فصلنامه بیهوشی و درد
سال دهم شماره 3 (پاییز 1398)

Chronic pain, is one of the psychosomatic disease that a lot of people meet throughout their life. The aim of this study was to determine the mediation role of alexithymia between ego defense styles and the intensity of pain that percipience by the patients with chronic pain.

The method of the study was the correlation, and the statistical universe was the 20-60 age patients with chronic pain who had referred to the Mahan clinic and the physical medicine and rehabilitation clinic of Arman in Tehran from spring to autumn of 1396. 520 patients who had musculoskeletal pain at least for 3 months, were chosen purposefully and answered the Toronto Alexithymia Scale (TAS-20), defense styles questionnaire(DSQ), and Numeric Rating Scale (NRS).

The intensity of pain had the positive relation with alexithymia, neurotic defense style, and immature defense style (p< 0.001). Alexithymia had negative relation with mature defense style (p< 0.001), and a positive relation with immature defense style (p< 0.001). Alexithymia (t=4.31, β= 0.19), and immature defense style (t=6.06, β= 0.26) could clarify the variance of the pain intensity. Alexithymia could also clarify the mature defense style (t= 8.75, β= -0.35), and the immature defense style (t= 6.17, β= 0.27).

Based on the findings, the relation between immature defense style and the intensity of pain, was not a simple linear relationship, but alexithymia could affect this relation. Also, the alexithymia could be in a total mediator role for the mature defense style and the intensity of pain

  Although suctioning is an important nursing intervention in neonates under mechanical ventilation, it can lead to complications such as pain, respiratory distress, hypoxemia, bronchospasm and hospital infection. The purpose of this study was to determine the relationship between pain score and its effective indices in neonatal endotracheal open suction under ventilator in the neonatal intensive care unit of Hamadan hospitals.

This descriptive correlational study has been performed in 120 preterm infants under mechanical ventilation in Neonatal intensive care unit of Hamadan hospitals. First,, the respiratory rate and oxygen saturation of the neonatal arterial blood were recorded 5 minutes before the patient suction by the researcher in three shifts based on the findings of the direct monitoring of the infant. During and 5 minutes after suction, the respiratory rate and oxygen saturation index was re-recorded. Data were analyzed using descriptive and regression tests.

According to the results of the adapted model, linear regression between the number of respiration and arterial oxygen saturation during the suction with the pain score was not statistically significant, but there was a significant correlation between the Apgar score of the birth time and the pain score (P =0/000).

  Endotracheal open suction in premature infants could greatly affect the number of respiration and oxygen saturation in arterial blood gas and increase the pain score in these infants.

Psychologists have looked for measuring credibility and effectiveness of psychological interventions in chronic pain field, in recent years. In this regard, meta-analysis can defines the effect rate of psychological interventions by integrating the obtained results from different studies.

This study wants to study the effective rate of psychological interventions on reducing pain severity, follows meta-analysis model. For this purpose 20 Studies with appropriate methodology accepted were selected and meta-analysis using. The research tool was meta-analysis check list. It seems that a meta-analysis study with accurate rate of psychological interaction on pain severity would be helpful. On the other hand, meta-analysis can prepare a clear result about this intervention.

According to the findings of this study, the magnitude of the effect is equal to 1.25, which is high according to the Cohen effect size interpretation table. The most significant effect (1.81) is related to Sheikhi, et.al (2016) and the least amount of effect (0.54) in this research is related to the research of Amirani, et.al (2014).

The results of the meta-analysis showed that psychological treatments have a high effect on reduction of chronic pain. In sum, evidence suggests psychological treatment of chronic pain is promising.

  The aim of this study was to investigate the effects of rehabilitation period with elastic training on frequency spectrum of foot forces in females with low back pain during walking.

The sample of this study included 20 girls with low back pain.The experimental group did elastic gait training for 6 weeks. Peak plantar forces during both pre and post-test were recorded by a foot scan system (sample rate: 300 Hz).

Results of this study demonstrated that the frequency variable with the power 99.5 % in the Toe (P=0.022), Second to 5th Fingers (p=0.002), First metatarsal (p<0.001), Second metatarsal (p=0.014), Third metatarsal (p<0.001), Mid foot (p=0.021),  Lateral heel (p=0.019), and also the number of essential harmonics in the Toe (p=0.006), Second to 5th  fingers (p<0.001), First metatarsal (p<0.001),  Second metatarsal (p=0.019), Third metatarsal (p=0.005), Fourth metatarsal (p=0.024), fifth metatarsal (p=0.047), and Inside The Foot (p=0.040) areas demonstrated greater values during post-test than that in the pre-test. Also, other findings of the present study did not show any significant difference during the post-test compared to the pre-test during elastic training.

In general, the results of the present study showed that the elastic gait training causes an increase in the frequency with the power 99.5 % and the number of essential harmonics in different areas of the foot.

The aim of the present study was determination and fitting of emotional regulation strategies model on the basis of attachment dimensions in patients with rheumatic arthritis.

This research is descriptive and correlation. The study statistical population included all the patients with rheumatic arthritis referred to Imam Khomeini hospital and clinics related to health of Tehran who overall, 300 patients were selected through available sampling based on specialist diagnosis.  The instrumentals of this study were attachment dimension scale, cope scale, social self-efficacy scale, dysfunctional reactions questionnaire and distress disclosure index who participants completed.  Data were analyzed using AMOS software and structural equation modeling.

The results showed the direct and positive effect of attachment anxiety on non-adaptive strategies of over-activation, the direct and negative effect of attachment anxiety on inactive adaptation strategies and the direct and negative effect of attachment anxiety on adaptive strategies. Also, the direct and positive effect of attachment avoidance on inactive adaptation strategies, the direct and negative effect of attachment avoidance on non-adaptive strategies of over-activation and the direct and negative effect of attachment avoidance on adaptive strategies was shown. Other results showed the indirect and negative effect of attachment anxiety through social self-efficacy on nonadaptive strategies of over-activation, the indirect and positive effect of attachment anxiety through social self-efficacy on adaptive strategies, the indirect and negative effect of attachment anxiety through cognitive capacity of unwanted thoughts suppression on inactive adaptation strategies, the indirect and negative effect of attachment avoidance through self- disclosure on inactive adaptation strategies, the indirect and positive effect of attachment avoidance through self- disclosure on non-adaptive strategies of over-activation and the indirect and negative effect of attachment avoidance through cognitive capacity of unwanted thoughts suppression on non-adaptive strategies of over-activation.

According to the findings, it is an important requirement to pay attention to use some therapies on the basis of effective variables on emotion regulation strategies.

The aim of this study was to investigate the effectiveness of massage after impulse exercises on pain and proprioception sense of ankle in female beginner taekwondo players. 

Eighteen 20-30 years old beginner taekwondo players in Meshkinshahr were selected by voluntary sampling and were divided randomly into experimental (massage) and control groups; each group contains 9 people. Both groups performed 3 repetitions of 20 seconds kick exercises with 20 seconds rest between repetitions and then the experimental group received 30 minutes massage. The level of pain and proprioception sense of ankle was measured respectively with McGill pain questionnaire and reconstruction error method for 20 and 25 degree of plantar flexion at rest, immediately after exercise, immediately after massage, 2 and 48 hours after exercise. One way Anova with repeated measure and independent t-test were used for within subjects effects and between subjects effects respectively.

The level of pain was significantly higher at all measuring time compared to rest time in both groups (p<0.05) however after applying massage, it was significantly lower in massage group compared to control group at all times (p<0.05). Intra -group changes for reconstruction error of 20 degree in plantar flexion was not significant in none of experimental and control groups (P=0.103, P=0.833, respectively), however intra-group changes for reconstruction error of 25 degree in plantar flexion was significant in massage group (P = 0.001), but not in control group (p=0.18). Intra group differences for reconstruction error of 20 and 25 degree in plantar flexion was significant only 2 hours after exercise and it was lower in massage group (p=0.026 and p=0.003 respectively).

The results of the present study indicate that massage decreases pain and improves proprioception sense 2 hours after applying.

The Survey of plantar pressure variables provides better understanding of the potential injury to the plantar area nowadays. The aim of this study was the Comparison of plantar pressure variables during walking in male and female.

The present study included 15 males and 15 female. A foot scan set (sampling rate: 300Hz) was used for measuring plantar pressure variables during walking in male and female. Independent sample t-test was used for statistical analysis.

Results demonstrated that the Medio-lateral (p=0/001) and anterior-posterior (p=0/001) displacement of the center of pressure during walking in male is greater than  female. Also fifth metatarsal peak plantar pressure during walking in male is greater than female (p= 0/004). In addition peak force first (p=0/043), third (p=0/049), fourth (p= 0/012), fifth (p= 0/011) and heel medial (p= 0/049) metatarsals during walking in male greater than that female.

According to the findings of this study, the increase in Center of pressure fluctuations and pressure and forces during walking in men and the relationship between pressure and force pattern with injury, indicates more susceptibility to injury during walking in men.

Chronic pain is a pervasive, destructive and expensive problem with a biopsychosocial nature. Psychological interventions suggested to be an effective choice for chronic pain, and many trials  confirmed its effectiveness and several meta-analyses have estimated the amount of its effect. Considering the psychological and social aspects of pain, it’s possible that the Iranian population respond differently to these interventions. Our goal is to evaluate the effectiveness of psychological interventions on pain intensity in Iranian adults with chronic pain by meta-analyzing domestic trials conducted.

We searched IranDoc, Element, and PubMed for eligible studies. Risk of bias assessed for each trial according to Cochrane collaboration guidelines. Total effect size estimated and possible moderators investigated.

We found large effect sizes in both post treatment and follow up (d>0.80), but with significant heterogeneity among studies. Additional analyses suggested that researchers’ education levels have the most predictive effect with MA researchers reporting larger effect sizes than Ph.D. researchers.

We speculate that the true effect size of psychological interventions is probably lower than what we estimated here and partly these results are functions of methodological errors or of biases. Considering the high number of researches in Iran it seems that few modifications could result in big progress in our literature. Some suggestions made for improving research protocols as well as analyses and reports.

Lumbar muscle imbalances could affect the lower extremity. The aim of present study was to survey the relationship between pain and lumbar arch with ankle muscle activity and comparison these variables in males and females with chronic non-specific low back pain when implementing single leg squat.

47 Participants with chronic nonspecific low back pain (CNLBP) were selected in this study (male=22 and female=25). Visual Analogue Scale (VAS) was used to evaluate the LBP intensity. Lumbar lordosis curve was recorded using a flexible ruler. The Participants perform single leg squat position and dominant foot electromyography would be measured when the person was in the single leg squat position. The Pearson correlation coefficient was used to examine the relationship between variables and Independent t test was used to compare variables between males and females.

The results showed there were positive and significant correlation between pain of tibialis anterior muscle activity and peroneus longus muscle in males and females.

Regarding the results of this study, it would be concluded that low back pain is one of those factor that may increase ankle muscle activity. Treatment of low back pain could decrease the risk of injury caused by changes in postural control mechanisms and proprioception in lumbar and other joints in the kinetic chain, especially the ankle joint.