International Journal of Musculoskeletal Pain prevention
Volume:7 Issue: 3, Summer 2022

Stroke is the third leading cause of death after cardiovascular disease and cancer. Stroke causes disability in various forms in sufferers. It has been suggested that various pathological mechanisms are involved in causing this injury. Articles show that regular exercise is a way to treat stroke patients. One of the most common exercise therapy models is treadmill exercise.However, there is still controversy about when to start   treadmill workouts, the intensity of the workout, the type of treadmill workout, and how it has positive effects. This article offers an overview of treadmill exercise and its’ effects on post-ischemic stroke rehabilitation. In this study, the effect of exercise time, exercise intensity, exercise style, and the positive effects of this type of exercise on rehabilitation of patients after ischemic stroke were briefly examined.

The aim of the present study was to assess the correlation between the stability metrics related to the center of pressure excursion measurements and the WOMAC questionnaire scores.

Method and Materials:

Fourteen patients with moderate knee osteoarthritis and fourteen healthy age-matched individuals were participated to stand with open and closed eyes, and on firm and rocking support on a force platform. The WOMAC questionnaire was obtained from the patient group. One-way ANOVA was utilized to determine the effects of knee osteoarthritis, vision, and support on postural stability metrics. Spearman’s correlation was also used to indicate the correlation between the stability metrics and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) sub scores.

The anterior-posterior variability of the center of pressure was significantly greater in patients (2.7 mm, p=.003). Elimination of the visual feedback and the rocking support affected the sway area and the AP (p<.001), and the ML variability (p<.024). The pain subscore of the WOMAC questionnaire was negatively and strongly correlated to the AP total mean velocity (open-eyes: r=-.466, closed-eyes: r=-.779). The pain was positively and strongly correlated to the AP variability (open-eyes: r=.796, closed-eyes: r=.744). Patients with knee osteoarthritis showed more postural instabilities.

The instability in the anterior-posterior was more eminent than in the lateral direction. The pain was the most role-playing factor in the destabilization of the posture among the patients with knee osteoarthritis but may be disregarded in physically-difficult conditions of standing.

The purpose of this study was to examine the inter- and intra-rater reliability of corrective exercise specialist raters assessing movement and postural impairments of transient Low Back Pain (LBP) developers during Prolonged Standing Protocol (PSP) which called Pain Developers (PDs).

Method and Materials:

Twenty-four subjects developing transient LBP during prolonged standing (9males, 15females) between 17-85 years of age, were examined by 2 corrective exercise specialists. In order to control the effect of repeated testing on intra-rater reliability, both raters assessed the subjects at the same time. To assess inter-rater reliability, one of the raters assessed the subjects one week later. Examination findings were recorded independently, without discussion. Inter- and intra-rater reliability were indexed by the percent of agreement and kappa coefficient.

Overall, the kappa values for intra- and inter-rater reliability of the items ranged from 0.12 - 0.86 and 62.5 - 1.00, respectively.

The results of the present study indicate these clinical test items as a reliable tool for corrective exercise specialists. They can reliably utilize these test items for identification of movement and alignment impairments that need to be modified in order to prevent the onset of LBP in in healthy-back PDs.

The purpose of this study was to investigate the lived experience of pain metaphors in cancer patients.

Method and Materials:

The method of this study was qualitative with hermeneutic phenomenological approach. The study population included all cancer patients in Tehran in 2021-2022 who experienced pain from cancer and its treatment. According to the theoretical saturation rule, 20 cancer patients in stages 2 and 3 of the cancer were selected by purposive method and interviewed in-depth and semi-structured manner. The interview lasted from 40 to 90 minutes. The time and place of the interviews were determined by the participants. Questions with a general question as to what you analogized your experience with cancer and its treatments. After each interview and recording it, the content of the interview was written in fully. The extracted data were analyzed using the method of hermeneutic analysis of Diekelmann et al. (1989).

According to interpretive hermeneutic analysis; lived experiences of pain in cancer patients are 4 main themes including; the metaphor of lived war, the metaphor of lived scheduled pain cage, the metaphor of living in dark future with pain and the metaphor of lived with overload pain.  

To conclude, metaphors have important role in pain expressions. Researchers suggest cognitive therapies to change metaphors of pain.

Work Related Musculoskeletal Disorders (WRMSDs) are becoming serious health problems with prevalence in school teachers higher from rural areas. It affects the functional capacity and productivity at work leading to more absenteeism, sick leaves and early retirement . Rural teachers have less resources to overcome these problems and reduce WRMSDs.  Hence the aims of this study were 1) to assess WRMSDs rate 2) to assess knowledge and attitude regarding WRMSD 3) to study the impact of health education program among this target group.

Method and Materials:

In this experimental study, 62 teachers participated.  Pre validated questionnaire regarding knowledge and attitude about WRMSDs was administered. The rate of WRMSDs was assessed and then the session on health education related to same was given to them through  online manner once/week and asked them to follow instruction for the entire week. Knowledge, attitude and pain were assessed pre and post health education training  and follow up was taken after 4 weeks of training sessions completion.

The rate of WRMSDs among rural school teachers was 64.52%  (95% CI = %51.34– %76.26). Low Back Pain (LBP) and all body pain was found in the majority of the teachers followed by knee and neck pain. After 4 weeks, pain intensity was significantly reduced from 64.5% (CI - 51% to 76%) to 51.6% after 4 weeks of intervention. It was further reduced to 33.9 % in the follow-up period. Score for knowledge and attitude was also improved significantly after 4 weeks but attitude changed after one month follow-up.

This study showed that health education and ergonomic interventional program could reduce pain, improve knowledge and change attitude of school teachers in rural areas. Whereas long duration programs with frequent feedbacks are needed to change attitude in long term.

The purpose of this study was to investigate the prediction of pain catastrophizing based on pain anxiety symptoms and cognitive flexibility in cancer patients

Method and Materials:

In this cross-sectional study all cancer patients in Tehran in 2021-22 were the target population. Among this population  250 cancer patients were selected via candidate and at reach sampling method. Then the selected patients completed the Paknejadet al.`s Pain Anxiety Symptoms (2014), Sullivan et al. `s Pain Catastrophizing Pain (1995),and Dennis et al.`s (2010) Cognitive Flexibility Questionnaire. For data analysis, Pearson correlation and step by step regression analysis were used. Data were analyzed by SPSS-24.

There was a relationship between cognitive flexibility and pain anxiety symptoms with pain catastrophizing (P0.01>). The relationship between pain catastrophizing with pain anxiety symptoms was positive. However, there was a negative relationship between pain catastrophizing and cognitive flexibility. Moreover, catastrophizing pain could be predicted based on anxiety symptoms and cognitive flexibility.

To conclude, it seems in cancer patients some cognitive factors have important roles in pain catastrophizing as pain anxiety symptoms and cognitive flexibility.