• Journal of muscle and joint health
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• v.16 no.1
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• pp.36-45
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• 2009

Purpose: This study was to determine the effects of laughter therapy on stress response and pain of military patients with low back pain. Method: The subjects in the experimental group received 3-sessions of laughter therapy on 3 consecutive days. The primary outcome measures were state anxiety, depression, blood pressure, pulse rate and pain. Result: After 3 sessions of laughter therapy, the scores of state anxiety(p=.046), depression(p=.028) and pulse rate(p=.003) were significantly lower and diastolic blood pressure(p=.038) was significantly higher in the experimental group than those in the control group. The level of pain(p=.711) was not different significantly between two groups. Conclusion: Laughter therapy could be an effective strategic intervention for military patients with low back pain to reduce the level of anxiety and depression. Further studies are needed to determine long-term effects of laughter therapy and its effects on cardiovascular system and pain.

• The Korean Journal of Pain
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• v.34 no.1
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• pp.47-57
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• 2021

Background: Lumbar disc herniation (LDH) is a common cause of radicular pain, but the mechanism is not clear. In this study, we investigated the engagement of toll-like receptor 4 (TLR4) and the nuclear factor-kappa B (NF-κB) in radicular pain and its possible mechanisms. Methods: An LDH model was induced by autologous nucleus pulposus (NP) implantation, which was obtained from coccygeal vertebra, then relocated in the lumbar 4/5 spinal nerve roots of rats. Mechanical and thermal pain behaviors were assessed by using von Frey filaments and hotplate test respectively. The protein level of TLR4 and phosphorylated-p65 (p-p65) was evaluated by western blotting analysis and immunofluorescence staining. Spinal microglia activation was evaluated by immunofluorescence staining of specific relevant markers. The expression of proand anti-inflammatory cytokines in the spinal dorsal horn was measured by enzyme linked immunosorbent assay. Results: Spinal expression of TLR4 and p-NF-κB (p-p65) was significantly increased after NP implantation, lasting up to 14 days. TLR4 was mainly expressed in spinal microglia, but not astrocytes or neurons. TLR4 antagonist TAK242 decreased spinal expression of p-p65. TAK242 or NF-κB inhibitor pyrrolidinedithiocarbamic acid alleviated mechanical and thermal pain behaviors, inhibited spinal microglia activation, moderated spinal inflammatory response manifested by decreasing interleukin (IL)-1β, IL-6, tumor necrosis factor-α expression and increasing IL-10 expression in the spinal dorsal horn. Conclusions: The study revealed that TLR4/NF-κB pathway participated in radicular pain by encouraging spinal microglia activation and inflammatory response.

• Journal of Acupuncture Research
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• v.38 no.2
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• pp.140-145
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• 2021

Background: Aconitum sinomontanum Nakai (ASN) has been reported to have analgesic effects. In this study an animal model of pharmacopuncture using ASN (100-500 mg/kg) was examined. Methods: Sprague-Dawley (SD) rats (n = 40) were randomly assigned to ASN-Low (1 mg/mL, 1.8 mL, ASN-L), ASN-Intermediate (5 mg/mL, 1.8 mL, ASN-M), ASN-High (10 mg/mL, 1.8 mL, ASN-H), negative control (0.2 mL normal saline), and positive control (0.2 mL 0.5% lidocaine) groups. All experiments were administered to the rats' left hind leg. The analgesic response was assessed by monitoring the physical (hot plate, and von Frey test) and chemical (formalin) responses to pain. Results: All ASN pharmacopuncture groups demonstrated significant differences in pain response to the hot plate test, von Frey test, and formalin test, compared to the control group (p < 0.05). The response of the ASN-M group and ASN-H groups to the hot plate, the formalin, and the von Frey tests were significantly different, compared to the lidocaine group (p < 0.05). Conclusion: ASN pharmacopuncture had a significant analgesic effect on SD rats in response to physical and chemical models of pain.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.2
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• pp.207-213
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• 2011

Purpose: The purpose of this study was to determine the preventive effect of joint mobilization on biphasic pain response induced formalin test. Methods: Sprague-dawley rats(n=30) were ramdomly divided into the control group without intervention, sham control group with application of hand contact without mobilization, joint mobilization group with application of hand contact with mobilization. Joint mobilization of knee procedure involved an grade III extension mobilization basically with anterior-posterior gliding of the tibia on the femur. Formalin injection caused biphasic pain response which is lated for 60 minute. The first phase result from primary afferent sensory fiber, wheareas the second phase has been proposed to central sensitization in the central nervous system. Behavioral analysis was performed by digital camera after 5% formalin subcutaneous injection into the dorsal foot. Results: Pain response of joint mobilization group show significant lower than control gorup and sham control group. Conclusion: This result suggest that pre-application of joint mobilization may be effective intervention to prevent the formalin induced pain.

• Physical Therapy Korea
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• v.15 no.3
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• pp.26-34
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• 2008

The purposes of this study were to assess and modify the original classification categories of the modified Oswestry Low Back Pain Disability Questionnaire (ODQ) and to determine the unidimensionality of the modified ODQ applying Rasch Analysis. The data were obtained from 108 work-related low back pain patients by physical therapists. Construct validity of the scale using the Rasch model required the structure of the rating scale to be modified from 6 response levels to 4 response levels. Eight items from the modified ODQ fit the Rasch model. The items, "pain intensity" and "social life" showed misfit statistics. In general, the order of item difficulty of the remaining 8 items showed a logical item difficulty hierarchy with the "changing degree of pain" item being the most difficult and the "walk" item being the easiest. The results showed that further study is needed to expand the construct of ODQ including additional higher-level items related to work activities. This study may be useful for establishing a standard method to assess the functionality of low back pain patients.

• The Korean Journal of Physiology and Pharmacology
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• v.11 no.6
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• pp.253-257
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• 2007

Among the arthritis symptoms, chronic pain is the most serious, and it can profoundly affect the quality of human life. Unfortunately, the mechanism of development in arthritis and arthritic pain has not yet been precisely elucidated. Accumulating evidence indicates that nitric oxide (NO) plays a pivotal role in nociceptive processing in the spinal cord. However, the modulation mechanism of NO in the peripheral site of arthritis and arthritic pain has not been clarified. Therefore, I determined in the present study which nitric oxide synthase (NOS) was involved in the induction of arthritis and arthritic pain. Monoarthritis was induced by intra-articular injection of carrageenan (2%, $50{\mu}l$) into rats, and resulted in the reduction of weight load on the injected leg, increase of knee joint diameter and inflammatory response. Pre-treatment of rats with L-N6-(1-iminoethyl)-lysine (L-NIL, $500{\mu}g$, in $50{\mu}l$), an inhibitor of inducible NOS (iNOS), partially prevented the induction of pain-related behavior and partially reduced inflammatory response in the synovial membrane in the knee joint. These results suggest that iNOS in the knee joint may play an important role in the induction of pain-related behavior and inflammation, and that NO produced by iNOS may be associated with nociceptive signaling in the peripheral site.

• Journal of Korean Academy of Nursing
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• v.13 no.2
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• pp.1-21
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• 1983

The purposes of this study were to(a) develop theoretical modifications of the extended gate control theory of pain using Fishbein's model and（b) test the efficacy of these modifications. Attitude, social subjective norm, personal subjective norm, habit and state anxiety were operationalized to represent internal stimuli for the cognitive-evaluative and motivational-affective dimensions of the theory. Pain expression was operationalized as sensory and affective responses to pain, and pain endurance. Sixty-two female nurses from 20 to 50 years of age participated. A semantic differential scale measured attitude and motivations to comply; a Likerty-type scale measured personal and social norms and habit. Spielberger's STAI measured state anxiety, Pain was produced using a modified submaximum effort tourniquet technique. Pair expression was measured using ratio scales of sensory intensity and unpleasantness developed by Gracely and his associates. Pain endurance was measured by subtracting time of pain threshold from pain tolerance. The first hypothesis examining whether pain endurance would be more significantly related to the affective response than to the sensory response was net rejected. Four remaining hypotheses, testing the ability of the five variables to predict the sensory and affective responses were not rejected. However, the habit of pain expression and the attitude toward pain expression contributed to the prediction of both sensory and affective responses to pain. The interaction between the cognitive-evaluative and the sensory-discriminative dimensions and the interaction between the cognitive-evaluative and motivational-affective dimensions were partially supported by the data from these two variables. The interaction between the motivational-affective and the sensory-discriminative dimensions was also supported by the relationship of sensory to affective responses. The variables which did not significantly predict pain expression appeared to have potential for prediction. Revision and testing of the tools for better reliability, validity, and clinical usuability are needed. The study contributed to theory building. The identification of variables which pre-dict pain behavior must occur before effective nursing interventions can be developed.

• The Korean Journal of Pain
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• v.21 no.3
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• pp.173-178
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• 2008

Background: The intrathecal (IT) $GABA_A$ receptor antagonist, bicuculline (BIC), results in tactile allodynia (TA) through disinhibition in the spinal cord. Such disinhibition is considered to be an important mechanism for neuropathic pain. Agmatine, an endogenous polyamine, has a neuro-protective effect in the central nervous system. We investigated the analgesic effects and mechanisms of agmatine action on BIC-induced TA. Methods: Male Sprague-Dawley rats, weighting 250-300 g, were subjected to implantations of PE-10 into the lumbar subarachnoid space for IT drug injection. Five days after surgery, either $10{\mu}l$ of normal saline (NS) or agmatine ($30{\mu}g$ or $10{\mu}g$) in $10{\mu}l$ NS were injected 10 min prior to BIC ($10{\mu}g$) or NMDA ($5{\mu}g$). We assessed the degree of TA (graded 0: no response, 1: mild response, 2: moderate response, 3: strong response) every 5 min for 30 min. Areas under curves and degree of TA were expressed as mean ${\pm}$ SEM. Results were analyzed using one-way ANOVA followed by a Tukey test for multiple comparisons. P < 0.05 was considered significant. Results: IT BIC-induced strong TA reached its peak and plateaued between 10 to 15 min. IT NS-NMDA induced mild transient TA for up to 15 min. Preemptive IT AG attenuated IT BIC-induced TA dose dependently and preemptive IT AG10 completely abolished the IT NMDA-induced TA. Conclusions: Preemptive IT AG attenuated the IT BIC-induced TA through inhibitory actions on postsynaptic NMDA receptor activation. AG might be a viable therapeutic option in the treatment of neuropathic pain.

• Physical Therapy Korea
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• v.20 no.4
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• pp.22-31
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• 2013

The aim of the present study was to compare measurement precisions of the Oswestry Back Pain Disability Questionnaire (ODQ) and a computer adaptive testing (CAT) method. The ODQ has been regarded as one of the most reliable condition-specific measure for back pain for decades. Cross-sectional study was carried out with two independent convenient samples from two out-patient rehabilitation clinics for back pain ($n_1=42$) and non-back pain group ($n_2=42$). Participants were asked to fill out the ODQ and CAT of International Classification of Functioning, Disability and Health-Activity Measure (ICF-AM). A series of Rasch analyses were performed to calculate person ability measures. The CAT measures had greater relative precision in discriminating the groups than did the ODQ measure in comparisons of the relative precision. The CAT measure appears to be more effective than did the ODQ measure in terms of measurement precision. By administering test items calibrated in a way, CAT measures using item response theory may promise a means with measurement precision as well as efficiency.

• The Korean Journal of Pain
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• v.21 no.1
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• pp.27-32
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• 2008

Background: Experimental evidence indicates that ginseng modulate the nociceptive transmission. Authors examined the role of adrenergic and cholinergic receptors on the antinociceptive action of Korean red ginseng against the formalin-induced pain at the spinal level. Methods: Catheters were inserted into the intrathecal space of male Sprague-DawIey rats. Fifty ${\mu}l$ of 5% formalin solution was injected to the hindpaw for induction of pain and formalin-induced pain (flinching response) was observed. The role of spinal adrenergic and cholinergic receptors on the effect of Korean red ginseng was assessed by antagonists (Prazosin, yohimbine, atropine and mecamylamine). Results: Intrathecal Korean red ginseng produced a dose-dependent suppression of the flinching response in the rat formalin test. All of prazosin, yohimbine, atropine and mecamylamine antagonized the antinociception of Korean red ginseng. Conclusions: Spinal Korean red ginseng is effective against acute pain and facilitated pain state evoked by formalin injection. All of alpha 1, alpha 2, muscarinic and nicotinic receptors may play an important role in the antinociceptive action of Korean red ginseng at the spinal level.