in patients with rheumatoid arthritis.

It was a descriptive-correlational study thus, among patients with rheumatoid arthritis in Esfahan who has been visited in rheumatology clinics in spring 2018, 240 patients were selected according to inclusion and exclusion criterias. Participants in the study completed depression inventory, pain beliefs and perceptions inventory and pain-related anxiety questionnaire. Also, the data were analyzed using Pearson correlation coefficient and stepwise regression analysis.

Correlation analysis showed that there was a significant relationship between pain belief and pain anxiety with depression. Also, based on regression analysis, beliefs associated with pain and anxiety would predict depression in patients with rheumatoid arthritis.

Rheumatoid arthritis is a progressive, chronic disease that also affects the psychological functions of patients. Therefore, special attention is paid to the psychological well-being of patients in the treatment of this disease.

Low back pain is one of the important causes of early retirement in athletes. The purpose of this research was to study the effect of combined core stability and sensory-motor exercises on pain, performance, and movement fear in retired male athletes with non-specific chronic low back pain.

This study was a semi-experimental, and its design was two-groups with pretestposttest. Subjects were 30 retired male athletes with non-specific chronic low back pain that by double-blind method, randomly divided into two experimental and control groups. The visual analog scale of pain, Oswestry questionnaire, and Tampa scale were used for evaluating pain, disability and fear of movement, respectively. The experimental group performed eight-week core stability, and sensory-motor exercises and the control group did not experience any other treatment intervention. The Mann-Whitney U test was used for inter-group difference and Wilcoxon test for the intra-group difference at a significant level of p≤0.05.

The findings of the present study showed a significant reduction in the pain and fear of movement and an increase in the performance of retired male athletes with non-specific chronic low back pain after eight weeks of combined core stability and sensory-motor exercises.

It seems that increases in body core strength and stability with the extension of neuromuscular control resulting from improved function of proprioception following eight weeks of combined core stability and sensory-motor exercises may reduce pain and fear of movement and increases the performance in retired male athletes with non-specific chronic low back pain.

Pain management is the core of care in traumatic injuries, which unfortunately is not properly managed in the pre-hospital stages. The use of pharmacological pain management by emergency medical technicians in the Iran is also subject to widespread restrictions and prohibited, so focusing on nonpharmacological pain management techniques can help improve pain management and quality of care for the injured. The aim of this study was to develop and localize a clinical guideline for the management of nonpharmacological pain in a pre-hospital emergency.

This study was carried out through a multi-stage evolutionary study. . In the first phase, systematic review of articles, books and clinical guides of pre-hospital acute pain management was performed and then  38 clinical guides and 150 related articles were found in the study databases.The research team identified 4 more comprehensive, up-to-date and most relevant clinical guides. Then, the experts, the 3 clinical guides that were most relevant to the topic were selected by examining their quality with the AGREE tools. Next, the drafted localized clinical guideline was developed based on the highest rated clinical guideline recommendations, Then the Delphi method and the panel of experts were used to finalize the localized clinical guideline recommendations.

A total of 27 recommendations from Delphi participants’ consensus recommendations were taken into consideration and each were localized as a clinical guideline for non-medication pain management patients.

The results of the present study showed that in Iran no clinical practice guideline or written guideline for non-pharmacologic management of pain in pre-hospital settings has been published so far, so that emergency centers can apply it. Usage of these guidelines would improve and supply part of the need for emergency medical technicians in pain management to improve pain management status.

The purpose of this study was to determine the role of marital intimacy and spiritual intelligence in predicting pain after elective cesarean section surgery. This research was a descriptive-correlation type. The statistical population of the study consisted of all women who underwent elective cesarean section in Qom governmental  hospitals during the summer of 1397 who were selected by non-random sampling 200 people and evaluated by questionnaire on matters of matrimonial intimacy (Bagarozi 2001), spiritual intelligence (2008) and McGill’s Pain Questionnaire (1997). Data were analyzed using descriptive statistics and inferential statistics including Pearson correlation and simultaneous regression. The results showed that there was a negative and significant relationship between marital intimacy, spiritual intelligence and postpartum pain, and marital intimacy and spiritual intelligence wer 0.17 share in the prediction of pain after cesarean section.

Nowadays, multiple sclerosis disorder has been increased. The aim of this study was to investigate the effect of six weeks of massage in water on walking speed, postural control, pain intensity, fatigue and quality of life in women with multiple sclerosis in Khomeini city.

In this study, a trial was performed in which 30 patients with multiple sclerosis (EDSS 2-5) were randomly selected and randomly assigned to two blind groups of 15 patients. The massage group was in water (mean age 39.60 ± 8.33, 160 ± 6.04 cm and body weight 26.59 ± 3.74 cm2 and control group 36 ± 6.56 years, Height 158.86±2.92 cm, and body mass 26.95 ± 2.33 kg/m2). The experimental group performed a massage therapy program in water  for six weeks, three sessions per week and the duration of 20 minutes for lower extremities (thighs, knees, legs, wrists and feet), the control group performed the natural activities of daily living, before and after the training, speed of walking with rocket test, static and dynamic equilibrium Arranged by a modified stamina and Y test, pain intensity by visual acuity scale, Fatigue was assessed by MFIS questionnaire and quality of life by SF scale of 36 The data were refined using descriptive statistics. Measurement of the nature of the data was performed by Shapiro-Wilk test and data analysis was used to compare the independent t-test. Also, SPSS version 25 was used. The significance level was considered as (p<0.05).

The results of the study showed that six weeks of massage in water had a significant effect on walking speed, postural control (static and dynamic balance), pain intensity, fatigue and quality of life in women with multiple sclerosis (p<0.05).

Based on this study, it can be concluded that water massage could be effective for people with multiple sclerosis. Therefore, massage therapists are to be advised to use these rehab techniques to improve walking speed, postural control (static and dynamic balance), pain intensity, fatigue, and quality of life in people with multiple sclerosis.

Patellofemoral pain syndrome (PFPS) is a common knee disorder frequently occurred in young females. Abnormalities of lower limb movement patterns during weight-bearing activities can directly affect referred pain. The purpose of this study was to determine the effect of knee valgus control feedback exercise on pain, eccentric hip muscle torque, performance and knee angle in females with PFPS.

32 women with PFPS with mean age 22.6±6.18 years selected and were divided into experimental (n=16) and control (n=16) groups. The isokinetic dynamometer, visual analogue scale (VAS), 4 lower extremity performance tests includes (single leg hop test, triple hop test, crossover hop test and single leg 6m timed hop test) and single leg squat were used respectively in order to measure eccentric hip muscle torque, pain, performance and knee angle. The Shapiro-Wilk, repeated measure, paired and sample t tests were used for statistical analysis (significance level α≤0.05).

Based on the findings of this study, the significant changes were reported in experimental group in hip abductor to adductor ratio (P=0.001) hip external to internal rotation ratio (P=0. 001), pain (P=0. 001), and all performance tests (P=0. 001) and knee valgus angles were (P=0. 001), that indicate knee valgus control feedback exercises improve the hip torque ratio, pain, dynamic knee valgus angle and performance.

The results revealed that, dynamic knee valgus control feedback exercises have a beneficial effect on PFPS participants due to alteration in biomechanical variables such as eccentric hip muscle torque, performance variables, knee dynamic valgus angle and pain.